Vitamin B for advanced non-alcoholic fatty liver disease? –

Better understand the development of fatty liver disease

Researchers have identified a new mechanism for the development of advanced forms of fatty liver disease. Fortunately, the process can be reversed with vitamin B12 and folic acid supplements.

A new study involving experts from Peking University examined the effects of the amino acid homocysteine ​​on the progression of non-alcoholic steatohepatitis, metabolism and autophagy. The results are published in the Journal of Hepatology.

What is non-alcoholic fatty liver disease?

Non-alcoholic fatty liver disease (NAFL) describes fatty deposits in the liver that are not related to alcohol consumption. About 25% of all adults worldwide are affected, researchers report.

Non-alcoholic fatty liver disease is one of the most common causes of liver transplants worldwide, the team said. The high prevalence is due to the link between diabetes and obesity.

When the disease then progresses to inflammation and scarring, it is called non-alcoholic steatohepatitis (NASH).

Liver dysfunction caused by NASH

"While fat deposition in the liver is reversible in the early stages, progression to NASH leads to liver dysfunction, cirrhosis and increases the risk of liver cancer," says study author Dr. Madhulika Tripathi in a press release from Duke-NUS Medical School.

To date, there is no pharmacological treatment for NASH due to a lack of understanding of the mechanisms of the disease, according to the team. Although NASH is known to have elevated blood levels of the amino acid homocysteine, its role in the development of the disease has so far remained unclear.

role of homocysteine

However, researchers have now been able to confirm the link between homocysteine ​​and NASH progression in preclinical models and in humans. Additionally, the team found that when homocysteine ​​levels in the liver increase, the amino acid attaches to various liver proteins, changing their structure and altering their function.

Researchers report that when homocysteine ​​binds to a protein called syntaxin 17, it prevents it from fulfilling its role in transporting and digesting fat in fatty acid metabolism, mitochondrial turnover, and preventing inflammation. .

The team explains that the cellular process of autophagy, in which cells eliminate malformed proteins or damaged organelles, is disrupted. This leads to the progression of fatty liver disease to non-alcoholic steatohepatitis.

Vitamin B12 and folic acid prevent NASH

However, the study also showed that supplementing the diet in preclinical models with vitamin B12 and folic acid increased levels of syntaxin 17 in the liver and restored its role in autophagy. In addition, disease progression slowed and liver inflammation and fibrosis decreased.

“Our results are both exciting and important because they suggest that a relatively inexpensive therapy, namely vitamin B12 and folic acid, could be used to prevent and/or delay the progression of NASH,” reports L. author of the study, Dr. Brijesh Singh.

The expert adds that serum and liver homocysteine ​​levels can also serve as biomarkers of the severity of NASH. Similarly, homocysteine ​​could also affect other liver proteins. In the future, the team plans to take a closer look at which liver proteins are involved.

NASH therapy in perspective

Experts hope this research will lead to the development of therapies for NASH.

The possibility of using vitamin B12 and folic acid as first-line therapies for the prevention and treatment of NASH could lead to enormous cost savings and reduce the health burden of NASH in developed and developing countries. , adds Dr. singh. added.

So far, the only way to treat end-stage liver disease is through transplantation. But the study shows that a simple, affordable and easily accessible intervention could potentially halt or reverse liver damage. (as)

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This text corresponds to the specifications of the specialized medical literature, medical guidelines and current studies and has been verified by health professionals.


Madhulika Tripathi, Brijesh Kumar Singh, Jin Zhou, Keziah Tikno, Anissa Widjaja, et al. : Vitamin B12 and folate decrease inflammation and fibrosis in NASH by preventing homocysteinylation of syntaxin 17; in: Journal of Hepatology (published 07/08/2022), Journal of Hepatology Duke-NUS Medical School: B vitamins may potentially be used to treat advanced non-alcoholic fatty liver disease: Duke-NUS (published 04/08/2022 ), Duke-NUS School of Medicine

Important note:
This article contains general advice only and should not be used for self-diagnosis or treatment. It cannot substitute a visit to the doctor.