title: Catechins in dietary supplements and hepatotoxicity.
abstract: BACKGROUND
  Many herbal dietary supplements (HDS) contain green tea extract (GTE) and its component catechins, although their presence may not always be indicated on the product label.
  
  
  OBJECTIVE
  Because GTE and catechins have been implicated in human hepatotoxicity in several case reports, our objective was to determine whether catechins were present in HDS that were implicated in hepatotoxicity, even if not identified among the labeled ingredients, and whether these compounds could be associated with liver injury.
  
  
  METHODS
  We assayed 97 HDS implicated in human hepatotoxicity for catechins.
  
  
  RESULTS
  We found that 29 of 73 HDS (39.7%) that did not identify GTE or any of its component catechins on their label contained catechins. Among patients with confirmed hepatotoxicity, there was no statistically significant association between the presence of catechin or the dose consumed and liver injury causality score, severity, or pattern of liver injury. Catechin levels tended to be highest in products used for weight loss, although catechin concentrations were low in most products.
  
  
  CONCLUSIONS
  Many HDS commonly contain catechins that are implicated in hepatotoxicity, although their presence may not be indicated on the product label. Although our results did not establish an association between GTE or catechins with hepatotoxicity, they highlight some of the many complexities and uncertainties that surround the attribution of drug-induced liver injury (DILI) to HDS.
authors.affiliation: Division of Hepatology, Einstein Medical Center, 5401 Old York Road, Suite 505, Philadelphia, PA 19141, USA. NavarroV@einstein.edu
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Navarro
authors.forename: Herbert L
authors.initials: HL
authors.lastname: Bonkovsky
authors.forename: Sun-Il
authors.initials: SI
authors.lastname: Hwang
authors.forename: Maricruz
authors.initials: M
authors.lastname: Vega
authors.forename: Huiman
authors.initials: H
authors.lastname: Barnhart
authors.forename: Jose
authors.initials: J
authors.lastname: Serrano
mesh_terms: D000328:Adult; D002392:Catechin / Q000009:adverse effects / Q000032:analysis*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D019587:Dietary Supplements / Q000009:adverse effects / Q000032:analysis* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D028321:Plant Preparations / Q000009:adverse effects / Q000737:chemistry* / Q000592:standards; D055815:Young Adult
chemical_list: D028321:Plant Preparations; D002392:Catechin