Effect of Nutraceutical Supplementation and Mediterranean Hypocaloric Diet on Calculated Steatosis Indices and Inflammation: Clinical and In Vitro Evidences

Abstract

This study evaluated the effect of a nutraceutical supplementation (NS) and Mediterranean hypocaloric diet (MHD) on hepatic steatosis indices (HSIs), γ‐glutamyl transferase (γGT), and lipid profile in adults with hyperlipidemia and nonalcoholic fatty liver disease (NAFLD). In vitro study on HepG2 cells explored potential molecular mechanisms. A retrospective study was conducted on 45 overweight/obese subjects (19 M) prescribed MHD with/without NS. Anthropometric data, biochemical parameters, HSIs, and γGT were collected at baseline and after 3 months. In vitro, cells were pretreated with single and mixed NS components and then with tumor necrosis factor α (TNFα) or fatty acids (FAs). Antioxidant and antiinflammatory activities were evaluated by fluorescence assays and quantitative polymerase chain reaction or enzyme‐linked immunosorbent assay; antiapoptotic effects by Western blot. After 3 months, all subjects improved anthropometric and biochemical parameters but only the combined MHD and NS treatment significantly reduced insulin resistance, HSIs, low‐density lipoprotein cholesterol, and γGT. In vitro, treatment with mixed NS components decreased TNFα‐/FAs‐induced reactive oxygen species. Combined treatment also modulated the inflammatory response by lowering interleukin‐6 and interleukin‐1β, increasing interleukin‐10 and pro‐caspase 8 expression. These findings suggest that NS, due to its antiinflammatory properties, represents a promising strategy for NAFLD management.