Introduction NAFLD is a global clinical challenge which progresses to cirrhosis and liver cancer. Defective transport of free fatty acids and mitochondrial dysfunction lead to explosion of a series of free radicals, apoptosis, up regulated cytokines and fibrogenesis ultimately causing cirrhosis and cancer. Curcumin is a pan-antioxidant with anti-inflammatory, anti-apoptotic, anti-microbial, and anti-fibrogenic properties. This study evaluates the role of curcumin in NAFLD to progression of NASH
Methods Eighty patients (n = 80) with mean BMI 29%, NAFLD score 0.66, NASH fibrotic score 0.33, HOMA IR 3.8, ALT 58, LDLc 143, HDLc 29, Triglyceride 186 and Adipokines ( leptin, Adiponectin, Retinal Binding Proteins) were divided into Group A-(n = 20) pioglitazone 15mg, Group B-(n = 20) vitamin E, Group C-(n = 20) curcumin (all the three above groups received placebo), and Group D (n = 20) vitamin E plus curcumin. Pre and post values (Triglycerides, LDLc, HDLc, ALT, HOMA-IR, TNF-alfa, Leptin, Adiponectin, Retinol Binding Protein, HBA1c, Serum necro-inflammatory NAFLD and NASH fibrotic score were analysed at 3, 6, and 12 months. Diet and exercise were left unchanged. Daily alcohol content was less than 30 grammes
Results Group A-Minimal changes on ALT, HbA1c, HOMA, lipids, no changes in TNF-alfa, adipokines, lipid profile and necro-inflammatory score and/or NASH fibrosis score. Group B and Group C had modest changes in ALT, lipid profile, HbA1c and HOMA; while no changes in adipokines, necro-inflammatory score and fibrotic score. Group D had significant changes in all scores particularly the adipokines and small improvements in fibrotic score. All patients tolerated the medications well
Conclusion This study postulates the effects of Curcumin plus vitamin E in NAFLD may prevent NASH with a modest anti-fibrotic effects and necroinflammatory score; with impressive changes in adipokines levels. Additive effects of Curcumin with vitamin E has significant effects on Serum lipids and insulin sensitivity. Unavailability of Pre and post liver biopsy was the limitation A large control trial needs to validate.
Disclosure of Interest None Declared
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