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Oxidant Stress and Antioxidant Status Among Patients With Nonalcoholic Fatty Liver Disease (NAFLD)

Madan, Kaushal MD, DM*; Bhardwaj, Payal MSc*; Thareja, Sandeep MD, DM*; Gupta, Siddhartha D. MD; Saraya, Anoop MD, DM, DNB*

Journal of Clinical Gastroenterology: November-December 2006 - Volume 40 - Issue 10 - p 930-935
doi: 10.1097/01.mcg.0000212608.59090.08
Liver, Pancreas, and Biliary Tract: Clinical Research

Background One of the major pathogenic mechanisms for progression of nonalcoholic fatty liver disease (NAFLD) is oxidative stress. Recently, many studies have demonstrated the role of oxidative stress in NAFLD however, studies describing the antioxidant status in these patients are lacking.

Aim To study the levels of oxidative stress and antioxidant status among patients with NAFLD.

Patients and Methods It was a prospective study in which 29 patients with NAFLD, 25 diseased controls with chronic viral hepatitis, and 23 healthy controls were enrolled. Apart from standard biochemical parameters, lipid peroxidation products were measured as thiobarbituric acid reactive substances. As measures of antioxidant capacity, superoxide dismutase, vitamin C levels and ferric reducing ability of plasma were measured.

Results Level of thiobarbituric acid reactive substances was significantly higher among NAFLD patients as compared with diseased [4.7 nmol/mL (1.0 to 10.2) vs. 2.4 nmol/mL (0.8 to 10.7); P=0.02] or healthy controls [4.7 nmol/mL (1.0 to 10.2) vs. 1.8 nmol/mL (0.5 to 4.1); P=0.0001]. FRAP was found to be significantly higher in patients with NAFLD as compared with healthy controls [450.3 (197.6 to 733.3) vs. 340.8 (141.6 to 697.5) μmol Fe2+ liberated; P=0.04], even though it was similar between NAFLD and diseased controls. Among NAFLD patients, there was no significant correlation between histological grading or staging and levels of pro and antioxidants.

Conclusions Products of lipid peroxidation are significantly increased among patients with NAFLD as compared with chronic viral hepatitis or healthy controls. Larger studies and newer markers of oxidative stress are required to clarify the association between oxidative stress and histological severity in NAFLD.

Departments of *Gastroenterology and Human nutrition

Pathology, All India Institute of Medical Sciences, New Delhi, India

Reprints: Anoop Saraya, MD, DM, DNB, Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029, India (e-mail:

Received for publication February 1, 2006; accepted March 29, 2006

© 2006 Lippincott Williams & Wilkins, Inc.