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Risk of Liver Injury Associated with Green Tea Extract in SLIMQUICK(®) Weight Loss Products: Results from the DILIN Prospective Study.

Abstract

INTRODUCTION

Herbal and dietary supplements (HDS) have been increasingly recognized as a cause for acute liver injury (Navarro et al. Hepatology 60(4):1399-1408, 2014; Bailey et al. J Nutr 141:261-266, 2011). HDS products frequently contain numerous ingredients, and are marketed under various product names. A perusal of marketed weight loss products indicates that green tea extract (GTE) is a common ingredient in many. We aimed to describe the course and outcome of six patients who developed liver injury attributed to SLIMQUICK(®) weight loss products.

METHODS

Patients with suspected drug-induced liver injury were enrolled in a prospective study of the Drug-Induced Liver Injury Network (DILIN) and causality was assessed by a panel of hepatologists. During the period under study, 6 of 1091 cases of liver injury were attributed to a SLIMQUICK(®) product and were assigned causality scores of probable, highly likely, or definite.

RESULTS

Six cases of acute liver injury attributed to SLIMQUICK(®) products were enrolled in the DILIN prospective study between 2007 and 2011. All were women aged 22 to 58 years. Two had a normal body weight and four were mildly obese (body mass index 22.9-32.2 kg/m(2)). All were taking SLIMQUICK(®) products for weight loss and no patient reported prior use. Laboratory tests revealed a hepatocellular pattern of injury, with initial alanine aminotransferase (ALT) levels above 1000 U/L in all but one patient. Three patients were hospitalized and one underwent successful liver transplantation. No patients died of liver injury. GTE and/or its component catechins were listed among the ingredients for five of the six products.

CONCLUSIONS

SLIMQUICK(®) products can lead to severe acute hepatocellular liver injury, which may result in transplantation. Given the frequency of GTE as a component in weight loss products, this ingredient should be studied further as a possible cause for liver injury.

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  • Authors+Show Affiliations

    ,

    Einstein Medical Center, 5401 Old York Road, Philadelphia, PA, 19141, USA.

    ,

    Einstein Medical Center, 5401 Old York Road, Philadelphia, PA, 19141, USA.

    ,

    University of Michigan School of Medicine, Ann Arbor, MI, USA.

    ,

    Indiana University School of Medicine, Indianapolis, IN, USA.

    ,

    NIDDK, National Institutes of Health, Bethesda, MD, USA.

    ,

    University of Mississippi, Oxford, MS, USA.

    Einstein Medical Center, 5401 Old York Road, Philadelphia, PA, 19141, USA. navarrov@einstein.edu.

    Source

    Drug safety 39:8 2016 08 pg 749-54

    MeSH

    Adult
    Alanine Transaminase
    Chemical and Drug Induced Liver Injury
    Dietary Supplements
    Female
    Hospitalization
    Humans
    Liver Transplantation
    Middle Aged
    Plant Extracts
    Prospective Studies
    Severity of Illness Index
    Tea
    Weight Loss
    Young Adult

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    27189593

    Citation

    Zheng, Elizabeth X., et al. "Risk of Liver Injury Associated With Green Tea Extract in SLIMQUICK(®) Weight Loss Products: Results From the DILIN Prospective Study." Drug Safety, vol. 39, no. 8, 2016, pp. 749-54.
    Zheng EX, Rossi S, Fontana RJ, et al. Risk of Liver Injury Associated with Green Tea Extract in SLIMQUICK(®) Weight Loss Products: Results from the DILIN Prospective Study. Drug Saf. 2016;39(8):749-54.
    Zheng, E. X., Rossi, S., Fontana, R. J., Vuppalanchi, R., Hoofnagle, J. H., Khan, I., & Navarro, V. J. (2016). Risk of Liver Injury Associated with Green Tea Extract in SLIMQUICK(®) Weight Loss Products: Results from the DILIN Prospective Study. Drug Safety, 39(8), pp. 749-54. doi:10.1007/s40264-016-0428-7.
    Zheng EX, et al. Risk of Liver Injury Associated With Green Tea Extract in SLIMQUICK(®) Weight Loss Products: Results From the DILIN Prospective Study. Drug Saf. 2016;39(8):749-54. PubMed PMID: 27189593.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk of Liver Injury Associated with Green Tea Extract in SLIMQUICK(®) Weight Loss Products: Results from the DILIN Prospective Study. AU - Zheng,Elizabeth X, AU - Rossi,Simona, AU - Fontana,Robert J, AU - Vuppalanchi,Raj, AU - Hoofnagle,Jay H, AU - Khan,Ikhlas, AU - Navarro,Victor J, PY - 2016/5/19/entrez PY - 2016/5/18/pubmed PY - 2017/12/15/medline SP - 749 EP - 54 JF - Drug safety JO - Drug Saf VL - 39 IS - 8 N2 - INTRODUCTION: Herbal and dietary supplements (HDS) have been increasingly recognized as a cause for acute liver injury (Navarro et al. Hepatology 60(4):1399-1408, 2014; Bailey et al. J Nutr 141:261-266, 2011). HDS products frequently contain numerous ingredients, and are marketed under various product names. A perusal of marketed weight loss products indicates that green tea extract (GTE) is a common ingredient in many. We aimed to describe the course and outcome of six patients who developed liver injury attributed to SLIMQUICK(®) weight loss products. METHODS: Patients with suspected drug-induced liver injury were enrolled in a prospective study of the Drug-Induced Liver Injury Network (DILIN) and causality was assessed by a panel of hepatologists. During the period under study, 6 of 1091 cases of liver injury were attributed to a SLIMQUICK(®) product and were assigned causality scores of probable, highly likely, or definite. RESULTS: Six cases of acute liver injury attributed to SLIMQUICK(®) products were enrolled in the DILIN prospective study between 2007 and 2011. All were women aged 22 to 58 years. Two had a normal body weight and four were mildly obese (body mass index 22.9-32.2 kg/m(2)). All were taking SLIMQUICK(®) products for weight loss and no patient reported prior use. Laboratory tests revealed a hepatocellular pattern of injury, with initial alanine aminotransferase (ALT) levels above 1000 U/L in all but one patient. Three patients were hospitalized and one underwent successful liver transplantation. No patients died of liver injury. GTE and/or its component catechins were listed among the ingredients for five of the six products. CONCLUSIONS: SLIMQUICK(®) products can lead to severe acute hepatocellular liver injury, which may result in transplantation. Given the frequency of GTE as a component in weight loss products, this ingredient should be studied further as a possible cause for liver injury. SN - 1179-1942 UR - https://www.unboundmedicine.com/medline/citation/27189593/Risk_of_Liver_Injury_Associated_with_Green_Tea_Extract_in_SLIMQUICK_®__Weight_Loss_Products:_Results_from_the_DILIN_Prospective_Study_ L2 - https://dx.doi.org/10.1007/s40264-016-0428-7 DB - PRIME DP - Unbound Medicine ER -