Vitamin E Helpful for Pediatric Liver Disease

Healthnotes Newswire (April 1, 2004)—Supplementing with vitamin E may improve liver function in obese children with fatty liver disease who cannot adhere to a weight loss diet, reports a study in the Journal of Pediatric Gastroenterology and Nutrition (2004;38:48–55).

Obesity is associated with the development of health conditions that affect the cardiovascular, respiratory, hepatobiliary (referring to the liver and gallbladder), metabolic, and musculoskeletal systems. Childhood obesity is becoming increasingly prevalent, and may result in fatty accumulation in the liver, followed by inflammation and death of liver cells. These changes can be detected by liver enzyme elevations on a blood test and by ultrasound of the liver, as well as by a liver biopsy. Fatty deposits in the liver are seen as bright areas (called bright liver) on ultrasound.

One quarter of obese children who have bright liver on ultrasound examination also have elevated levels of liver enzymes (an indication of liver inflammation). Obesity-related fatty accumulation in the liver is a form of nonalcoholic fatty liver disease. Nonalcoholic fatty liver disease may range in severity from mild, with little or no permanent damage to the liver, to severe liver damage that may lead to liver failure. The primary goal in the treatment of obesity-related fatty liver disease is weight reduction, as the early changes seen in the disease may be reversed with weight loss.

The mechanisms for the progression of fatty liver disease are not known, but some propose that free-radical damage to liver cells could be a cause. The antioxidant vitamin E may protect against this. The current study investigated the effect of vitamin E and a weight loss diet on liver enzyme levels and bright liver in obese children with fatty liver disease. Twenty-eight participants were randomly assigned to receive either (1) 400 IU of vitamin E per day for two months, followed by 100 IU of vitamin E per day for three months, and a low-calorie diet, or (2) placebo and a low-calorie diet. Both groups were given a moderate exercise program to follow for the study period.

Those participants who received vitamin E but were unable to lose weight experienced a statistically significant decrease in liver enzyme levels. Vitamin E treatment did not appear to benefit to those people who were able to lose weight. Participants in the placebo group who were able to lose weight also had significant reductions in liver enzyme levels, compared with placebo group participants who were not. The disappearance of bright liver on ultrasound was only seen in those participants who lost weight, regardless of whether or not they received vitamin E. Adherence to the low-calorie diet was poor in both groups, so liver enzyme reductions among those receiving vitamin E who did not lose weight was a significant finding.

Other studies have found a similar benefit of antioxidant vitamins in the treatment of nonalcoholic fatty liver disease. This is the first controlled pediatric study to confirm vitamin E’s role in reducing liver inflammation in obesity-related fatty liver disease.