Table 1.

Published meta-analysis studies of randomized clinical trials investigating the impact of silibinin/silymarin on classical cardiovascular risk factors.

Reference	Total Studies & Cohorts–Dose Range	Study Objectives	Outcomes
Voroneanu, et al., 2016 [55]	5 RCTs, 270 pts, T2DM Silymarin extract Daily dose 200 and 600 mg	Metabolic parameters, CKD progression, cardiovascular mortality and morbidity	↓ glycemic indices ↔ lipid profile, indefinite effect on CKD, ↔ cardiovascular mortality, ↓ risk for nonfatal MI (only in intensive treatment)
Hadi, et al., 2018 [89]	7 RCTs, 370 pts, T2DM Silymarin extract Daily dose 200, 420 and 600 mg	Metabolic parameters	↓ FBG, ↓ HbA1c, ↓ fasting Insulin, ↓ LDL-C, ↑ HDL-C, ↔ TChol, ↔ TG, ↓ MDA
Mohammadi, et al., 2018 [90]	10 RCTs, 620 pts, dyslipidemia Silymarin extract Daily dose range 280 to 2100 mg	Metabolic parameters	↓ LDL-C, ↓ TG, ↓ TChol, ↑ HDL-C
Xiao, et al., 2020 [91]	15 RCTs & 1 prospective study, 1358 pts, T2DM and/or dyslipidemia Silymarin extract Daily dose range 105 to 1000 mg	Metabolic parameters	↓ FBG, ↓ HbA1c, ↓ HOMA-IR, ↔ FBI, ↓ LDL-C, ↓ TG, ↓ TChol, ↑ HDL-C, ↓ CRP, ↔ MDA, ↔ ALT, ↔ AST, ↔ CPK, ↔ creatinine, ↔ Phosphokinase

Key: ALT, Alanine transaminase; AST, Aspartate transaminase; CKD, chronic kidney disease; FBG, Fasting blood glucose; FBI, fasting blood insulin; HbA1c, glycosylated haemoglobin; HDL-C, High-density lipoprotein-Cholesterol; HOMA-IR, Homeostatic Model Assessment for Insulin Resistance; CRP, C-reactive protein; LDL-C, Low-density lipoprotein-Cholesterol; MI, myocardial infarction; MDA, Malondialdehyde; pts, patients; RCT, randomize controlled trials; T2DM, type 2 diabetes mellitus; TG, triclycerides; ↓, decrease; ↑, increase; ↔, significant change.