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

Hormones (Athens). 2018 Dec;17(4):573-579. doi: 10.1007/s42000-018-0083-8. Epub 2018 Nov 22.


Aim: The 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).

Methods: In 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 (400 IU/d) or spironolactone (25 mg/d) plus vitamin E for 52 weeks.

Results: Noggin levels were lower in SS (5.8 ± 1.5 pmol/l) and NASH (8.7 ± 2.4 pmol/l) patients than in controls (13.7 ± 2.7 pmol/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 × 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.

Keywords: Bone morphogenetic protein; Noggin; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Oxidative stress; Simple steatosis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Carrier Proteins / blood*
  • Carrier Proteins / drug effects
  • Case-Control Studies
  • Drug Therapy, Combination
  • Humans
  • Mineralocorticoid Receptor Antagonists / administration & dosage
  • Mineralocorticoid Receptor Antagonists / pharmacology*
  • Non-alcoholic Fatty Liver Disease / blood*
  • Non-alcoholic Fatty Liver Disease / drug therapy*
  • Spironolactone / administration & dosage
  • Spironolactone / pharmacology*
  • Vitamin E / administration & dosage
  • Vitamin E / pharmacology*


  • Carrier Proteins
  • Mineralocorticoid Receptor Antagonists
  • Vitamin E
  • noggin protein
  • Spironolactone

Associated data