THE EFFECTS OF VITAMIN B12 SUPPLEMENTATION ON SERUM HOMOCYSTEINE LEVEL AND HEPATIC STEATOSIS AND FIBROSIS IN NON-ALCOHOLIC FATTY LIVER DISEASE: A RANDOMIZED CONTROLLED TRIAL

Authors

Kashan University of Medical Sciences

10.22034/icrj.2022.173684

Abstract

Background And Aims:
Previous studies have reported evidence of an association between serum vitamin B12 levels and non-alcoholic fatty liver disease (NAFLD). The present study aimed to evaluate.
The effects of vitamin B12 supplementation on serum liver enzymes, homocysteine, grade of hepatic steatosis, and metabolic profiles in patients with NAFLD.
Methods:
Forty patients with NAFLD were enrolled in a parallel, double-blind placebo-controlled trial. They were randomly allocated to receive either one oral tablet of vitamin B12 (1000µg cyanocobalamin) or a placebo per day for 12 weeks. Serum levels of homocysteine, aminotransferases, fasting blood glucose (FBG), lipids, and malondialdehyde (MDA), as well as homeostasis model assessment of insulin resistance (HOMA-IR) were assessed. The grade of liver steatosis and fibrosis was measured by real-time 2-dimensional U/S shear wave elastography.
Results:
Vitamin B12 supplementation significantly decreased serum levels of homocysteine compared with placebo (-2.74 Vs. -0.54 µmol/L; P=0.038). Although serum alanine transaminase (ALT) in the vitamin B12 group decreased significantly, this change did not reach a significant level compared to the placebo group (-10.30 Vs. -7.30 IU/L; P>0.05). Despite the significant within-group decrease in FBG, MDA, and grade of liver steatosis and fibrosis on ultrasonography in the vitamin B12 group, between-group comparisons did not reveal any significant difference.
Conclusion:
Supplementation with vitamin B12 might decrease serum levels of homocysteine in patients with NAFLD; Therefore, it may protect against the adverse outcomes of hyper-homocysteinemia, such as the increased risk of inflammation and oxidative stress in the liver.

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