Table 4.
The efficiency of nutraceutical supplementation in NAFLD patients.
| Study | Nutraceutical | Composition | Group * | Diagnosis | Duration | Results ** | Possible Mechanism |
|---|---|---|---|---|---|---|---|
| Illnait et al. [206] (2013) | D-002–substance derived from beeswax in dose 50 mg twice a day + low fat, low energy diet | Mixture of six of the higher aliphatic alcohols (C26, C26, C28, C30, C32, and C34) | 44 patients with NAFLD (22 in D-002 group) | USG | 24 weeks | ↑: Plasma total antioxidant status ↓: HOMA-IR, insulin, liver steatosis Normalization of liver echo pattern in USG (7 patients), symptoms improvement (12 patients) |
Antioxidant properties; improvement of IR probably through AMP-kinase activation, which leads to metabolic gene regulation and decline of AMP-mediated insulin secretion by pancreatic β-cells |
| Ferro et al. [207] (2022) | Livogen Plus® 6 capsules per day | Doses for 6 capsules: 667 mg of Curcuma longa extract complexed with γ-cyclodextrin, 667 mg of refined fish oil concentrate, 400 mg of BPF and wild type Cynara Cardunculus extract, 334 mg of black seed oil of Nigella sativa, 267 mg of standardized fraction of root of Picrorhiza kurroa, 200 mg reduced GHS and SAMe, 167 mg of Artichoke leaf extract, Indole-3-carbinol and silybin phospholipids, 127 mg of milk thistle fruit dry extract, and other natural compounds |
127 patients with NAFLD (62 in Livogen Plus group) | Transient elastography | 12 weeks | ↓: CAP, DBP, insulin, HOMA-IR Improvement in liver steatosis shown only in subjects with severe NAFLD |
Antioxidant properties; prevention of lipid peroxidation; stimulation of mitochondrial β-oxidation |
| Abidov et al. [208] (2010) | Xanthigen™ 3 capsules per day + calorie restricted diet | 100 mg pomegranate seed oil + 100 mg brown marine algae containing 0.8 mg fucoxanthin | 72 obese females with NAFLD (36 in Xanthigen group) | Magnetic hepatic ultrasound scanning + image-guided proton magnetic resonance spectroscopy | 16 weeks | ↓: BW, WC, body fat content, HFC, CRP, TG, ALT, AST, GGT | Promotion of hepatic fatty acids β-oxidation; increase in resting energy expenditure; weight loss, which promotes decrease in inflammatory cytokines |
| Fogacci et al. [209] (2022) | Eufortyn® Colesterolo Plus 1 tablet per day + 1-month Mediterranean diet standardization before start of the study | Doses per tablet: 1000 mg of Phytosome Bergamot Polyphenolic fraction, 100 mg of Cynara cardunculus L. dry extract, 20 mg of Cynara scolymus L. dry extract, 25 mg of Coenzyme Q10 phytosome and 5 mg of zinc | 56 healthy subjects with polygenic hypercholesterolemia (28 in nutraceutical group) | 8 weeks | ↓: TC, LDL-C, LDL-C to HDL-C ratio, hs-CRP, WC, lipid accumulation products, FLI | Anti-inflammatory and antioxidant properties; inhibition of HMG-CoA reductase; interaction with liver SREPBs and ACAT; increase in bile acids excretion to feces; improvements in endothelial function; regulation of VEGF, ET-1, eNOS genes expression | |
| Vilar Gomez et al. [210] (2009) | Viusid oral sachets 50 g per day + hypocaloric diet + aerobic exercise | 666 mg of malic acid 33 mg of glycyrrhizic acid 666 mg of glucosamine 2 mg of calcium pantothenate 20 mg of ascorbic acid 666 mg of arginine 333 mg of glycine 66 μg of folic acid 600 mg of pyrodoxal 0.3 μg of cyanocobalamine 5 mg of zinc sulphate |
60 patients with NAFLD (30 in Viusid group) | Liver biopsy + histology | 6 months | ↓: NAS, histological: steatosis, hepatocyte ballooning and lobular inflammation | Viusid mechanisms of action remain unclear however may be related to improvements in methylation reactions in hepatocytes, e.g., production of glutathione and improvements in cell membrane integrity, anti-inflammatory, and antioxidant properties |
Abbreviations: ACAT—acetyl-CoA C-acetyltransferase, ALT—alanine aminotransferase, AMP—adenosine monophosphate, AST—aspartate aminotransferase, BPF—bergamot polyphenol fraction, BW—bodyweight, CAP—controlled attenuation parameter, CFU—colony-forming units, CRP—C-reactive protein, DBP—diastolic blood pressure, eNOS—endothelial NO synthase, ET-1—endothelin 1, FLI—fatty liver index, GGT—γ-glutamyltranspeptidase, GHS—glutathione, HDL-C—high density lipoprotein cholesterol, HFC—hepatic fat content, HMG-CoA—3-hydroxy-3-methylglutaryl-Coenzyme A, HOMA-IR—homeostasis model assessment of insulin resistance, LDL-C—low density lipoprotein cholesterol, NAFLD—non-alcoholic fatty liver disease, NAS—NAFLD activity score, VEGF—vascular endothelial growth factor, SAMe—S-adenosyl-l-methionine, SREBP—sterol regulatory element-binding protein, TC—total cholesterol, TG—triglycerides, USG—ultrasonography, WC—waist circumference. * In the group column, the number of respondents analyzed was given, not the people who were included in the study and for various reasons were excluded from it during procedures. ** Changes shown in results column are significant.