Noggin levels in nonalcoholic fatty liver disease: the effect of vitamin E treatment

AimThe evaluation of (a) noggin levels in patients with simple steatosis (SS) vs. nonalcoholic steatohepatitis (NASH) vs. controls, and (b) the effect of combined spironolactone plus vitamin E vs. vitamin E monotherapy on noggin levels in biopsy-proven patients with nonalcoholic fatty liver disease (NAFLD).MethodsIn the case-control study, 15 patients with SS, 16 with NASH, and 24 controls were included. In the randomized controlled trial, NAFLD patients were assigned to vitamin E (400IU/d) or spironolactone (25mg/d) plus vitamin E for 52weeks.ResultsNoggin levels were lower in SS (5.81.5pmol/l) and NASH (8.72.4pmol/l) patients than in controls (13.7 +/- 2.7pmol/l; p for trend=0.040), but were similar in SS and NASH patients. After adjustment for potential cofounders, log(noggin) remained different between groups. Log(noggin) levels similarly increased post-treatment in both groups: log(noggin) was not different between groups (p=0.20), but increased within groups over time (p<0.001), without a significant group x time interaction (p=0.62). Log(noggin) significantly increased at month 2 post-treatment (p=0.008 vs. baseline) and remained stable thereafter.Conclusions Lower noggin levels were observed in NAFLD patients than in controls. Noggin levels increased similarly by either combined low-dose spironolactone plus vitamin E or vitamin E monotherapy.Trial registration NCT01147523