Conclusion : Probiotic treatment or supplementation is a promising therapeutic method for NAFLD
Background : Nonalcoholic fatty liver disease ( NAFLD ) has become prevalent in recent decades , especially in developed countries , and approaches for the prevention and treatment of NAFLD are not clear .
The aim of this research was to analyze and summarize r and omized controlled trials that investigated the effects of probiotics on NAFLD .
A Randomized Trial of Silymarin for the Treatment of Nonalcoholic Steatohepatitis
BACKGROUND & AIMS : Silymarin is a complex mixture of 6 major flavonolignans and other minor polyphenolic compounds derived from the milk thistle plant Silybum marianum ; it has shown antioxidant , anti‐inflammatory and antifibrotic effects , and may be useful in patients with nonalcoholic fatty liver disease ( NAFLD ) . We aim ed to study the efficacy of silymarin in patients with nonalcoholic steatohepatitis (NASH)—the more severe form of NAFLD . METHODS : We performed a r and omized , double‐blind , placebo‐controlled trial of consecutive adults with biopsy‐proven NASH and a NAFLD activity score ( NAS ) of 4 or more at a tertiary care hospital in Kuala Lumpur , Malaysia , from November 2012 through August 2014 . Patients were r and omly assigned to groups given silymarin ( 700 mg ; n = 49 patients ) or placebo ( n = 50 patients ) 3 times daily for 48 weeks . After this 48‐week period , liver biopsies were repeated . The primary efficacy outcome was a decrease of 30 % or more in NAS ; findings from 48‐week liver biopsies were compared with those from the baseline biopsy . Secondary outcomes included changes in steatosis , lobular inflammation , hepatocyte ballooning , NAS and fibrosis score , and anthropometric measurements , as well as glycemic , lipid , and liver profiles and liver stiffness measurements . RESULTS : The percentage of patients achieving the primary efficacy outcome did not differ significantly between the groups ( 32.7 % in the silymarin group vs 26.0 % in the placebo group ; P = .467 ) . A significantly higher proportion of patients in the silymarin group had reductions in fibrosis based on histology ( reductions of 1 point or more ; 22.4 % ) than did the placebo group ( 6.0 % ; P = .023 ) , and based on liver stiffness measurements ( decrease of 30 % or more ; 24.2 % ) than did the placebo group ( 2.3 % ; P = .002 ) . The silymarin group also had significant reductions in mean aspartate aminotransferase to platelet ratio index ( reduction of 0.14 , P = .011 compared with baseline ) , fibrosis‐4 score ( reduction of 0.20 , P = .041 compared with baseline ) , and NAFLD fibrosis score ( reduction of 0.30 , P < .001 compared with baseline ) ; these changes were not observed in the placebo group ( reduction of 0.07 , P = .154 ; increase of 0.18 , P = .389 ; and reduction of 0.05 , P = .845 , respectively ) . There was no significant difference between groups in number of adverse events ; adverse events that occurred were not attributed to silymarin . CONCLUSIONS : In a r and omized trial of 99 patients , we found that silymarin ( 700 mg , given 3 times daily for 48 weeks ) did not reduce NAS scores by 30 % or more in a significantly larger proportion of patients with NASH than placebo . Silymarin may reduce liver fibrosis but this remains to be confirmed in a larger trial . It appears to be safe and well tolerated . Clinical Trials.gov : NCT02006498
Conclusion : Probiotic treatment or supplementation is a promising therapeutic method for NAFLD
Background : Nonalcoholic fatty liver disease ( NAFLD ) has become prevalent in recent decades , especially in developed countries , and approaches for the prevention and treatment of NAFLD are not clear .
The aim of this research was to analyze and summarize r and omized controlled trials that investigated the effects of probiotics on NAFLD .