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Meta-Analysis
. 2022 Sep 9:13:949746.
doi: 10.3389/fimmu.2022.949746. eCollection 2022.

Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysis

Kailin Yang  1 , Junpeng Chen  2 , Tianqing Zhang  3 , Xiao Yuan  1 , Anqi Ge  4 , Shanshan Wang  1 , Hao Xu  1 , Liuting Zeng  5 , Jinwen Ge  1   6
Affiliations
Meta-Analysis

Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysis

Kailin Yang et al. Front Immunol. .

Abstract

Background: Dietary polyphenol treatment of non-alcoholic fatty liver disease (NAFLD) is a novel direction, and the existing clinical studies have little effective evidence for its therapeutic effect, and some studies have inconsistent results. The effectiveness of dietary polyphenols in the treatment of NAFLD is still controversial. The aim of this study was to evaluate the therapeutic efficacy of oral dietary polyphenols in patients with NAFLD.

Methods: The literature (both Chinese and English) published before 30 April 2022 in PubMed, Cochrane, Medline, CNKI, and other databases on the treatment of NAFLD with dietary polyphenols was searched. Manual screening, quality assessment, and data extraction of search results were conducted strictly according to the inclusion and exclusion criteria. RevMan 5.3 software was used to perform the meta-analysis.

Results: The RCTs included in this study involved dietary supplementation with eight polyphenols (curcumin, resveratrol, naringenin, anthocyanin, hesperidin, catechin, silymarin, and genistein) and 2,173 participants. This systematic review and meta-analysis found that 1) curcumin may decrease body mass index (BMI), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Triglycerides (TG) total cholesterol (TC), and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) compared to placebo; and curcumin does not increase the occurrence of adverse events. 2) Although the meta-analysis results of all randomized controlled trials (RCTs) did not reveal significant positive changes, individual RCTs showed meaningful results. 3) Naringenin significantly decreased the percentage of NAFLD grade, TG, TC, and low-density lipoprotein cholesterol (LDL-C) and increased high-density lipoprotein cholesterol (HDL-C) but had no significant effect on AST and ALT, and it is a safe supplementation. 4) Only one team presents a protocol about anthocyanin (from Cornus mas L. fruit extract) in the treatment of NAFLD. 5) Hesperidin may decrease BMI, AST, ALT, TG, TC, HOMA-IR, and so on. 6) Catechin may decrease BMI, HOMA-IR, and TG level, and it was well tolerated by the patients. 7) Silymarin was effective in improving ALT and AST and reducing hepatic fat accumulation and liver stiffness in NAFLD patients.

Conclusion: Based on current evidence, curcumin can reduce BMI, TG, TC, liver enzymes, and insulin resistance; catechin can reduce BMI, insulin resistance, and TG effectively; silymarin can reduce liver enzymes. For resveratrol, naringenin, anthocyanin, hesperidin, and catechin, more RCTs are needed to further evaluate their efficacy and safety.

Keywords: dietary polyphenol; meta-analysis; natural plant active ingredients; non-alcoholic fatty liver disease; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram.
Figure 2
Figure 2
(A) Risk of bias graph; (B) Risk of bias summary.
Figure 3
Figure 3
Outcomes in curcumin treatment (A: BMI; B: HOMA-IR; C: ALT; D: AST; E: TG; F: TC; G: LDL-C; H: HDL-C). CI, confidence interval; SD, standard deviation.
Figure 4
Figure 4
Outcomes in resveratrol treatment (A: BMI; B: HOMA-IR; C: ALT; D: AST; E: TG; F: TC; G: LDL-C; H: HDL-C).
Figure 5
Figure 5
Outcomes in catechin treatment (A: BMI; B: HOMA-IR; C: ALT; D: AST; E: TG; F: TC; G: LDL-C; H: HDL-C).
Figure 6
Figure 6
Outcomes in silymarin treatment (A: BMI; B: ALT; C: AST).
Figure 7
Figure 7
Schematic diagram of the mechanism of dietary polyphenols in the treatment of NAFLD (SCFAS, short-chain fatty acids; NAFLD, non-alcoholic fatty liver disease).
See this image and copyright information in PMC

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