Role of the PNPLA3 polymorphism rs738409 on silymarin + vitamin E response in subjects with non-alcoholic fatty liver disease

  1. Rocío Aller de la Fuente 1
  2. Cristina Laserna Jiménez 1
  3. Miguel Ángel Rojo 2
  4. Natalia Mora Cuadrado 1
  5. María Concepción García Sánchez 1
  6. María Pina 1
  7. Rebeca Sigüenza 1
  8. Miguel Durà 1
  9. D. Primo 1
  10. Olatz Izaola Jáuregui 1
  11. Daniel Antonio de Luis Román 2
  1. 1 Hospital Clínico Universitario. Valladolid, Spain
  2. 2 Universidad de Valladolid. Valladolid, Spain
Revista:
Revista Española de Enfermedades Digestivas

ISSN: 2340-416 1130-0108

Año de publicación: 2018

Volumen: 110

Número: 10

Páginas: 634-640

Tipo: Artículo

DOI: 10.17235/REED.2018.5602/2018 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Revista Española de Enfermedades Digestivas

Objetivos de desarrollo sostenible

Resumen

Background: non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in developed countries. Lifestyle changes are the pillar of the treatment, although a pharmacological approach is sometimes required in the case of a failure to respond/adhere to the diet. Objective: the aim of this study was to evaluate the effect of silymarin and the influence of the patatin-like phospholipase domain-containing protein 3 (PNPLA3) variant on the response to treatment in patients with NAFLD in a pilot study. Methods: a total of 54 patients with a NAFLD proven biopsy were enrolled in an open prospective study and were treated with Eurosil 85® (silymarin + vitamin E) for six months. Biochemical parameters and cardiovascular risk factors (diabetes mellitus, dyslipidemia, hypertriglyceridemia, arterial hypertension and HOMA-IR > 2.5) were recorded before and after six months of treatment. Non-invasive indexes (fatty liver index, lipid accumulation product and NAFLD-fibrosis score) were also calculated. The rs738409 PNPLA3 gene polymorphism status was also determined. Results: significant statistical changes from baseline values after six months of treatment were observed in transaminases levels but not in non-invasive index markers. Twenty patients (37.1%) were G allele carriers and had a higher percentage of lobular inflammation and ballooning on the basal liver biopsy. Patients with the G allele had a smaller decrease in transaminases levels after treatment with silymarin + vitamin E than non-G-allele carriers. Conclusions: treatment with silymarin + vitamin E produced a decrease in transaminases after six months of treatment without an accompanying weight loss. PNPLA3 G-allele carriers responded poorly to the treatment.