Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis
Introduction and Objectives: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease with a high prevalence worldwide and poses serious harm to human health. There is growing evidence suggesting that the administration of specific supplements or nutrients may slow NAFLD progression. Sily...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Annals of Hepatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268123002776 |
| _version_ | 1797281231381987328 |
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| author | Shudi Li Fei Duan Suling Li Baoping Lu |
| author_facet | Shudi Li Fei Duan Suling Li Baoping Lu |
| author_sort | Shudi Li |
| collection | DOAJ |
| description | Introduction and Objectives: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease with a high prevalence worldwide and poses serious harm to human health. There is growing evidence suggesting that the administration of specific supplements or nutrients may slow NAFLD progression. Silymarin is a hepatoprotective extract of milk thistle, but its efficacy in NAFLD remains unclear. Materials and Methods: Relevant studies were searched in PubMed, Embase, the Cochrane Library, Web of Science, clinicaltrails.gov, and China National Knowledge Infrastructure and were screened according to the eligibility criteria. Data were analyzed using Revman 5.3. Continuous values and dichotomous values were pooled using the standard mean difference (SMD) and odds ratio (OR). Heterogeneity was evaluated using the Cochran's Q test (I2 statistic). A P<0.05 was considered statistically significant. Results: A total of 26 randomized controlled trials involving 2,375 patients were included in this study. Administration of silymarin significantly reduced the levels of TC (SMD[95%CI]=-0.85[-1.23, -0.47]), TG (SMD[95%CI]=-0.62[-1.14, -0.10]), LDL-C (SMD[95%CI]=-0.81[-1.31, -0.31]), FI (SMD[95%CI]=-0.59[-0.91, -0.28]) and HOMA-IR (SMD[95%CI]=-0.37[-0.77, 0.04]), and increased the level of HDL-C (SMD[95%CI]=0.46[0.03, 0.89]). In addition, silymarin attenuated liver injury as indicated by the decreased levels of ALT (SMD[95%CI]=-12.39[-19.69, -5.08]) and AST (SMD[95% CI]=-10.97[-15.51, -6.43]). The levels of fatty liver index (SMD[95%CI]=-6.64[-10.59, -2.69]) and fatty liver score (SMD[95%CI]=-0.51[-0.69, -0.33]) were also decreased. Liver histology of the intervention group revealed significantly improved hepatic steatosis (OR[95%CI]=3.25[1.80, 5.87]). Conclusions: Silymarin can regulate energy metabolism, attenuate liver damage, and improve liver histology in NAFLD patients. However, the effects of silymarin will need to be confirmed by further research. |
| first_indexed | 2024-03-07T16:54:20Z |
| format | Article |
| id | doaj.art-ff5950a2579345f195cde6dac92fc4a8 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-03-07T16:54:20Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-ff5950a2579345f195cde6dac92fc4a82024-03-03T04:29:04ZengElsevierAnnals of Hepatology1665-26812024-03-01292101174Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysisShudi Li0Fei Duan1Suling Li2Baoping Lu3The Second Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou 450000, ChinaThe First Affiliated Hospital of Henan University of TCM Zhengzhou 450000, ChinaThe First Affiliated Hospital of Henan University of TCM Zhengzhou 450000, ChinaHenan University of Chinese Medicine, Zhengzhou 450046, China; Corresponding author.Introduction and Objectives: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease with a high prevalence worldwide and poses serious harm to human health. There is growing evidence suggesting that the administration of specific supplements or nutrients may slow NAFLD progression. Silymarin is a hepatoprotective extract of milk thistle, but its efficacy in NAFLD remains unclear. Materials and Methods: Relevant studies were searched in PubMed, Embase, the Cochrane Library, Web of Science, clinicaltrails.gov, and China National Knowledge Infrastructure and were screened according to the eligibility criteria. Data were analyzed using Revman 5.3. Continuous values and dichotomous values were pooled using the standard mean difference (SMD) and odds ratio (OR). Heterogeneity was evaluated using the Cochran's Q test (I2 statistic). A P<0.05 was considered statistically significant. Results: A total of 26 randomized controlled trials involving 2,375 patients were included in this study. Administration of silymarin significantly reduced the levels of TC (SMD[95%CI]=-0.85[-1.23, -0.47]), TG (SMD[95%CI]=-0.62[-1.14, -0.10]), LDL-C (SMD[95%CI]=-0.81[-1.31, -0.31]), FI (SMD[95%CI]=-0.59[-0.91, -0.28]) and HOMA-IR (SMD[95%CI]=-0.37[-0.77, 0.04]), and increased the level of HDL-C (SMD[95%CI]=0.46[0.03, 0.89]). In addition, silymarin attenuated liver injury as indicated by the decreased levels of ALT (SMD[95%CI]=-12.39[-19.69, -5.08]) and AST (SMD[95% CI]=-10.97[-15.51, -6.43]). The levels of fatty liver index (SMD[95%CI]=-6.64[-10.59, -2.69]) and fatty liver score (SMD[95%CI]=-0.51[-0.69, -0.33]) were also decreased. Liver histology of the intervention group revealed significantly improved hepatic steatosis (OR[95%CI]=3.25[1.80, 5.87]). Conclusions: Silymarin can regulate energy metabolism, attenuate liver damage, and improve liver histology in NAFLD patients. However, the effects of silymarin will need to be confirmed by further research.http://www.sciencedirect.com/science/article/pii/S1665268123002776NAFLDEnergy metabolismLiver injuryLiver histological changesAnthropometric parameters |
| spellingShingle | Shudi Li Fei Duan Suling Li Baoping Lu Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis Annals of Hepatology NAFLD Energy metabolism Liver injury Liver histological changes Anthropometric parameters |
| title | Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis |
| title_full | Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis |
| title_fullStr | Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis |
| title_full_unstemmed | Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis |
| title_short | Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis |
| title_sort | administration of silymarin in nafld nash a systematic review and meta analysis |
| topic | NAFLD Energy metabolism Liver injury Liver histological changes Anthropometric parameters |
| url | http://www.sciencedirect.com/science/article/pii/S1665268123002776 |
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