Annatto Tocotrienol may improve markers of liver health in people with NAFLD

03-Aug-2020 - Last updated on 04-Aug-2020 at 15:16 GMT

Supplementation with delta tocotrienol may improve liver health markers in people with Non-Alcoholic Fatty Liver Disease (NAFLD), says a new study that claims to be the first to the efficacy of this vitamin E form in this population.

Six hundred milligrams per day of the delta-tocotrienol supplement for 24 weeks led to significant reductions in levels of liver enzymes, markers of oxidative stress, fatty liver index, and HOMA-IR scores (a measure of insulin resistance), according the study conducted at the Armed Forces Institute of Pathology in Pakistan.

Data published in Complementary Therapies in Medicine also indicated that both the placebo and tocotrienol groups experienced in anthropometric values, such as weight, BMI and waist circumference since both groups were assigned to a low-fat diet, but participants in the tocotrienol group experienced significantly greater reductions in all three measures, compared to placebo.

NAFLD is the most prevalent liver abnormality in Western countries and parallels the epidemic of metabolic syndrome, obesity and diabetes. Frequently disabling and occasionally leading to cirrhosis, fatty liver disease has currently costs the US health care system about $32 billion annually.

Vitamin E forms

Vitamin E is a family of eight separate but related molecules: four tocopherols (alpha, beta, gamma, delta) and four tocotrienols (alpha, beta, gamma, delta). Tocotrienols are derived from three major sources, including rice, palm and annatto.

The new study used annatto tocotrienols from DeltaGold, which is free from tocopherol, and was manufactured by US-based manufacturer American River Nutrition.

Commenting on the research, Dr Barrie Tan, President of American River Nutrition, said: “While an earlier 12-week study already suggested significant benefits of DeltaGold for NAFLD patients, we now have evidence of a compelling duration-response benefit of tocotrienol to liver health.

“Doctors currently recommend alpha-tocopherol supplementation for NAFLD patients in an effort to reduce oxidative stress, but we think that tocotrienol will be much more powerful and will go further to help. This is the subject of an ongoing 12-month clinical trial, which will compare the effects of alpha-tocopherol versus DeltaGold in NAFLD patients, and we look forward to sharing those results soon.”

Study details

For the new 24 week study, the researchers recruited 71 people with NAFLD and randomly assigned them to receive either placebo or DeltaGold tocotrienol (300mg twice daily).

The results showed that liver enzymes (serum aminotransferases (ALT, AST)) decreased by 18-21% after 24 weeks in the tocotrienol group, while significant decreases in triglycerides (13%), malondialdehyde (MDA, a marker of oxidative stress: 19% reduction), and hs-CRP (21%) were also reported.

Liver © Getty Images Lindama — © Lindama / Getty Images

The Fatty Liver Index (FLI), which includes measures of weight, BMI, waist circumference, GGT, and triglycerides, decreased by 15% after 24 weeks of DeltaGold supplementation.

Improvements in anthropometric measures were also significantly greater in the tocotrienol group, with weight reductions of 6.8 kg (14.9 lbs) after 24 weeks, compared to 2.1 kg (4.6 lbs) in the placebo group. In addition, BMI and waist circumference in the tocotrienol group decreased by 2.4 kg/m2 and 2.9 cm, respectively, compared to 0.7 kg/m2 and 1.15 cm in the placebo group.

Examining metabolic syndrome risk factors, other measurements at 24 weeks included HOMA-IR, adiponectin, and leptin. HOMA-IR, a calculation that marks for the presence and extent of insulin resistance, was reduced by 15% in the tocotrienol group.

Both adiponectin and leptin are hormones that are critically secreted by adipose tissue. Adiponectin regulates glucose levels and fatty acid breakdown, whereas leptin can be pro-angiogenic, pro-inflammatory, and chronically elevated in obesity. In the tocotrienol group, adiponectin levels increased by 44%, whereas leptin decreased by 18%. In comparison, adiponectin in the placebo group increased by only 3%, with leptin decreasing 3%. IL-6 and TNF-alpha, also thought to be major inflammatory mediators of both NAFLD and insulin resistance, were reduced by 24% and 21%, respectively, in the tocotrienol group.

“The present study demonstrated that delta-tocotrienol supplementation for 24 weeks effectively improved biochemical markers of hepatocellular injury and steatosis in patients with NAFLD,” wrote the researchers.

“Therefore, delta -tocotrienol might be considered as a therapeutic option in the management of patients with NAFLD.

“However, multi centric clinical trials are recommended to validate the results of present study and to elucidate the pathways and molecular mechanisms of delta -tocotrienol actions in patients with NAFLD.”

Source: Complementary Therapies in Medicine
August 2020, Volume 52, 102494, doi: 10.1016/j.ctim.2020.102494
“Delta-tocotrienol supplementation improves biochemical markers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease: A randomized, placebo-controlled trial”
Authors: M.A. Pervez et al.