These studies demonstrated improvement in biochemical profiles , with a decline in or normalization of liver enzymes .
However , some concerns have been raised regarding the use of vitamin E in patients with NASH due to its adverse effects profile and lack of significant improvement in hepatic fibrosis .
There has been a growing interest in the role of vitamin E supplementation in the treatment and /or prevention of nonalcoholic fatty liver ( NAFLD ) .
Furthermore , histological assessment showed favorable outcomes in lobular inflammation and hepatic steatosis following treatment with vitamin E. Current guidelines regarding the use of vitamin E in the setting of NAFLD recommend that vitamin E-based treatment be restricted to biopsy-proven nondiabetic patients with NASH only .
Ursodeoxycholic acid with vitamin E in patients with nonalcoholic steatohepatitis: long-term results.
BACKGROUND The combination of ursodeoxycholic acid ( UDCA ) and vitamin E is a therapeutic option for nonalcoholic steatohepatitis ( NASH ) but r and omized controlled studies have produced inconsistent results . The objective of this study was to report the long-term tolerability and efficacy of this combination in our ten-year single center experience . METHODS The study group included 101 adult patients with persistent elevation of serum aminotransferases ( AST and ALT ) and /or γ glutamyl-transferase ( GGT ) , in whom a histological diagnosis of NASH was made from January 1998 to January 2009 , and who were treated with a combination of UDCA with vitamin E.  RESULTS Median body mass index ( 30 kg/m(2 ) ) remained unchanged during the study . UDCA and vitamin E were well tolerated ( 5 % withdrawal for side effects ) . Mean serum AST , ALT and GGT levels ( expressed as times of Upper Normal Limit ) diminished significantly ( 1.39 ± 0.74 to 0.78 ± 0.34 for AST , 1.72 ± 0.92 to 0.91 ± 0.69 for AST and 3.25 ± 2.85 to 1.30 ± 1.30 for GGT ) . AST , ALT and GGT reached normal range in 80 % , 70 % and 65 % of the patients , respectively . From the ten patients who had a second liver biopsy during follow-up , NAS score improved in seven , and worsened in one . CONCLUSIONS The combination of UDCA with vitamin E significantly improves liver function tests in long-term and is very well tolerated
These studies demonstrated improvement in biochemical profiles , with a decline in or normalization of liver enzymes .
However , some concerns have been raised regarding the use of vitamin E in patients with NASH due to its adverse effects profile and lack of significant improvement in hepatic fibrosis .
There has been a growing interest in the role of vitamin E supplementation in the treatment and /or prevention of nonalcoholic fatty liver ( NAFLD ) .
Furthermore , histological assessment showed favorable outcomes in lobular inflammation and hepatic steatosis following treatment with vitamin E. Current guidelines regarding the use of vitamin E in the setting of NAFLD recommend that vitamin E-based treatment be restricted to biopsy-proven nondiabetic patients with NASH only .