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

Elizabeth X. Zheng, Simona Rossi, Robert J. Fontana, Raj Vuppalanchi, Jay H. Hoofnagle, Ikhlas Khan, Victor J. Navarro

Research output: Contribution to journalArticle

8 Citations (Scopus)

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/m2). 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.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalDrug Safety
DOIs
StateAccepted/In press - May 17 2016

Fingerprint

Chemical and Drug Induced Liver Injury
Tea
Liver
Weight Loss
Prospective Studies
Wounds and Injuries
Pharmaceutical Preparations
Dietary supplements
Dietary Supplements
Causality
Ideal Body Weight
Gastroenterology
Catechin
Alanine Transaminase
Liver Transplantation
Names
Body Mass Index
Transplantation

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Toxicology

Cite this

Risk of Liver Injury Associated with Green Tea Extract in SLIMQUICK® Weight Loss Products : Results from the DILIN Prospective Study. / Zheng, Elizabeth X.; Rossi, Simona; Fontana, Robert J.; Vuppalanchi, Raj; Hoofnagle, Jay H.; Khan, Ikhlas; Navarro, Victor J.

In: Drug Safety, 17.05.2016, p. 1-6.

Research output: Contribution to journalArticle

Zheng, Elizabeth X. ; Rossi, Simona ; Fontana, Robert J. ; Vuppalanchi, Raj ; Hoofnagle, Jay H. ; Khan, Ikhlas ; Navarro, Victor J. / Risk of Liver Injury Associated with Green Tea Extract in SLIMQUICK® Weight Loss Products : Results from the DILIN Prospective Study. In: Drug Safety. 2016 ; pp. 1-6.
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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{\circledR} 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{\circledR} product and were assigned causality scores of probable, highly likely, or definite. Results: Six cases of acute liver injury attributed to SLIMQUICK{\circledR} 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/m2). All were taking SLIMQUICK{\circledR} 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{\circledR} 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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