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Efficacy of docosahexaenoic acid-choline-vitamin E in paediatric NASH: a randomized controlled clinical trial

Evelyn Zöhrer1, Anna Alisi2, Jörg Jahnel1

  • 1a Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz 8036, Austria.

Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme
|May 17, 2017
PubMed

Insights

A nutritional mix of docosahexaenoic acid (DHA), choline (CHO), and vitamin E (VE) significantly improved liver fat and reduced liver enzymes in children with nonalcoholic steatohepatitis (NASH). This dietary intervention also improved glucose levels, offering a promising therapeutic avenue for pediatric NASH.

Area of Science:

  • Hepatology
  • Pediatric Gastroenterology
  • Nutritional Science

Background:

  • Nonalcoholic steatohepatitis (NASH) is a common and progressive liver disease in children.
  • Pediatric NASH requires effective, non-invasive treatment strategies.
  • Nutritional interventions are being explored for managing pediatric liver diseases.

Purpose of the Study:

  • To evaluate the efficacy of a nutritional supplement (DHA-CHO-VE) combined with lifestyle modification in children with biopsy-proven NASH.
  • To assess the impact of the intervention on liver steatosis, liver enzymes, and metabolic parameters.
  • To investigate changes in serum bile acids and FGF19 as biomarkers of NASH severity.

Main Methods:

  • A randomized controlled trial involving 40 children and adolescents with biopsy-proven NASH.
  • Participants received either lifestyle modification plus placebo or lifestyle modification plus a DHA-CHO-VE supplement.
  • Primary outcome: improvement in liver hyperechogenicity; Secondary outcomes: ALT, metabolic parameters, serum bile acids, and FGF19 levels.

Main Results:

  • Significant reduction in severe steatosis in the DHA-CHO-VE group (50% to 5%, p=0.001).
  • Improved alanine aminotransferase (ALT) and fasting glucose levels exclusively in the treatment group.
  • Significantly increased plasma fibroblast growth factor 19 (FGF19) levels, while serum bile acids remained unchanged.

Conclusions:

  • A combination of DHA, vitamin E, and choline shows potential in improving liver steatosis and metabolic dysfunction in pediatric NASH.
  • The nutritional supplement effectively reduced liver fat and improved key biochemical markers.
  • Further research is warranted to confirm the long-term benefits and specific mechanisms of DHA and VE in pediatric NASH treatment.

Keywords:
FGF19acide docosahexaénoïqueacides biliairesbile acidscholinedocosahexaenoic acidnonalcoholic fatty liver diseasesteatosisstéatose hépatique non alcooliquevitamin Evitamine E

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