The effect of oral Alpha lipoic acid (ALA) on serum Leptin, Irisin and plasminogen activator inhibitor-1 (PAI-1) in non alcoholic fatty liver disease (NAFLD) : A double blind randomized controlled clinical trial

Abstract

Aim : Non alcoholic fatty liver disease (NAFLD) – liver expression of metabolic syndrome – is one of the most common non communicable diseases in the recent century. Insulin Resistance, oxidative stress and inflammation are the main reasons that lead to NAFLD via steatosis and inflammation in liver. Studies suggest that Alpha lipoic acid (ALA), may increase insulin sensitivity and suppress inflammations due to its antioxidant effects. This study was conducted to assess the effect of oral supplementation of ALA on serum level of Leptin, Irisin and Plasminogen activator inhibitor-1 (PAI-1) in patients with NAFLD. Methods : Forty five patients with NAFLD that their illness approved by ultrasonographic findings was recruited in this randomized double blind clinical trial. Patients were randomly allocated in two groups. “ALA group” that receive 2 capsules of ALA each contains 600mg (N=23), and “Placebo group” that receive 2 capsules contains corn starch and same as ALA capsules in shape and color (N=22). The intervention was carried out for 12 months. Anthropometric measurements, body composition, biochemical evaluations and liver ultrasonography were measured before and after the study. 3 days recall and physical activity questionnaire were completed at the beginning of study, the 6th week, and at the end of 12th week. Results: There were no significant differences in demographic issues, severity of liver damage, and cytokines and liver enzymes between groups at the beginning of study. For end of study analysis, we used ANCOVA to adjust for baseline values, energy intake physical activity and BMI changes. At the end of study Aspartat aminotransferas (AST) and PAI-1 serum level decreased in ALA group, but there was no significant difference between groups. In within and between group analysis observed Leptin serum level and subcutaneous abdominal fat thickness were decreased significantly in ALA group. Conclusion : Due to positive effect of ALA on Leptin serum level and abdominal subcutaneous fat, and also the association of these factors with the prediction and during the treatment of NAFLD, ALA may have a positive effect on patients with NAFLD as a complementary treatment, along with nutritional recommendations and physical activity.