title: Similar Reduction of Cholesterol-Adjusted Vitamin E Serum Levels in Simple Steatosis and Non-Alcoholic Steatohepatitis.
abstract: OBJECTIVE
  Reduced vitamin E levels have been reported in patients with non-alcoholic steatohepatitis (NASH), but no conclusive data on patients with simple steatosis (SS) are available. Aim of this study was to investigate the association between serum vitamin E levels and SS.
  
  
  METHODS
  A cohort of 312 patients with cardio-metabolic risk factors was screened for liver steatosis by ultrasonography (US). We reasonably classified as SS patients with US-fatty liver, normal liver function tests (LFTs) and with Cytokeratin 18 <246 mIU/ml. Liver biopsy was performed in 41 patients with US-fatty liver and persistent elevation of LFTs (>6 months). Serum cholesterol-adjusted vitamin E (Vit E/chol) levels were measured.
  
  
  RESULTS
  Mean age was 53.9±12.5 years and 38.4% were women. Non-alcoholic fatty liver disease (NAFLD) was detected at US in 244 patients; of those 39 had biopsy-proven NASH and 2 borderline NASH. Vit E/chol was reduced in both SS (3.4±2.0, P<0.001), and NASH (3.5±2.1, P=0.006) compared with non-NAFLD patients (4.8±2.0 μmol/mmol chol). No difference was found between SS and NASH (P=0.785). After excluding patients with NASH, a multivariable logistic regression analysis found that Vit E/chol (odds ratio (OR): 0.716, 95% confidence interval (CI) 0.602-0.851, P<0.001), alanine aminotransferase (ALT, OR: 1.093, 95% CI 1.029-1.161, P=0.004), body mass index (OR: 1.162, 95% CI 1.055-1.279, P=0.002) and metabolic syndrome (OR: 5.725, 95% CI 2.247-14.591, P<0.001) were factors independently associated with the presence of SS.
  
  
  CONCLUSIONS
  Reduced vitamin E serum levels are associated with SS, with a similar reduction between patients with SS and NASH, compared with non-NAFLD patients. Our findings suggest that the potential benefit of vitamin E supplementation should be investigated also in patients with SS.
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.|Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Pastori
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.|Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Baratta
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.|Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Carnevale
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cangemi
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Del Ben
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bucci
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.|Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Rome, Italy.
authors.forename: Licia
authors.initials: L
authors.lastname: Polimeni
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Labbadia
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Nocella
authors.affiliation: Department of Surgical Sciences, Sapienza University, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Scardella
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Pani
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Pignatelli
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Violi
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Angelico