Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Via del Vespro 141, 90127 Palermo, Italy.
Department of Science and Drug Technology, University of Turin, Turin, Italy.
Pharmacol Res. 2023 Mar;189:106679. doi: 10.1016/j.phrs.2023.106679. Epub 2023 Feb 8.
Non-Alcoholic Fatty Liver Disease (NAFLD) is a common condition affecting around 10-25% of the general adult population, 15% of children, and even > 50% of individuals who have type 2 diabetes mellitus. It is a major cause of liver-related morbidity, and cardiovascular (CV) mortality is a common cause of death. In addition to being the initial step of irreversible alterations of the liver parenchyma causing cirrhosis, about 1/6 of those who develop NASH are at risk also developing CV disease (CVD). More recently the acronym MAFLD (Metabolic Associated Fatty Liver Disease) has been preferred by many European and US specialists, providing a clearer message on the metabolic etiology of the disease. The suggestions for the management of NAFLD are like those recommended by guidelines for CVD prevention. In this context, the general approach is to prescribe physical activity and dietary changes the effect weight loss. Lifestyle change in the NAFLD patient has been supplemented in some by the use of nutraceuticals, but the evidence based for these remains uncertain. The aim of this Position Paper was to summarize the clinical evidence relating to the effect of nutraceuticals on NAFLD-related parameters. Our reading of the data is that whilst many nutraceuticals have been studied in relation to NAFLD, none have sufficient evidence to recommend their routine use; robust trials are required to appropriately address efficacy and safety.
非酒精性脂肪性肝病（NAFLD）是一种常见的疾病，影响着大约 10-25%的普通成年人群、15%的儿童，甚至超过 50%的 2 型糖尿病患者。它是导致肝脏相关发病率的主要原因，心血管（CV）死亡率是常见的死亡原因。除了是导致肝硬化的肝脏实质不可逆转改变的初始步骤外，约有 1/6的 NASH 患者也有发生心血管疾病（CVD）的风险。最近，许多欧洲和美国的专家更喜欢使用缩写词 MAFLD（代谢相关脂肪性肝病），这更清楚地说明了疾病的代谢病因。NAFLD 管理建议与 CVD 预防指南推荐的建议相似。在这种情况下，一般的方法是规定体育活动和饮食改变以达到减肥的效果。在一些 NAFLD 患者中，生活方式的改变已经通过使用营养保健品来补充，但这些的证据仍然不确定。本立场文件的目的是总结与营养保健品对 NAFLD 相关参数的影响相关的临床证据。我们对数据的解读是，虽然已经研究了许多营养保健品与 NAFLD 的关系，但没有一种有足够的证据推荐其常规使用；需要进行强有力的试验来适当解决疗效和安全性问题。
