The effects of vitamin B12 supplementation on metabolic profile of patients with non-alcoholic fatty liver disease: a randomized controlled trial
What this study found
Vitamin B12 lowered homocysteine, but it did not produce clear between-group improvements in the main hepatic or metabolic outcomes. In the B12 group, homocysteine fell from 15.1 to 11.5 µmol/L, while placebo changed from 14.5 to 14.1 µmol/L; the within-group P value was 0.005 for B12 versus 0.351 for placebo. ALT decreased within the B12 group from 44 to 30 IU/l (P = 0.005), fasting glucose decreased from 99.50 to 96.77 mg/dl (P = 0.025), and steatosis improved within both groups, but between-group comparisons were not significant for steatosis (P = 0.516; ANCOVA 0.802) or fibrosis. The…
- Study & population
- Randomized controlled trial in adults with non-alcoholic fatty liver disease diagnosed by ultrasound and elevated ALT, recruited from Shahid Beheshti Hospital in Kashan, Iran.
- Intervention
- Vitamin B12 was given as oral cyanocobalamin 1000 µg daily for 12 weeks.
- Key limitation
- Small single-center trial with only 20 participants per arm and 33 completers, limiting precision and generalizability.
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Open PDFOriginal abstract
The present study is the first effort to evaluate the effects of vitamin B12 supplementation on the serum level of liver enzymes, homocysteine, grade of hepatic steatosis, and metabolic profiles in patients with non-alcoholic fatty liver disease (NAFLD). Forty patients with NAFLD were enrolled in a double-blind placebo-controlled trial to receive either one oral tablet of vitamin B12 (1000 µg cyanocobalamin) or a placebo per day for 12 weeks. We investigated serum levels of homocysteine, aminotransferases, fasting blood glucose (FBG), lipids, malondialdehyde (MDA), and homeostasis model assessment of insulin resistance (HOMA-IR). The grade of liver steatosis and fibrosis was measured by real-time 2-dimensional shear wave elastography. Vitamin B12 supplementation significantly decreased serum levels of homocysteine compared to placebo (medians: − 2.1 vs. − 0.003 µmol/l; P = 0.038). Although serum alanine transaminase (ALT) in the vitamin B12 group decreased significantly, this change did not reach a significant level compared to the placebo group (medians: − 7.0 vs. 0.0 IU/l; P > 0.05). Despite the significant within-group decrease in FBG, MDA, and liver steatosis in the vitamin B12 group, between-group comparisons did not reveal any significant difference. Vitamin B12 supplementation might decrease serum levels of homocysteine in patients with NAFLD. The fasting blood glucose and serum levels of MDA were significantly improved in the trial group who received vitamin B12. However, these changes did not reach a significant level compared to the placebo group. In this respect, further studies with larger sample sizes, different doses, and types of vitamin B12 will reveal additional evidence. Trial Registration: At http://irct.ir/ as IRCT20120718010333N5 on December 25, 2019.