effect of 12 weeks regular physical activity and vitamin E in the treatment of non-alcoholic steatohepatitis: a pilot study

ABSTRACT

Despite the prevalence of Non-Alcoholic Fatty Liver Disease [NAFLD] and Non-Alcoholic Steatohepatitis [NASH], there was no treatment has been proven to be effective in these common diseases. Although many studies have shown that lifestyle modifications such as increasing physical activities and exercise could be effective in the treatment of these common diseases, the optimal strategy was still not determined. According to the beneficial effects of antioxidant agents in the treatment of NASH, vitamin E has been used for this purpose by some clinicians. We designed this study for assessing beneficial effects of regular physical activity on the biochemical and imaging responses in patients with NASH and comparing this with vitamin E as an accepted treatment for NASH. This study was Randomized and single-blind clinical trials were carried out in Gonbad-e Kavus through which a total of 30 consecutive patients with the ultra sonographic diagnosis of non-alcoholic steatohepatitis [NASH]were enrolled and randomized to one of the three groups Vitamin E 800 mg/day, regular physical activity, or both. In all treatment groups improvement in liver transaminases level, serum lipids and ultrasonographic grading of fatty liver occurred after three months of treatment. When these decrement was compared between the treatment groups, there was no statistically significant difference in the value of improvement between the three groups [ANOVA p>0.5]. I.e. all three interventions improved the biochemical and ultrasonographic finding of fatty liver in the same way. Both groups with regular exercise had significant mean weight loss in comparison with the vitamin E group [a mean decrease of 3.0 kg in exercise group, 5.8 kg in subjects on regular exercise plus vitamin E and 0.2 kg in vitamin E group, ANOVA p=0.04]. There were no significant differences between exercise and vitamin E alone or in combination regarding the reduction in the level of liver enzymes and sonographic evidences of fatty liver although both resulted in significant improvements in biochemical endpoints. This implies that physical activity could be considered as effective as vitamin E in the improvement of biochemical and ultrasonographic presentations of NASH and the addition of Vitamin E does not offer any benefits. According to the findings of this pilot study a full-powered study with a control group should be designed