Table 3. Role of supplements in NASH and NAFLD from systematic reviews and meta-analyses.
NAFLD: nonalcoholic fatty live disease; NASH: nonalcoholic steatohepatitis; BMI: body mass index; ALT: alanine transaminase; AST: aspartate transaminase; TG: triglyceride; TC: total cholesterol; LDL-C: low-density lipoprotein-cholesterol; MS: metabolic syndrome; RCCT: randomized control clinical trials
| Author (year) | Study design | Supplements | Conclusion | |
| Carpi et al. (2022) [28] | Systematic review | Probiotics | Probiotics do not play a healing role and work by preventing the formation of toxic metabolites in the liver | |
| Yang et al. (2022) [29] | Systematic review and meta-analysis | Polyphenols | Curcumin | Decreased BMI, ALT, AST, TG, and TC |
| Naringenin | Decreased percentage of NAFLD, TG, TC, and LDL-C | |||
| Silymarin | Improved AST, ALT, liver fat, and stiffness, which play a liver-protective role | |||
| Gurusamy et al. (2018) [30] | Meta-analysis and review of 202 RCTs | Nutritional supplementation | The evidence indicates considerable uncertainty about effect for people with NAFLD | |
| Hariri et al. (2019) [31] | Systematic review of RCCTs | Vitamin D | Vitamin D improves lipid profile and inflammatory mediators without significant effect on liver enzymes and might improve symptoms of NAFLD | |
| Sharpton et al. (2019) [32] | Systematic review and meta-analyses | Probiotics and synbiotics | Improvement of liver-specific markers (ALT), liver stiffness measurement by elastography, and liver steatosis | |
| Pani et al. (2020) [33] | Systematic review | Inositol deficiencies | Increased fatty liver in animals | |
| Wei et al. (2021) [34] | Systematic review and meta-analyses | Resveratrol | Resveratrol supplementation did not result in significant changes in ALT and AST | |
| Dludla et al. (2020) [35] | Meta-analyses of RCT | Coenzyme Q10 | Lower inflammation markers in MS patients | |
| Lee et al. (2020) [36] | Systematic review and meta-analyses | Omega-3 polyunsaturated fatty acids | Significantly improved TG, HDL, TC, and BMI | |
| Liu et al. (2023) [37] | Systematic review and meta-analyses | L-carnitine | Improves liver function tests and regulates TG | |
| Chung et al. (2014) [38] | Systematic review and meta-analyses | High-fructose corn syrup | There was insufficient evidence to draw conclusions | |