Non-alcoholic steatohepatitis (NASH) refers to fatty liver combined with inflammation of liver cells. The prevalence of this disease in the general public is about 20%, but it is more common in high-risk groups (such as hyperlipidemia, diabetes, obesity). The prevalence rate among patients) can reach 50~90%! The scary thing is that if non-alcoholic steatohepatitis is not properly controlled, it may progress to cirrhosis, liver failure, and in rare cases liver cancer. In the course of the disease, non-alcoholic steatohepatitis can be said to be an important turning point and must be treated. Active intervention has begun; however, apart from lifestyle adjustments (such as weight loss, exercise), there is no clinically effective drug treatment for this disease. This article would like to share with you the intervention method proposed in a latest paper, which may open a new page for the treatment of non-alcoholic steatohepatitis (hereinafter referred to as NASH)!
Published in the journal "Journal of Hepatology" in 2022paper, his research team first analyzed past papers and found that the concentration of homocysteine (Hcy) in the blood was positively correlated with the severity of NASH, while the concentrations of vitamin B12 and folic acid in the blood were positively correlated with the severity of NASH. Negative correlation. Therefore, the research team conducted a series of experiments to study the pathological mechanism of hyperhomocysteinemia (HHcy) in the course of NASH, and also studied the effects of vitamin B12 and folic acid on it.
The research team conducted cell and mouse experiments to explore the pathological mechanism and presented many important results. First of all, the research team also found that blood Hcy concentration is positively correlated with inflammation and fibrosis of liver cells. Such an influence can induce and aggravate the formation of NASH, which is consistent with previous research findings. In addition, the research team found that in the state of NASH, Many liver proteins have higher homocysteineylation (Homocysteinylation, Hcy-lation) and ubiquitination (Ubiquitination), and these proteins include Syntaxin 17 (Stx 17), a key autophagosome/lytic body fusion protein ( autophagosome/lysosome fusion protein), when Stx 17 is degraded through homocysteine and ubiquitination, it will cause autophagy to be hindered and Stx 17's function of regulating inflammation and fibrosis to fail, thereby promoting NASH. Exacerbation; surprisingly, in the experiment, supplementing vitamin B12 and folic acid through diet will promote the conversion of Hcy into methionine (Methionine), thereby reducing Hcy in the blood and reducing the amount of homocysteine-containing protein. , improve the performance of Stx 17, promote the oxidation of fatty acids, and ultimately improve the inflammatory tissue pattern of liver cells!
Based on the above, although this paper still belongs to cell/animal testing and needs to be confirmed by more human clinical trials in the future,For patients with non-alcoholic steatohepatitisConsidering that there is currently no clear and effective treatment method, the author believes thatVitamin B12 and folic acid are a special nutritional intervention worth trying, and this method has no obvious side effects, but it is recommendedDosage and tracking methods should still be discussed in detail with the clinician. In addition, for the general public who do not suffer from non-alcoholic steatohepatitis, considering that due to the unbalanced eating habits of modern people, there is still a high proportion of people whose dietary intake of vitamin B12 and folic acid is insufficient. The author recommends that in addition to adjusting the dietary content , you can also consider usingRegular blood drawing/abdominal ultrasound examination, combined with appropriate nutritional supplements, to achieve better health!
〈The author is former Attending Physician in National Taiwan University Hospital, and Master of Science from National Taiwan University〉
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