The use of single nutrients for health management are often challenged due to lack of randomised controlled trials or small cohort size, or just general reluctance to regard these small molecules as anything other than a constituent of the mythical balanced diet.
There can be no denying that the increase in abdominal mass or obesity is not an imaginary event, even a cursory glance in your office or in the local town will identify significant differences in body mass. One of the consequences of this is the deposition of fats in the liver –an event referred to in simpler times as ‘fatty liver’ and now glorified with the name ‘non alcoholic steatohepatitis’ less comprehendible and definitely scarier.
15% of these people will develop cirrhosis and many others will develop insulin resistance so early management and resolution is appealing.
The US National Institute of Diabetes and Kidney Disease decided to see if a natural agent – Vitamin E might help and compared it to Pioglitazone (It modulates the transcription of the insulin-sensitive genes involved in the control of glucose and lipid metabolism in the muscle, adipose tissue, and the liver. As a result, Pioglitazone reduces insulin resistance in the liver and peripheral tissues ) and placebo with confirmed diagnosis and 80 in each group were followed for 96 weeks on the therapy and 24 weeks post therapy. Because diabetes may have confused the trial diabetics were excluded and average age was 45.
Whilst the active groups both demonstrated beneficial effects, transaminases declined in both, but insulin resistance only improved in the medicated group – as one would expect, the medicated group gained 5Kg over the vitamin E group and this did not resolve after discontinuation, although other improvements for both groups did disappear once stopped.
So this study demonstrates that additional Vit E offers distinct benefit to patients diagnosed with fatty liver, and if combined with suitable lifestyle changes may make a significant change in liver function.
An earlier post also looked at the role of essential fatty acids in the management of this condition, and this also improved liver function indicating that the two nutrients are worth using synergistically.
 Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med. 2010;362:1675-1685. View Abstract