Nicotinamide supplementation in diabetic nonalcoholic fatty liver disease patients: randomized controlled trial

El-Kady, Rasha R; Ali, Amani K; El Wakeel, Lamia M; Sabri, Nagwa A; May Ahmed Shawki;

Abstract


Background:
Nicotinamide has been reported to protect against liver steatosis and metabolic imbalances in nonalcoholic fatty liver disease (NAFLD) in animal models.

Objectives:
The objective was to investigate the efficacy and safety of nicotinamide supplementation in diabetic NAFLD patients.

Design:
This is a prospective randomized controlled open label study.

Methods:
Seventy diabetic NAFLD patients were randomly assigned either to the nicotinamide group (n = 35) who received nicotinamide 1000 mg once daily for 12 weeks in addition to their antidiabetic therapy or the control group (n = 35) who received their antidiabetic therapy only. The primary outcome was improvement in steatosis score, while secondary outcomes included assessment of liver stiffness, liver enzymes, lipid profile, insulin resistance, serum malondialdehyde, serum adiponectin, and patients’ quality of life (QOL).

Results:
Only 61 patients completed the study; 31 in the nicotinamide group and 30 in the control group. Comparisons between groups and within groups revealed nonsignificant changes in steatosis and fibrosis scores. However, significant reduction was observed in liver enzymes with a median decrease in alanine transaminase of 26.6% versus 0.74% in nicotinamide and control groups, respectively. After 12 weeks of treatment, the nicotinamide group showed significantly lower levels of low-density lipoprotein cholesterol (p value = 0.004), total cholesterol (p value = 0.006), and insulin resistance marker (p value = 0.005) compared with control. Serum triglycerides, malondialdehyde, and adiponectin levels were all comparable between the two groups. Regarding QOL, a significant improvement was detected in the total scores and the activity and fatigue domains scores.

Conclusion:
Nicotinamide at a dose of 1000 mg daily was tolerable, improved metabolic abnormalities and QOL of diabetic NAFLD patients with no effect on liver fibrosis or steatosis.


Other data

Title Nicotinamide supplementation in diabetic nonalcoholic fatty liver disease patients: randomized controlled trial
Authors El-Kady, Rasha R; Ali, Amani K; El Wakeel, Lamia M; Sabri, Nagwa A; May Ahmed Shawki 
Keywords Fibroscan;nicotinamide;nonalcoholic fatty liver disease;steatosis
Issue Date 2022
Publisher SAGE PUBLICATIONS LTD
Journal Therapeutic advances in chronic disease 
ISSN 2040-6223
DOI 10.1177/20406223221077958
PubMed ID 35222903
Scopus ID 2-s2.0-85125859390
Web of science ID WOS:000765349400001

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