Delta-tocotrienol supplementation improves biochemical markers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease: A randomized, placebo-controlled trial.
Complement Ther Med. 2020 Aug ;52:102494. Epub 2020 Jun 23. PMID: 32951743
Muhammad Amjad Pervez
OBJECTIVE: The aim of this study was to examine the effects of delta-tocotrienol (δ-tocotrienol) supplementation on biochemical markers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease (NAFLD).
DESIGN: The study design was a two-group, randomized, double-blind, placebo-controlled trial. The patients with NAFLD were randomly assigned to receiveδ-tocotrienol 300 mg twice daily or placebo for 24 weeks.
ENDPOINTS: The primary endpoints were change from baseline in fatty liver index (FLI) and homeostasis model of insulin resistance (HOMA-IR) after 24 weeks. Secondary endpoints included change from baseline in high sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), alanine transaminase (ALT), aspartate transaminase (AST) and grading of hepatic steatosis on ultrasound. Between-group differences were tested for significance using ANCOVA. Mean differences (MD) with 95 % CIs are reported.
RESULTS: A total of 71 patients (tocotrienol=35, placebo=36) were randomized and included in the intention to treat analysis. Compared with placebo,δ-tocotrienol significantly reduced (MD [95 % CI]) FLI (-8.52 [-10.7, -6.3]; p<0.001); HOMA-IR (-0.37 [-0.53, -0.21]; p<0.001), hs-CRP (-0.61[-0.81, -0.42]; p<0.001), MDA (-0.91 [-1.20, -0.63]; p<0.001), ALT (-8.86 [-11.5, -6.2]; p<0.001) and AST (-6.6 [-10.0, -3.08]; p<0.001). Hepatic steatosis was also reduced by a significantly greater extent with tocotrienol than with placebo (p =0.047). No adverse events were reported.
CONCLUSION: δ-tocotrienol effectively improved biochemical markers of hepatocellular injury and steatosis in patients with NAFLD. δ-tocotrienol supplementation might be considered as a therapeutic option in the management of patients with NAFLD.
TRIAL REGISTRATION: Sri Lankan Clinical Trials Registry (SLCTR/2015/023, 2015-10-03).