Insights & Discussion
Acupuncture relieved hepatic steatosis and reduced total cholesterol and triglyceride in non-alcoholic fatty liver disease patients.
From the 8 included trials, the values of the following examinations were extracted: liver ultrasonography, liver CT, body fat CT, aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyltransferase (GGT), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, fasting blood sugar (FBS), hosmeostatic model assessment for insulin resistance (HOMA-IR), weight, body mass index (BMI), waist hip ratio (WHR), obesity degree, body fat mass, body fat rate, leptin, malondialdehyde (MDA), and super oxide dismutase (SOD). In the 4 outcomes, cure rate in liver ultrasonography (RR=1.56; 95%CI=1.05~2.31; P=0.03), cure rate in liver CT (RR=2.23; 95%CI=1.33~3.72; P=0.002), TC (MD=-0.78; 95%CI=-1.41~-0.15; P=0.02), and TG (MD=-2.05; 95%CI= -3.88~-0.21; P=0.03), acupuncture was more effective than the control intervention.
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Jin Si Huang Ju tea, a traditional Chinese beverage, contains compounds that potentially reduce lipids, mitigate insulin resistance and reduce liver inflammation in vitro.
2023 European Journal of Medicinal Chemistry Effects and mechanism of action of Chrysanthemum morifolium (Jinsi Huangju) on hyperlipidemia and non-alcoholic fatty liver disease Li X, Li R, Wang X, Zhang X, Xiao Z, Wang H, et al.
Animal Study Cholesterol Chrysanthemum NAFLD
The researchers identified 14 compounds in the Jinsi Huangju tea using different spectroscopic techniques, 11 of which had not been previously identified in this plant. Two of these compounds, apigenin-7-O-6″-malonylglucoside and luteolin-7-O-6″-malonylglucoside, were synthesized for the first time with a yield of 1.2% over 5 steps.
In the findings, the natural compound apigenin-7-O-6″-malonylglucoside was found to inhibit the function of pancreatic lipase, reduce cellular lipid contents, and attenuate insulin resistance when tested in vitro. It was also observed to restore lipid and inflammatory profiles in plasma and the liver, as well as reduce hepatic steatosis in non-alcoholic fatty liver disease (NAFLD) mouse models. Thus, Jinsi Huangju and its active components are strong candidates for the development of drugs or functional foods that could provide a therapeutic strategy for hyperlipidaemia and NAFLD.
Pomegranate peel extract, along with a calorie deficit diet, could improve risk factors of metabolic syndrome and reduce fatty liver in patients with non-alcoholic fatty liver disease.
2023 Nutrition Journal Pomegranate (Punica granatum L.) peel extract ameliorates metabolic syndrome risk factors in patients with non-alcoholic fatty liver disease: a randomized double-blind clinical trial Barghchi H, Milkarizi N, Belyani S, Norouzian Ostad A, Askari VR, Rajabzadeh F, et al.
Randomised Controlled Trial NAFLD Pomegranate Peel
In the first phase, the research involved the hydro-alcoholic extraction of the peel of 750 kilograms of pomegranate using the soaking method. The second phase saw patients with non-alcoholic fatty liver disease divided into two groups - a placebo group and a pomegranate peel capsule group. Both groups followed a diet with a 500 kcal deficit for eight weeks. Aspects like intolerance to the treatment, participants' dietary intake, their lipid and glycemic profiles, blood pressure, body composition, insulin resistance indexes and changes in fatty liver disease evaluated through elastography were monitored.
Further, the study reported substantial decreases in multiple indicators such as body weight, waist circumference, body mass index, body fat index, trunk fat, blood pressure, total cholesterol, triglyceride levels, LDL cholesterol, fat free mass, and fasting blood sugar in the group that took pomegranate peel capsules compared to the placebo group. Meanwhile, HDL cholesterol and liver steatosis and stiffness saw improvement. No significant differences, however, were found in the insulin and homeostatic model assessment for insulin resistance between the two groups.
Carotenoid-rich foods like orange carrots were more effective in mitigating Non-alcoholic fatty liver disease than those with low carotenoid levels.
2022 Frontiers in Nutrition Carotenoids in orange carrots mitigate non-alcoholic fatty liver disease progression Balbuena E, Cheng J, Eroglu A
Experimental Study Carrot NAFLD Orange
In this study, male C57BL/6J mice were randomly assigned to one of four experimental diets for a period of 15 weeks: a low-fat diet, a high-fat diet, a high-fat diet with 20% white carrot powders, or a high-fat diet with 20% orange carrot powders.
Observations revealed that those mice on the high-fat diet enriched with carotenoids from the orange carrots gained less weight and displayed less hepatic lipid deposition compared to the white carrot group. Moreover, lower levels of triglyceride content were seen in the orange carrot group. The increase of particular proteins indicated that carotenoids found in orange carrots improved β-oxidation, thereby inhibiting NAFLD development more significantly. Further examination showed noticeably higher mRNA and protein levels of a particular transcription factor.
Chinese medicine formulas for nonalcoholic fatty liver disease were superior to antioxidants in alanine aminotransferase normalization.
2021 World Journal of Acupuncture-Moxibustion Chinese medicine formulas for nonalcoholic fatty liver disease: Overview of systematic reviews Dai L, Zhou WJ, Zhong LLD, Tang XD, Ji G
Review Article Fatty Liver Disease Metabolic Syndrome NAFLD
Seven systematic reviews were ultimately included. All systematic reviews were conducted based on randomized controlled trials and published in the last decade. According to the AMSTAR 2 tool, one systematic review was judged as having a moderate confidence level, whereas the other studies were rated as having a low or extremely low level of confidence. The ROBIS tool showed that the included systematic reviews all had a high risk of bias due to insufficient consideration of identified concerns. According to the GRADE system, only two outcomes were determined as high quality; namely, TCM formulas with the HuoXueHuaYu principle were better than conventional medications in ultrasound improvement, and TCM formulas were superior to antioxidants in alanine aminotransferase normalization. Other outcomes were downgraded to lower levels, mainly because of heterogeneity among studies, not meeting optimal information sample size, and inclusion of excessive numbers of small sample studies. Nevertheless, the evidence quality of extracted outcomes should be further downgraded when applying to clinical practice due to indirectness.
Traditional Chinese medicines such as Shenge formula, Shugan Jianpi Huatan decoction and Heze lipid lowing oral liquid decoction might have positive effects on NAFLD by improving TCM syndrome scores, liver function, and body lipid profile.
2021 Chinese Medicine Efficacy and safety of traditional Chinese medicines for non-alcoholic fatty liver disease: a systematic literature review of randomized controlled trials Liang, Z., Chen, X., Shi, J. et al.
Systematic Review Fatty Liver Disease Metabolic Syndrome NAFLD
A total of 53 RCTs involving 5997 participants with NAFLD were included in this review. Each included RCT tested a different TCMs giving a total of 53 TCMs identified in this study. Based on the evaluation of the RCT results, TCMs might have various beneficial effects such as improving TCM syndrome score, liver function, and body lipid profile. A range of non-serious, reversible adverse effects associated with the use of TCMs were also reported. However, no conclusion about the efficacy and safety of TCMs in NAFLD can be made. The quality of reporting was generally poor and the risks of bias was mostly uncertain in all trials.
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