Nano cerium oxide and cerium/zinc nanocomposites characterization and therapeutic role in combating obesity via controlling oxidative stress and insulin resistance in rat model.

BACKGROUND: CeO2NPs and ZnONPs can curb the increase of cholesterol and triglycerides observed in rats with non-alcoholic fatty liver disease. It was suggested that CeO2 NPs could potentially have an insulin-sensitizing effect, specifically on adipose tissue and skeletal muscle. It was reported that ZnONPs combat the increase of insulin resistance observed in obese rats and could be beneficial value in NAFLD. In our previous work, ZnO-NPs manifested valuable anti-obesity effects via lowering body weight gain, oxidative stress, BMI, lipids, and insulin resistance. METHODS: In the present study, cerium oxide nanoparticles (A-1) and cerium/zinc nanocomposites (A-2 and A-3) were synthesized by solgel to investigate their role on oxidative stress, adipocyte hormones, and insulin resistance in an obese rat model. X-ray diffraction, HRTEM, SEM, and XPS were carried out to confirm the crystal structure, the particle size, the morphology of the nanoparticles and the oxidation states. RESULTS: The Rietveld refinement has also been executed on A-1 (chi2 = 1.00; average Bragg = 2.92%; R-factor = 2.45%) and on A-2 (Rw = 9.87%, Rex= 9.68%, χ2 = 1.04, GoF = 1.02). The XPS spectra indicated the presence of Ce in + 4 and + 3 oxidation states and Zn as ZnO and ZnO.OH. Cerium oxide and ZnO crystal sizes lie in the range 40.53-45.01 and 40.53-45.01 nm, respectively. The results indicated that treating obese rats with any of the tested nano compounds (5 mg or 10 mg/Kg) lowered plasma cholesterol, triglycerides, LDL, insulin resistance, glucose, and BMI significantly relative to obese group values. On the other hand, HDL increased significantly in obese rats after treatment with either A-2 or A-3 compared to obese rats. The current investigation showed antioxidant activities for A-1, A-2, and A3 as evidenced by the significant increase in GSH level and a significant decrease in MDA. CONCLUSION: It was found that A-1, A-2, and A-3 have an efficient therapeutic role in treating of obesity-related hyperlipidemia, oxidative stress and insulin resistance. The results of A-2 and A-3 were more pronounced than those of A-1. The use of Zn/Ce nanocomposite (that have positive characteristics) in combating obesity and its complications could be become a new trend in therapeutic application for a management of obesity.

Zinc nanoparticles ameliorated obesity-induced cardiovascular disease: role of metabolic syndrome and iron overload.

Obesity is a complicated disease characterized by abundant fat accumulation. It is associated with cardiovascular disease. The current study aimed to appreciate the role of synthesized zinc oxide nanoparticles (ZnONPs) (18.72 nm in size) in curbing cardiovascular disease in an obesity model of a high fat/sucrose diet in male rats. For 16 weeks, 24 rats were fed a high-fat diet and a 25% sucrose solution to develop obesity, and after that, the rats were randomly allocated into four groups of rats. Group 1 served as the control group and consisted of normal, non-obese rats. Group 2 comprised obese rats that were injected with an equivalent volume of a neutral substance, serving as vehicle control. In Group 3 or 4, obese rats were treated with an intraperitoneal injection of 5 or 10mg/kg of zinc oxide nanoparticles (ZnONPs) for eight weeks. The treatment of obese rats with ZnONPs decreased plasma levels of monocyte chemoattractant Protein-1 (MCP-1), resistin, ENA78, tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL6), and C reactive protein (CRP). Also, the remediation of obese rats with ZnONPs led to a significant decrease in body mass index (BMI), body weight gain, leptin, cholesterol, triglycerides, LDL (Low-density lipoprotein), glucose, and insulin resistance index (HOMA-IR). Moreover, ZnONPs treatment lowered troponin, creatine phosphokinase-MB (CK-MB), lactate dehydrogenase (LDH), cardiac or adipose tissue iron content, and malondialdehyde (MDA) either in blood or heart tissue. Otherwise, treating obese rats with ZnONPs enhanced plasma adiponectin levels, cardiac-reduced glutathione (GSH), and superoxide dismutase (SOD). In addition, ZnONPs displayed a significant influence on the cardiovascular system since they combat the rise in blood pressure and the pathological changes of the heart and aorta besides maintaining plasma nitric oxide levels. The results showed a positive correlation between BMI and MDA, MPC-1, CK-MB, and LDH. ZnONPs are convenient in treating cardiovascular disease in obese rats via reduced blood pressure, oxidative stress, cardiac iron accumulation, insulin resistance, and inflammatory markers.

Endothelin-1 gene polymorphism (G8002A) and endothelial monocyte-activating polypeptide II: Role in vascular dysfunction in pediatric patients with ß-thalassemia major.

BACKGROUND: Endothelin-1 (ET-1), a potent endogenous vasoconstrictor, stimulates production of reactive oxygen species. Endothelial monocyte-activating polypeptide-II (EMAP-II) is a multifunctional polypeptide. AIM: To assess ET-1 gene polymorphism (G8002A) in pediatric patients with ß-thalassemia major (ß-TM) as a potential genetic marker for vascular dysfunction and its possible relation to EMAP II, oxidative stress and vascular complications. METHODS: ß-TM patients (n = 95) without symptomatic cardiac or renal disease were compared with 95 healthy controls. Markers of hemolysis, serum ferritin, urinary albumin-to-creatinine ratio, serum EMAP II, malondialdehyde (MDA) and antioxidant enzymes; superoxide dismutase (SOD), glutathione peroxidase (GPx), reduced glutathione (GSH), glutathione reductase and catalase were measured. ET-1 gene polymorphism (G8002A) was determined using polymerase chain reaction­restriction fragment length polymorphism. RESULTS: ß-TM patients had significantly higher EMAP II than healthy controls. EMAP II was significantly higher among patients with cardiac disease, pulmonary hypertension (PH) risk, nephropathy, poor compliance to therapy and ferritin ≥ 2500 µg/L. There were significant correlations between EMAP II and transfusion index, LDH, ferritin and oxidative stress markers. The AA genotype of ET-1 gene polymorphism (G8002A) was significantly higher among ß-TM patients than controls. The number of patients with cardiac disease, PH risk or nephropathy was significantly higher among AA genotype compared with GG and GA genotypes. Lactate dehydrogenase (LDH), serum ferritin, EMAP II, MDA, SOD and GPx were significantly higher in AA genotype. CONCLUSION: ET-1 gene polymorphism (G8002A) could be a possible genetic marker for prediction of increased susceptibility to cardiopulmonary and renal complications among pediatric patients with ß-TM.

Molecularly Imprinted Polymeric Sorbent for Targeted Dispersive Solid-Phase Microextraction of Fipronil from Milk Samples.

Fipronil, a phenyl pyrazole insecticide, is extensively used in agriculture to control insect infestation. It has the potential to assimilate into the food chain, leading to serious health concerns. We report molecularly imprinted polymer (MIP)-based dispersive solid-phase microextraction for the targeted determination of fipronil in milk samples. Designing such a sorbent is of paramount importance for measuring the accurate amount of fipronil for monitoring its permissible limit. Response surface methodology based on a central composite design following a face-centered approach was used to optimize experimental conditions. The maximum binding capacity of 47 mg g-1 was achieved at optimal parameters of time (18 min), temperature (42 °C), pH (7), and analyte concentration (120 mg L-1). Under these conditions, a high percentage recovery of 94.6 ± 1.90% (n = 9) and a low limit of detection (LOD) and limit of quantitation (LOQ) (5.64 × 10-6 and 1.71 × 10-5 µg mL-1, respectively) were obtained. The MIP was well characterized through a scanning electron microscope (SEM) as well as Brunauer-Emmett-Teller (BET), Fourier transform infrared spectroscopy (FTIR), and thermogravimetric analysis (TGA) methods. Adsorption kinetics of the MIP followed the pseudo-first-order model (R 2 0.99 and χ2 0.96), suggesting the MIP-analyte interaction to be a physiosorptive process, while adsorption isotherms followed the Freundlich model (R 2 0.99). The real sample analysis through high-performance liquid chromatography (HPLC) confirmed the selective determination of fipronil from milk samples.

Chemical Profile of Cyperus laevigatus and Its Protective Effects against Thioacetamide-Induced Hepatorenal Toxicity in Rats.

Cyperus species represent a group of cosmopolitan plants used in folk medicine to treat several diseases. In the current study, the phytochemical profile of Cyperus laevigatus ethanolic extract (CLEE) was assessed using UPLC-QTOF-MS/MS. The protective effect of CLEE at 50 and 100 mg /kg body weight (b.w.) was evaluated on hepatorenal injuries induced by thioacetamide (100 mg/kg) via investigation of the extract's effects on oxidative stress, inflammatory markers and histopathological changes in the liver and kidney. UPLC-QTOF-MS/MS analysis of CLEE resulted in the identification of 94 compounds, including organic and phenolic acids, flavones, aurones, and fatty acids. CLEE improved the antioxidant status in the liver and kidney, as manifested by enhancement of reduced glutathione (GSH) and coenzyme Q10 (CoQ10), in addition to the reduction in malondialdehyde (MDA), nitric oxide (NO), and 8-hydroxy-2'-deoxyguanosine (8OHdG). Moreover, CLEE positively affected oxidative stress parameters in plasma and thwarted the depletion of hepatorenal ATP content by thioacetamide (TAA). Furthermore, treatment of rats with CLEE alleviated the significant increase in plasma liver enzymes, kidney function parameters, and inflammatory markers. The protective effect of CLEE was confirmed by a histopathological study of the liver and kidney. Our results proposed that CLEE may reduce TAA-hepatorenal toxicity via its antioxidant and anti-inflammatory properties suppressing oxidative stress.

Cognitive, emotional, physical, and behavioral stress-related symptoms and coping strategies among university students during the third wave of COVID-19 pandemic.

Background: Stress is manifested by different physical, cognitive, emotional, and behavioral stress-related symptoms, and everyone experiences it uniquely. The COVID-19 Pandemic has tremendously affected university students' lives. So, we conducted this study to determine the stress frequency, causes, determinants, and related symptoms involving physical, cognitive, emotional, and behavioral traits and coping strategies among university students in Egypt during the third wave of the COVID-19 pandemic, 2021. Methods: Cross-sectional study targeted 1,467 randomly selected undergraduate university students, representing all colleges from 30 universities in Egypt, through a validated self-administrated questionnaire. Results: The total stress-related symptom score was statistically significant (p < 0.05), higher among females, married, living on campus, with a (B) GPA, and those who had both organic and psychological disorders. The top 10 prevalent physical symptoms were headaches, chronic fatigue, hair loss, low back pain, neck pain, shoulders and arm pain, ophthalmological symptoms, acne, shakiness of extremities, and palpitations, respectively. The most reported symptoms regarding the cognitive, emotional, and behavioral aspects were anxiety and racing thoughts, moodiness and irritability, and excessive sleeping, respectively. Nine hundred and thirty-seven (63.9%) reported that the COVID-19 pandemic badly affected their lives, either directly or indirectly. The study showed that the prevalence of stress among university students is more than 97%. One thousand and five (68.5%) preferred isolation as a relieving technique. Conclusion: Stress and its related physical, cognitive, emotional, and behavioral symptoms are prevalent among university students. Most of the university students who were recruited reported that the COVID-19 pandemic badly affected their lives and used negative ways to deal with stress, like staying alone and sleeping too much. Positive ways to deal with stress, like seeing a therapist or meditating, were less common.

The association between vitamin D levels and oxidative stress markers in Egyptian Behcet's disease patients.

BACKGROUND: Oxidative stress is postulated to have a major role in the pathophysiology of Bechet's Disease (BD). Growing evidence suggests that vitamin D has important roles in enhancing the expression of anti-inflammatory cytokines as well as certain antioxidants. However, there is little evidence currently about the antioxidant properties of vitamin D in BD. OBJECTIVE: To study the relationship between vitamin D levels and the oxidative stress markers in patients with BD in addition to its association with disease activity and severity. METHODS: Sixty BD patients (45 males, 15 females; mean age: 34.2 ± 9.6 years) were enrolled in this study and compared to a sex and age matched control group. Plasma 25-Hydroxy vitamin D (25-OH-D) was measured using Human (25-OH-D) ELISA assay. Plasma malondialdehyde (MDA), nitric oxide (NO), reduced glutathione (GSH), superoxide dismutase (SOD) activity, catalase (CAT) activity and total antioxidant capacity (TAC) were determined by spectrophotometric methods in both groups. Plasma calcium (Ca) was measured by ELISA assay. RESULTS: When compared to controls vitamin D, GSH, CAT activity, TAC and Ca were significantly lower in BD patients, while MDA and NO levels were significantly increased in BD patients. Our Results Found that vitamin D was inversely correlated to BD current Activity form (BDCAF), disease severity score, ESR, CRP, MDA and NO, while vitamin D was significantly positively correlated to GSH, SOD, TAC and Ca. CONCLUSION: Our study confirms that a lower level of vitamin D is associated with the oxidative stress state in BD patients as detected by MDA and NO elevation as well as decreased GSH, SOD activity, CAT activity and TAC. Hence, Vitamin D fortified foods and beverages or supplementation may improve disease severity and oxidative stress in BD patients.

Physicochemical properties of and volatile compounds in riboflavin fortified cloudy apple juice; study of its effect on job fatigue among Egyptian construction workers.

Fatigue and rapid exhaustion are common complaints among construction workers, as a result of high-effort levels, physical overexertion, weather and long physically demanding work hours. This study aimed to fortify cloudy apple juice with riboflavin (vitamin B2) to evaluate changes in chemical composition, antioxidant activity and volatile compounds in the fortified juice and to study its effect on the volunteer construction workers complaining of fatigue resulting from demanding physical duties. Analysis of volatile compounds in the fortified cloudy apple juice using Gas Chromatography and Gas Chromatography-Mass Spectrometry identified thirty-four volatile compounds including esters, alcohols, aldehydes and acids. The most predominant volatile compounds were alcohols followed by esters in both the control and fortified samples. We studied the effect of the supplementation of riboflavin-fortified cloudy apple juice versus conventional cloudy apple juice on the anthropometric parameters, the scores of two fatigue questionnaires (Checklist Individual Strength and Fatigue Severity Scale) and antioxidants biomarkers among young Egyptian male construction workers. This study revealed that consumption of 1.3 mg of riboflavin-fortified cloudy apple juice per day for twenty-eight days significantly improved their metabolism, with a decrease in mean body fat percentage and an increase in body muscle mass without statistically significant differences, the fortified juice significantly improved the fatigue questionnaires' scores. Moreover, the fortified supplement had a substantial change in antioxidant activity; there was significant increase in the plasma total antioxidant capacity (+74.19 %change) and catalase enzyme (+54.65 %change) with a significant decrease in the serum malondialdehyde level (-53.78 %change). When compared to the administration of conventional cloudy apple juice, although there was a significant decrease in serum malondialdehyde level (-4.63 %change) at the end of the study, only the subjective fatigue subscale of the CIS fatigue score significantly decreased among the construction workers (-24.61 %change). It could be concluded that vitamin B2 fortified-cloudy apple juice was effective in the reduction of fatigue and exhaustion in the study's subjects.

The differential effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on seizure frequency in patients with drug-resistant epilepsy - A randomized, double-blind, placebo-controlled trial.

OBJECTIVES: The omega-3 (n-3) fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are known to play an important role in maintenance and modulation of neuronal functions. There is evidence that omega-3 fatty acids may have anticonvulsant effects. The effect of DHA and EPA on seizure rate in patients with drug-resistant epilepsy (DRE) was investigated. METHODS: A double-blind, randomized, placebo-controlled clinical trial included ninety-nine (n = 99) subjects with DRE, aged 5-16 years (n = 85) and 17-45 years (n = 14). After randomization, subjects were given two, four, or six capsules per day of DHA (417.8 mg DHA and 50.8 mg EPA/capsule, n = 33), EPA (385.6 mg EPA and 81.2 mg DHA/capsule, n = 33), or placebo (high oleic acid sunflower oil, n = 33) for one year. The primary endpoint was the effect of treatment on rate of seizure. Random-effects negative binomial regression models were fitted to model the patients' total count of seizures per month. The treatment effects on seizure incidence rate ratio (IRR) were tested after controlling for the covariate effects of gender, age, rate of seizure per week at enrollment, type of seizure, and number of antiepileptic drug (AED) combinations used at enrollment. RESULTS: Fifty-nine subjects (n = 59) completed the study (59.6%). The average number of seizures per month were 9.7 ±â€¯1.2 in the EPA group, 11.7 ±â€¯1.5 in the DHA group, and 16.6 ±â€¯1.5 in the placebo group. Age, gender, and seizure-type adjusted seizure IRRs of the EPA and DHA groups compared with the placebo group were 0.61 (CI = 0.42-0.88, p = 0.008, 42% reduction) and 0.67 (CI = 0.46-1.0, p = 0.04, 39% reduction), respectively. There was no difference in IRR between the EPA and DHA groups (p = 0.56). Both treatment groups had a significantly higher number of seizure-free days compared with the placebo group (p < 0.05). SIGNIFICANCE: This study demonstrates that EPA and DHA are effective in reducing seizure frequency in patients with DRE.

Biophysical and biochemical roles of Moringa oleifera leaves as radioprotector.

It has been found that medicinal plants have chemical and/or therapeutic effects on different diseases related to oxidative damage. This work investigates the use of ethanolic Moringa oleifera leaves extract; as a protective and/or therapeutic agent against damage induced by high acute dose of ionizing radiation. Also, this study aims to explore the associations of electrical properties (relaxation time and DC conductivity of bone marrow) with biochemical markers (SOD, CAT and GSH) to detect and prognosticate radiation effects. Biophysical and biochemical data revealed that Moringa extract can improve the electrical properties of bone marrow and the antioxidants levels in the blood. They also showed that the feeding of Moringa leaves extract post irradiation is preferred to recover rapidly and continuously from radiation effects.

Response of rats to dose rates of ionizing radiation evaluated by dielectric properties of bone marrow.

The response of adult Wistar albino female rats toward two dose rates of gamma radiation delivered as acute dose of 7 Gy is investigated using classical methodologies as chemical, hematological and histological parameters in comparison with newly introduced dielectric parameters. Two groups of rats were exposed to γ ray with dose rates 533.35 mGy/min and 325.89 mGy/min. Then the irradiated groups were followed up for two weeks after irradiation. In case of higher dose rate, high percentage of animals was lost and there were substantial alterations in the dielectric parameters in addition to massive damage in liver and bone marrow cells. On the other hand, a reduction of death rate of rats, different behavior in the dielectric parameters of bone marrow and lesser injury of liver tissue were well noticeable in case of lower dose rate. Moreover, the sensitivity of dielectric parameters toward the two different dose rates was well pronounced during the 1st and 2nd weeks after irradiation more than other parameters.

Negative Impact of Prolonged Antibiotics or Persistent Diarrhea on Vitamin K1 Levels in 2-24 Weeks aged Egyptian Infants.

BACKGROUND: To evaluate the hazard of prolonged antibiotic therapy and/or persistent diarrhea on vitamin K1 (VK1) level and bleeding profile in infants (2-24 weeks). METHODS: A one-year case-control study, conducted at Ain Shams University, Egypt. 338 infants (2-24 weeks) were recruited and divided into 3 groups (1:1:3 ratios); group A (n=67) patients who received antibiotics for ≥10 days, group B (n=67) who had persistent diarrhea ≥ 14 days and group C (n=204) age- and gender- matched infants who had not either received antibiotics nor had diarrhea. All subjected to clinical assessment, bleeding history and had their complete blood count (CBC), PT and PTT, liver transaminases and VK1 level assayed. RESULTS: There was a significant increase in frequency of VKDB (vitamin K deficiency bleeding) and abnormal bleeding profile in cases than control group. There was significant negative correlation between VK1 level and duration of diarrhea, length of antibiotics used and bleeding profile. Antibiotic usage has hazardous effect on VK1 level in those with diarrhea; more patients were receiving antibiotic in those with persistent diarrhea and VKDB (N=55) than those with persistent diarrhea and normal VK1 (N=12). The longer duration of antibiotic therapy the lower level of VK1. Combining cephalosporin/penicillin therapy and/or diarrhea, in particular, had an impact on VK1 level. CONCLUSION: VKDB, a preventable cause of life-threatening hemorrhage, is still a major health problem in Egyptian infants, where persistent diarrhea and misuse of antibiotics are prevalent, necessitate a booster dose of VK in those high risk infants.

Therapeutic antioxidant and anti-inflammatory effects of laser acupuncture on patients with rheumatoid arthritis.

BACKGROUND AND OBJECTIVE: The laser acupuncture has many potential therapeutic effects. Currently, they are not evaluated for their therapeutic effects on rheumatoid arthritis (RA) patients. The aim of this study was to investigate the effects of laser acupuncture on the oxidative and antioxidative markers, as well as the inflammatory markers and disease activity of RA patients. DESIGN/MATERIALS AND METHODS: The study was conducted on 30 RA patients and 20 healthy subjects. The patients were subjected to laser acupuncture (904 nm, 100 mW power output, 1 minute irradiation time, beam area of 1 cm(2) , total energy per point 6 J, energy density 6 J/ cm(2) , irradiance 0.1 W/cm(2) , frequency 10000 Hz, duty-cycle 100%) for 3 days/week for duration of 4 weeks. The acupuncture points of exposure were LI4, TE5, LI 11, DU 14, LIV3, SP6, GB34, and S36. The levels of oxidative and antioxidant markers were determined by spectrophotometric methods whereas the inflammatory markers were determined by ELISA methods. Lastly, using DAS28 scores the disease activity was assessed. RESULTS: After laser acupuncture, the study group revealed significantly increased plasma superoxide dismutase (SOD), glutathione reductase (GR), catalase activities, blood glutathione (GSH), and plasma ATP concentrations, compared to those before treatment (P < 0.0005). Moreover, the results revealed significantly reduced plasma malondialdehyde (MDA), serum nitrate and nitrite, serum C-reactive protein (CRP), plasma interleukin-6 (IL-6) levels and significantly reduced glutathione peroxidase (GPx) activity and erythrocyte sedimentation rate (ESR) in laser exposed patients, compared to those before treatment (P < 0.0005). The RA patients subjected to laser acupuncture showed highly significant reduction in disease activity (P < 0.0005) based on DAS28 score. CONCLUSION: Our study results confirmed the effectiveness of laser acupuncture in alleviating oxidative stress and inflammation, improving antioxidant and energy metabolic status, while also suppressing the disease activity in RA patients. Laser acupuncture is a promising treatment modality to reduce the pain and suffering of RA patients because of its efficiency in inhibiting most of the main factors involved in the pathogenesis of this disease. Lasers Surg. Med. 48:490-497, 2016. © 2016 Wiley Periodicals, Inc.

Determination of Human Hemoglobin Derivatives.

The levels of the inactive hemoglobin (Hb) pigments [such as methemoglobin (metHb), carboxyhemoglobin (HbCO) and sulfohemoglobin (SHb)] and the active Hb [in the oxyhemoglobin (oxyHb) form] as well as the blood Hb concentration in healthy non pregnant female volunteers were determined using a newly developed multi-component spectrophotometric method. The results of this method revealed values of SHb% in the range (0.0727-0.370%), metHb% (0.43-1.0%), HbCO% (0.4-1.52%) and oxyHb% (97.06-98.62%). Furthermore, the results of this method revealed values of blood Hb concentration in the range (12.608-15.777 g/dL). The method is highly sensitive, accurate and reproducible.

Effect of antioxidant therapy on hepatic fibrosis and liver iron concentrations in ß-thalassemia major patients.

To assess the effects of combined vitamin therapy on oxidant-antioxidant hepatic status and hemoglobin (Hb) derivatives on ß-thalassemia major (ß-TM), a prospective study of 60 ß-TM patients aged 4 to 17 years, was conducted. Thirty-nine patients with initial low serum vitamins E, C and A, were treated with oral combined vitamins for 1 year compared to 21 patients with normal vitamin levels. Serum transaminases, serum ferritin, hepatic fibroscan elastography (TE) and magnetic resonance imaging R2* (MRI R2*) for liver iron concentration (LIC), were assessed before and after 6 and 12 months of therapy. Antioxidant capacity was assessed by levels of reduced glutathione (GSH), malondialdehyde (MDA), catalase, superoxide dismutase and GSH enzymes. The studied vitamins, reduced GSH and Hb levels were significantly elevated and paralleled by progressive decline in MDA and ferritin during therapy (p <0.001). Serum transaminase and superoxide dismutase were significantly decreased, while GSH reductase was significantly elevated during therapy (p <0.001). Improvement of hepatic fibrosis as 23.0% had TE (>12 kPa) at baseline compared to 20.5% after therapy (p >0.05), although LIC values were significantly decreased (p <0.001). Combined vitamin therapy improves the antioxidant/oxidant balance, LIC and hepatic fibrosis in young ß-TM patients.