There was no significant change in the γGT levels .
Significant differences were not found .
CONCLUSION Silymarin minimally reduced , but without clinical relevance , the serum levels of ALT and AST .
AIM To evaluate the effect of silymarin on the serum levels of alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) and gamma glutamyl transpeptidase ( γGT ) in patients with liver diseases .
Effect of silymarin plus vitamin E in patients with non-alcoholic fatty liver disease. A randomized clinical pilot study.
OBJECTIVE Non-alcoholic fatty liver disease ( NAFLD ) is an increasingly recognized health problem . Various treatment strategies such as thiazolidinediones , metformin , lipid-lowering agents and antioxidants have been evaluated . So far , no single intervention has convincingly improved liver histology . Experience of using silymarin alone or in combination with other agents in patients with NAFLD is limited in the medical literature . The present study was conducted to evaluate the efficacy of silymarin plus vitamin E in the treatment of NAFLD . PATIENTS AND METHODS A sample of 36 patients was enrolled . The diagnosis of NAFLD was confirmed by percutaneous liver biopsy . All patients were r and omized to one of the following intervention groups : group I : treated with 2 tablets per day of silymarin plus vitamin E ( Eurosil 85 ® , MEDAS SL ) and a lifestyle modification program consisting of hypocaloric diet ( 1520 kcal , 52 % of carbohydrates , 25 % of lipids and 23 % of proteins ) and exercise for 3 months and group II ( only with the hypocaloric diet )  . Anthropometric variables as waist circumference , weight , body mass index ( BMI ) were measured . Biochemical parameters : Glucose , triglycerides , AST , ALT , GGt levels and insulin resistance ( HOMA-IR ) were determined under fasting conditions . Non-invasive NAFLD-index were applied before and after the treatments : Fatty liver index ( FLI ) , liver accumulation product ( LAP ) and NAFLD-Fibrosis score ( FS ) . RESULTS The mean age was 47.4 ± 11.2 years old ( range 18 - 67 ) ; 22 men and 14 women . In group I , 11 patients ( 61 % ) have a NAS-score > 5 and 10 ( 55.5 % ) in the group II ( NS ) . Anthropometric parameters decreased after treatment in both groups . Patients in both groups showed a decrease in GGt levels after treatment ( group I : 68 IU/L vs. 46.2 ± 27 IU/L ; p < 0.05 and group II 80.5 ± 46 IU/L vs. 50.3 ± 27 IU/L ; p < 0.05 ) . Only in group II we observed a significant decrease in AST and ALT levels . In both groups , we observed a decrease in : FLI index ( group I : 86.2 ± 19 vs. 76.9 + 20 ; p < 0.05 and in group II : 85.2 ± 18 vs. 77.5 ± 23 ; p < 0.05 ) , and NAFLD-FS index ( group I : -1.6 ± 1.8 vs. -2.1 ± 1.5 ; p < 0.05 and in group II -1 ± 1.9 vs. -1.5 ± 2.1 ; p < 0.05 ) . Patients in group I who did not get a 5 % loss of weight also displayed decreased GGt levels , and in the FLI and NAFLD-FS indexes ; whereas patients in group II without decrease of 5 % by weight showed no improvement in any of the analyzed parameters . CONCLUSIONS Treatment with silymarin plus vitamin E and a hypocaloric diet ameliorate function hepatic test , and non-invasive NAFLD index . Silymarin can be an alternative valid therapeutic option particularly when other drugs are not indicated or have failed or as a complementary treatment associated with other therapeutic programs
There was no significant change in the γGT levels .
Significant differences were not found .
CONCLUSION Silymarin minimally reduced , but without clinical relevance , the serum levels of ALT and AST .
AIM To evaluate the effect of silymarin on the serum levels of alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) and gamma glutamyl transpeptidase ( γGT ) in patients with liver diseases .