Role of the PNPLA3 polymorphism rs738409 on silymarin + vitamin E response in subjects with non-alcoholic fatty liver disease
- Rocío Aller de la Fuente 1
- Cristina Laserna Jiménez 1
- Miguel Ángel Rojo 2
- Natalia Mora Cuadrado 1
- María Concepción García Sánchez 1
- María Pina 1
- Rebeca Sigüenza 1
- Miguel Durà 1
- D. Primo 1
- Olatz Izaola Jáuregui 1
- Daniel Antonio de Luis Román 2
- 1 Hospital Clínico Universitario. Valladolid, Spain
- 2 Universidad de Valladolid. Valladolid, Spain
ISSN: 2340-416, 1130-0108
Año de publicación: 2018
Volumen: 110
Número: 10
Páginas: 634-640
Tipo: Artículo
Otras publicaciones en: Revista Española de Enfermedades Digestivas
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.