Vitamin E supplementation was previously reported to improve liver histology in patients with nonalcoholic steatohepatitis, which is a manifestation of the metabolic syndrome (MetS). α-tocopherol bioavailability in healthy adults is higher than in those with MetS, thereby suggesting that the latter group has increased requirements. In populations with MetS-associated hepatic dysfunction, impaired α-tocopherol trafficking is likely. The α-tocopherol catabolites α-carboxyethyl hydroxychromanol (α-CEHC) and α-carboxymethylbutyl hydroxychromanol (α-CMBHC) are useful biomarkers of α-tocopherol status. During the first 24 h, participants with MetS excreted 41% less α-CEHC, 63% less hexadeuterium-labeled (d6)-α-CEHC, and 58% less d6‑α‑CMBHC, and had 52% lower plasma d6-α-CEHC areas under the concentration curves compared with healthy adults. It was concluded that in populations with MetS-associated hepatic dysfunction impaired α-tocopherol trafficking is likely, thus making these patients prime candidates for supplementation.
Traber MG, Mah E, Leonard SW, Bobe G, Bruno RS. Metabolic syndrome increases dietary α-tocopherol requirements as assessed using urinary and plasma vitamin E catabolites: a double-blind, crossover clinical trial. Am J Clin Nutr. 2017 Jan 11. pii: ajcn138495. doi: 10.3945/ajcn.116.138495. [Epub ahead of print] This trial was registered at clinicaltrials.gov as NCT01787591.