Nicotinamide riboside and pterostilbene reduces markers of hepatic inflammation in NAFLD: A double-blind, placebo-controlled clinical trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 36082508 · doi:10.1002/hep.32778
What was done
A 6-month prospective, randomized, double-blind, placebo-controlled clinical trial evaluated daily supplementation with NRPT (a combination of nicotinamide riboside and pterostilbene) in 111 adults with NAFLD. Participants were assigned to one of three arms: placebo, recommended daily dose (NRPT 1×), or double dose (NRPT 2×). The primary endpoint was hepatic fat fraction, with prespecified secondary outcomes evaluating circulating liver enzymes (ALT, GGT) and toxic lipids (ceramide 14:0).
What was found
NRPT failed its primary endpoint: no significant change was observed in hepatic fat fraction compared with placebo. For prespecified secondary outcomes, the NRPT 1× group showed a significant time-dependent decrease in circulating ALT, GGT, and ceramide 14:0 versus placebo, with the decrease in ceramide 14:0 associated with ALT reduction. A dose-dependent effect was not observed in the NRPT 2× group for ALT, GGT, or ceramide 14:0. No raw numerical values, effect sizes, or p-values were reported in the abstract.
Why it matters
While NRPT did not alter liver fat content, standard-dose supplementation was well tolerated and reduced circulating markers of hepatic inflammation and lipotoxicity in patients with NAFLD.
Limits
The study failed its primary outcome (hepatic fat fraction), so positive findings rely on secondary endpoints. There was no dose-response relationship (the 2× dose showed no effect), histological liver outcomes were not evaluated, the sample size was relatively small (111 across three arms), and specific numerical data are omitted from the abstract.
Cited by
- partial Eight randomized clinical trials have shown beneficial effects of NR in lowering inflammation.