Efficacy of Mediterranean diet in a peculiar case of non-alcoholic steatohepatitis and hypobetalipoproteinemia

s / Digestive and Liver Disease 47S (2015) e226–e235 e233 therapy strategies, such as vitamin E or insulin-sensitizers, lead to controversial clinical outcomes. The aim of this studywas to evaluate the efficacy of a fixed combination of berberine, tocotrienols and chlorogenic acid (Trixy®, Nathura s.r.l.), in combination with diet and moderate aerobic physical activity, on the biochemical parameters of steatosis. In this study we examined 19 patients consistent with ultrasounddiagnosedNAFLD, elevatedaminotransferase levels, BMI>25kg/m2 and<30kg/m2 and/or altered lipid and/or glucose levels. After three months of an appropriate diet andmoderate aerobic physical activity, we compared those who only followed the behavioural advice (n=10),with thosewhoalso took thenutraceutical (n=9), assessing any additional efficacy. In both groups we observed a marked improvement in most parameters. However, the percentages of reduction in plasma glucose, insulin and HOMA-IR were significantly different, e.g. themeanpercentages of reductionofHOMA-IR were−60.03%±9.328and−12.62%±12.11 in thenutraceutical and in the control group respectively (P<0.01). Even the HSI and the NAFLD fibrosis score diminished but they did not reach statistical significance probably for the short period of treatment. The use of the nutraceutical combination might reduce insulin resistance, which is likely the first hit of NAFLD. http://dx.doi.org/10.1016/j.dld.2015.07.039