Clinical Efficacy Evaluation Of Vitamin E Treatment For Nonalcoholic Fatty Hepatitis Without Diabetes Mellitus

Objective:To observe and discuss the clinical efficacy of vitamin E in the treatment of nonalcoholic steatohepatitis without diabetes;And explore the possible mechanism of vitamin E in the treatment of nonalcoholic steatohepatitis without diabetes.Methods:This study selected 60 patients who underwent liver biopsy from December 2016 to June 2017.The patients were randomized into a vitamin E treatment group of 30 patients and a placebo treatment group of 30 patients.Lifestyle intervention.The vitamin E treatment group was treated with vitamin E at a dose of vitamin E 3 times/day,0.1 gram each time,for 48 weeks.The placebo group was given a placebo(auxiliary and other matrix components)at the same dose of 3 times/day,0.1 g each time,for 48 weeks.Body weight,waist and hip circumference changes,biochemical changes(alanine aminotransferase,aspartate aminotransferase,?-valley,triglyceride,total cholesterol,low density lipoprotein,high density lipoprotein,HOMA-IR,etc.,cytokines(CK18-M30,CK18-M65))were observed and analyzed before and after treatment(12 weeks,24 weeks,36 weeks,48 weeks).Results:1.Comparison of BMI and waist-hip circumference between the two groups after treatment:Compared with the lifestyle intervention(placebo group),the body mass index and waist-to-hip ratio decreased in the vitamin E group(P<0.05).2.Comparison of liver function between the two groups after treatment:Compared with the placebo group,the vitamin E group was significant to the placebo group in ALT,AST,?-GT(P<0.05);there was no significant difference in TBIL and AKP.Sexual differences(P>0.05).The improvement of liver function after treatment in the treatment group was better than that of the control group.3.Comparison of glucose and lipids in the two groups after treatment:The efficacy of vitamin E group was significantly better than that of placebo group in TC,LDL and HOMA-IR(P<0.05).There was no significant difference between vitamin E group and placebo group in TG and HDL.(P>0.05).4.Comparison of liver controlled attenuation index(CAP)and liver stiffness(E)between the two groups after treatment:The vitamin E group had a significant improvement in the liver controlled attenuation index(CAP)and liver stiffness(E)compared with the placebo group(P<0.05).5.Comparison of CK18-M30 and CK18-M65 between the two groups after treatment:After treatment with vitamin E,the CK18-M30 and CK18-M65 indexes of the study group were significantly improved compared with the placebo group(P<0.05).6.No research-related adverse events occurred during the study period.Conclusions:1.The clinical efficacy of vitamin E group combined with lifestyle intervention in the treatment of patients with nonalcoholic fatty liver disease was significantly better than the placebo group(single lifestyle intervention).2.The role of vitamin E in the treatment of fatty liver disease may be related to anti-inflammatory(CK18-M30,CK18-M65),lipid-lowering(TC),and anti-insulin resistance.