Lifestyle intervention and antioxidant therapy in children with nonalcoholic fatty liver disease: A randomized, controlled trial

Valerio Nobili, Melania Manco, Rita Devito, Vincenzo Di Ciommo, Donatella Comparcola, Maria Rita Sartorelli, Fiorella Piemonte, Matilde Marcellini, Paul Angulo

Research output: Contribution to journalArticle

288 Citations (Scopus)

Abstract

No proven treatment exists for nonalcoholic fatty liver disease (NAFLD) in children and adolescents. We sought to determine the efficacy of lifestyle intervention with or without antioxidant therapy in pediatric NAFLD. A total of 53 patients (age 5.7-18.8 years, 37 boys) were included. Lifestyle intervention consisting of a diet tailored to the patient's calorie needs, and increased physical activity was prescribed in all. Patients were concomitantly randomized to alpha-tocopherol 600 IU/day plus ascorbic acid 500 mg/day (n = 25) or placebo (n = 28), and treated for 24 months. The study was an extension of a previous study aimed at evaluating the effect of 12-month lifestyle intervention and antioxidant therapy on serum levels of aminotransferases. The primary end point of the present study was change in liver histology on repeated biopsy at 24 months. Secondary end points were changes in body weight, liver enzymes, and insulin sensitivity indices on 2-hour oral glucose tolerance test. The amount of weight lost at 24 months was similar in the placebo and antioxidant groups (-4.75 [range, -16-4.0] versus -5.5 [range, -12.2-0.4] kg, respectively, P = 0.9). A significant improvement occurred in the grade of steatosis, lobular inflammation, and hepatocyte ballooning, and in the NAFLD activity score in both groups. Levels of aminotransferases, triglycerides, cholesterol, fasting glucose, and insulin, and insulin sensitivity indices improved significandy as well. The improvement in all these parameters was not significantly different between the two groups. Conclusion: Lifestyle intervention with diet and increased physical activity induces weight loss and is associated with a significant improvement in liver histology and laboratory abnormalities in pediatric NAFLD. Alpha-tocopherol plus ascorbic acid does not seem to increase the efficacy of lifestyle intervention alone.

Original languageEnglish
Pages (from-to)119-128
Number of pages10
JournalHepatology
Volume48
Issue number1
DOIs
Publication statusPublished - Jul 2008

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Life Style
Randomized Controlled Trials
Antioxidants
alpha-Tocopherol
Transaminases
Ascorbic Acid
Insulin Resistance
Liver
Histology
Placebos
Exercise
Pediatrics
Diet
Therapeutics
Body Weight Changes
Glucose Tolerance Test
Weight Loss
Hepatocytes
Fasting
Triglycerides

ASJC Scopus subject areas

  • Hepatology

Cite this

Lifestyle intervention and antioxidant therapy in children with nonalcoholic fatty liver disease : A randomized, controlled trial. / Nobili, Valerio; Manco, Melania; Devito, Rita; Di Ciommo, Vincenzo; Comparcola, Donatella; Sartorelli, Maria Rita; Piemonte, Fiorella; Marcellini, Matilde; Angulo, Paul.

In: Hepatology, Vol. 48, No. 1, 07.2008, p. 119-128.

Research output: Contribution to journalArticle

Nobili, Valerio ; Manco, Melania ; Devito, Rita ; Di Ciommo, Vincenzo ; Comparcola, Donatella ; Sartorelli, Maria Rita ; Piemonte, Fiorella ; Marcellini, Matilde ; Angulo, Paul. / Lifestyle intervention and antioxidant therapy in children with nonalcoholic fatty liver disease : A randomized, controlled trial. In: Hepatology. 2008 ; Vol. 48, No. 1. pp. 119-128.
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