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 .
Plasma transforming growth factor-beta1 level and efficacy of alpha-tocopherol in patients with non-alcoholic steatohepatitis: a pilot study.
BACKGROUND Non-alcoholic steatohepatitis is a distinct entity , characterized by fatty change , lobular inflammation and fibrosis of the liver . Some cases of non-alcoholic steatohepatitis progress to cirrhosis , but it is not easy to distinguish this disease from non-alcoholic fatty liver by non-invasive examinations . No proven therapy for non-alcoholic steatohepatitis exists . Transforming growth factor-beta1 is implicated in the development of liver fibrosis , and is inhibited by alpha-tocopherol ( vitamin E ) in the liver . Therefore , in this study , the significance of the measurement of the level of plasma transforming growth factor-beta1 and the effect of alpha-tocopherol on the clinical course of non-alcoholic steatohepatitis were investigated . METHODS Twelve patients with non-alcoholic steatohepatitis and 10 patients with non-alcoholic fatty liver , with a diagnosis confirmed by liver biopsy , were studied . None of the patients had a history of alcohol abuse , habitual medicine or malignant or inflammatory diseases . All patients were negative for hepatitis B , C and G virus . Patients were given dietary instruction for 6 months , and then alpha-tocopherol ( 300 mg/day ) was given for 1 year . Blood chemistries , measurement of plasma transforming growth factor-beta1 level and liver biopsies  were undertaken before and after the 1-year alpha-tocopherol treatment . RESULTS The serum alanine transaminase level decreased in non-alcoholic fatty liver patients , but not in non-alcoholic steatohepatitis patients , after 6 months of dietary therapy . Although the serum alanine transaminase level in non-alcoholic steatohepatitis patients was reduced during the 1-year alpha-tocopherol treatment , alpha-tocopherol had no effect on the serum alanine transaminase level in non-alcoholic fatty liver patients . The histological findings , such as steatosis , inflammation and fibrosis , of the non-alcoholic steatohepatitis patients were improved after alpha-tocopherol treatment . The plasma transforming growth factor-beta1 level in non-alcoholic steatohepatitis patients was significantly elevated compared with that in non-alcoholic fatty liver patients and healthy controls , and decreased , accompanied by an improvement in serum alanine transaminase level , with alpha-tocopherol treatment . CONCLUSIONS Our data suggest that the measurement of the level of plasma transforming growth factor-beta1 represents a possible method of distinguishing between non-alcoholic steatohepatitis and non-alcoholic fatty liver . Long-term alpha-tocopherol treatment may be safe and effective for non-alcoholic steatohepatitis . A r and omized , controlled , double-blind trial is needed to confirm the full potential of alpha-tocopherol in the management of non-alcoholic steatohepatitis
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 .