Fakhri Moloud, Fakheri Hafez, Azadbakht Mohammad, Moosazadeh Mahmood, Yousefi Seyde Sedighe
Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Int J Prev Med. 2022 Jun 24;13:87. doi: 10.4103/ijpvm.IJPVM_313_20. eCollection 2022.
Nonalcoholic fatty liver is the most common chronic liver disease. Regarding the side effects of synthetic medicines and the variety of natural products in Iran climate, the present study aimed to investigate the effect of medicinal plants and natural products on liver enzymes in patients with non-alcoholic fatty liver disease in Iran using meta-analysis.
To extract the intended studies, internal and external databases, including SID, Magiran, IranDoc, PubMed, Scopus, Web of Science, Embase, Cochrane, and Clinical Trial Registration System of Clinical trial.gov, the ISRCTN system, as well as Clinical Trial Registration System affiliated to the World Health Organization were searched. The obtained data were analyzed in STATA.14 software. A P value less than 0.05 was considered statistically significant.
A total of 44 rstudies were reviewed with a sample size of 1298 participant; they were published in the period from 2009 to 2018, silymarin had the highest effect on the reduction of AST (SMD = -2.68), cinnamon excreted the most profound effect on ALT (SMD = -2.69). In addition, cinnamon had the highest effect on gamma-glutamyl transferase (GGT) (SMD:-3.17), and curcumin had the highest effect on alkaline phosphatase (ALP) (SMD = -1.88). In the lipid profile, the effect of medicinal herbs and natural products on lowering total cholesterol and LDL was statistically significant. In the glycemic profile, the effect of medicinal plants and natural products on the reduction of fasting blood sugar, insulin, and hemoglobin A1c levels was statistically significant.
As evidenced by the obtained results, the highest effect of using natural products was observed in the reduction of GGT, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels, respectively; nonetheless, the effect of natural products on ALP reduction was not statistically significant.
非酒精性脂肪性肝病是最常见的慢性肝病。鉴于合成药物的副作用以及伊朗气候下天然产物的多样性，本研究旨在通过荟萃分析探讨药用植物和天然产物对伊朗非酒精性脂肪性肝病患者肝酶的影响。
为提取相关研究，检索了国内外数据库，包括伊朗科学信息数据库（SID）、伊朗医学数据库（Magiran）、伊朗文献数据库（IranDoc）、美国国立医学图书馆生物医学数据库（PubMed）、Scopus数据库、科学引文索引扩展版（Web of Science）、荷兰医学文摘数据库（Embase）、考克兰图书馆（Cochrane）以及美国国立医学图书馆临床试验注册系统（Clinical trial.gov）、国际标准随机对照试验编号注册系统（ISRCTN）以及世界卫生组织附属的临床试验注册系统。所获数据在STATA.14软件中进行分析。P值小于0.05被认为具有统计学意义。
共纳入44项研究，样本量为1298名参与者；这些研究发表于2009年至2018年期间，水飞蓟宾对降低谷草转氨酶（AST）的效果最佳（标准化均数差[SMD]= -2.68），肉桂对谷丙转氨酶（ALT）的影响最为显著（SMD = -2.69）。此外，肉桂对γ-谷氨酰转移酶（GGT）的影响最大（SMD：-3.17），姜黄素对碱性磷酸酶（ALP）的影响最大（SMD = -1.88）。在血脂方面，药用植物和天然产物对降低总胆固醇和低密度脂蛋白的作用具有统计学意义。在血糖方面，药用植物和天然产物对降低空腹血糖、胰岛素和糖化血红蛋白水平的作用具有统计学意义。
研究结果表明，天然产物在降低GGT、天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）水平方面效果最为显著；然而，天然产物对降低ALP的作用无统计学意义。
