Garcinia cambogia, Either Alone or in Combination With Green Tea, Causes Moderate to Severe Liver Injury.


Journal

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
ISSN: 1542-7714
Titre abrégé: Clin Gastroenterol Hepatol
Pays: United States
ID NLM: 101160775

Informations de publication

Date de publication:
06 2022
Historique:
received: 20 04 2021
revised: 05 08 2021
accepted: 09 08 2021
pubmed: 18 8 2021
medline: 10 5 2022
entrez: 17 8 2021
Statut: ppublish

Résumé

Garcinia cambogia, either alone or with green tea, is commonly promoted for weight loss. Sporadic cases of liver failure from G cambogia have been reported, but its role in liver injury is controversial. Among 1418 patients enrolled in the Drug-Induced Liver Injury Network (DILIN) from 2004 to 2018, we identified 22 cases (adjudicated with high confidence) of liver injury from G cambogia either alone (n = 5) or in combination with green tea (n = 16) or Ashwagandha (n = 1). Control groups consisted of 57 patients with liver injury from herbal and dietary supplements (HDS) containing green tea without G cambogia and 103 patients from other HDS. Patients who took G cambogia were between 17 and 54 years, with liver injury arising 13-223 days (median = 51) after the start. One patient died, one required liver transplantation, and 91% were hospitalized. The liver injury was hepatocellular with jaundice. Although the peak values of aminotransferases were significantly higher (2001 ± 1386 U/L) in G cambogia group (P < .018), the median time for improvement in total bilirubin was significantly lower compared with the control groups (10 vs 17 and 13 days; P = .03). The presence of HLA-B∗35:01 allele was significantly higher in the G cambogia containing HDS (55%) compared with patients because of other HDS (19%) (P = .002) and those with acute liver injury from conventional drugs (12%) (P = 2.55 × 10 The liver injury caused by G cambogia and green tea is clinically indistinguishable. The possible association with HLA-B∗35:01 allele suggests an immune-mediated mechanism of injury. gov number: NCT00345930.

Sections du résumé

BACKGROUND & AIMS
Garcinia cambogia, either alone or with green tea, is commonly promoted for weight loss. Sporadic cases of liver failure from G cambogia have been reported, but its role in liver injury is controversial.
METHODS
Among 1418 patients enrolled in the Drug-Induced Liver Injury Network (DILIN) from 2004 to 2018, we identified 22 cases (adjudicated with high confidence) of liver injury from G cambogia either alone (n = 5) or in combination with green tea (n = 16) or Ashwagandha (n = 1). Control groups consisted of 57 patients with liver injury from herbal and dietary supplements (HDS) containing green tea without G cambogia and 103 patients from other HDS.
RESULTS
Patients who took G cambogia were between 17 and 54 years, with liver injury arising 13-223 days (median = 51) after the start. One patient died, one required liver transplantation, and 91% were hospitalized. The liver injury was hepatocellular with jaundice. Although the peak values of aminotransferases were significantly higher (2001 ± 1386 U/L) in G cambogia group (P < .018), the median time for improvement in total bilirubin was significantly lower compared with the control groups (10 vs 17 and 13 days; P = .03). The presence of HLA-B∗35:01 allele was significantly higher in the G cambogia containing HDS (55%) compared with patients because of other HDS (19%) (P = .002) and those with acute liver injury from conventional drugs (12%) (P = 2.55 × 10
CONCLUSIONS
The liver injury caused by G cambogia and green tea is clinically indistinguishable. The possible association with HLA-B∗35:01 allele suggests an immune-mediated mechanism of injury.
CLINICAL TRIALS
gov number: NCT00345930.

Identifiants

pubmed: 34400337
pii: S1542-3565(21)00871-5
doi: 10.1016/j.cgh.2021.08.015
pmc: PMC9004424
mid: NIHMS1792452
pii:
doi:

Substances chimiques

HLA-B Antigens 0
Tea 0

Banques de données

ClinicalTrials.gov
['NCT00345930']

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1416-e1425

Subventions

Organisme : NIDDK NIH HHS
ID : U01 DK065211
Pays : United States
Organisme : NIDDK NIH HHS
ID : U24 DK065176
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK083027
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK083020
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK065238
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK065193
Pays : United States
Organisme : NIGMS NIH HHS
ID : P20 GM130457
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK065176
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK083023
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK065184
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082992
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK065201
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK100928
Pays : United States

Informations de copyright

Copyright © 2022. Published by Elsevier Inc.

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Auteurs

Raj Vuppalanchi (R)

Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

Herbert L Bonkovsky (HL)

Wake Forest University School of Medicine, Winston-Salem, North Carolina.

Jawad Ahmad (J)

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Huiman Barnhart (H)

Duke Clinical Research Institute, Duke University, Durham, North Carolina.

Francisco Durazo (F)

University of California Los Angeles Medical School, Los Angeles, California.

Robert J Fontana (RJ)

Department of Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan.

Jiezhun Gu (J)

Duke Clinical Research Institute, Duke University, Durham, North Carolina.

Ikhlas Khan (I)

National Center for Natural Products Research, University of Mississippi, University, Mississippi.

David E Kleiner (DE)

Liver Disease Research Branch, Division of Digestive Diseases and Nutrition, and the Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, and the Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.

Christopher Koh (C)

Liver Disease Research Branch, Division of Digestive Diseases and Nutrition, and the Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, and the Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.

Don C Rockey (DC)

Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.

Elizabeth J Phillips (EJ)

Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

Yi-Ju Li (YJ)

Duke Clinical Research Institute, Duke University, Durham, North Carolina.

Jose Serrano (J)

Liver Disease Research Branch, Division of Digestive Diseases and Nutrition, and the Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, and the Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.

Andrew Stolz (A)

Department of Medicine, University of Southern California School of Medicine, Los Angeles, California.

Hans L Tillmann (HL)

East Carolina University, Greenville, North Carolina.

Leonard B Seeff (LB)

Department of Medicine, Einstein Healthcare Network, Philadelphia, Pennsylvania.

Jay H Hoofnagle (JH)

Liver Disease Research Branch, Division of Digestive Diseases and Nutrition, and the Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, and the Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.

Victor J Navarro (VJ)

Department of Medicine, Einstein Healthcare Network, Philadelphia, Pennsylvania. Electronic address: NavarroV@einstein.edu.

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