使用水飞蓟素对代谢功能障碍相关脂肪性肝病患者肝酶和代谢因子的影响:系统综述和荟萃分析。

IF 0.9 Q4 GASTROENTEROLOGY & HEPATOLOGY
Canadian liver journal Pub Date : 2024-02-26 eCollection Date: 2024-02-01 DOI:10.3138/canlivj-2023-0021
Adnan Malik, Muhammad Malik, Shahbaz Qureshi
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引用次数: 0

摘要

背景:脂肪肝包括多种相关的肝脏疾病,主要影响不饮酒或少量饮酒的人群。水飞蓟素是豆科植物水飞蓟的一种,几个世纪以来一直被用于治疗不同的疾病。目前几乎没有证据证明水飞蓟素对人体有疗效:评估水飞蓟素对非酒精性脂肪肝(NAFLD)或最近更名为代谢功能障碍相关性脂肪肝(MASLD)患者的影响:我们在 PubMed、SCOPUS、Web of Science 和 Cochrane 图书馆中搜索了评估水飞蓟素用于非酒精性脂肪肝患者的相关临床试验。使用 Cochrane 的偏倚风险工具对偏倚风险进行了评估。我们纳入了以下结果:丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)(mg/dL)、纤维化缓解程度、低密度脂蛋白(LDL)和 HOMA-IR。我们使用平均差(MD)和相对 95% 置信区间(CI)对连续数据进行了分析:结果:我们纳入了九项临床试验。我们发现,水飞蓟素能显著降低谷丙转氨酶(MD= -17.12 [-28.81, -4.43])(P < 0.004)、谷草转氨酶(MD= -12.56 [-19.02, -6.10])(P < 0.0001)和谷草转氨酶(MD= -22.60 [-23.83, -21.38])(P < 0.00001)的水平。它还改善了高密度脂蛋白(MD= 2.13 [1.60, 2.66])(P < 0.01)。一项研究报告称,纤维化程度明显改善(P = 0.023):水飞蓟素治疗可明显降低MASLD患者的生化指标和转氨酶水平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of silymarin use on liver enzymes and metabolic factors in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis.

Background: Fatty liver disease comprises a wide range of related liver disorders affecting mainly people who drink no or minimal amounts of alcohol. Silymarin is a member of the Carduus marianum family that has been used for centuries to treat different diseases. There is little evidence supporting its efficacy in humans.

Objectives: To evaluate the effects of Silymarin in patients with non alcoholic fatty liver disease (NAFLD) or recently renamed metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods: We searched PubMed, SCOPUS, Web of Science, and Cochrane Library for relevant clinical trials assessing the use of silymarin in patients with NAFLD. A risk of bias assessment was performed using Cochrane's risk of bias tool. We included the following outcomes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) (mg/dL), degree of fibrosis resolution, low-density lipoprotein (LDL), and HOMA-IR. We analyzed continuous data using mean difference (MD) and relative 95% confidence interval (CI).

Results: We included nine clinical trials. We found that silymarin significantly reduced the levels of ALT (MD= -17.12 [-28.81, -4.43]), (P < 0.004), AST (MD= -12.56 [-19.02, -6.10]), (P < 0.0001) and TG (MD = -22.60 [-23.83, -21.38]) (p < 0.00001). It also improved HDL (MD= 2.13 [1.60, 2.66]), (P < 0.01)). There was no significant difference regarding GGT (P=o.07), TC (P= 0.52), LDL (P= 0.06), HOMA-IR (P= 0.06) and BMI (p=0.1).One study reported significant improvement in the degree of fibrosis (P = 0.023).

Conclusion: Silymarin treatment significantly reduces biochemical and transaminase levels in patients with MASLD.

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