scholarly journals Efficacy of Ursodeoxycholic Acid in Nonalcoholic Fatty Liver Disease: An Updated Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Author(s):  
Wenyue Zhang ◽  
Yao Tang ◽  
Juan Huang ◽  
Hong Ren ◽  
Yixuan Yang ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Ursodeoxycholic Acid ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Total Bilirubin ◽  
Meta Analysis ◽  
Nonalcoholic Fatty Liver ◽  
Randomized Controlled

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is a kind of chronic liver disease among general population. Recent years, more and more new experiments have made the role of ursodeoxycholic acid (UDCA) become clearer. In this meta-analysis, we analyzed the efficacy of ursodeoxycholic acid (UDCA) for the treatment of nonalcoholic fatty liver disease (NAFLD). Methods We searched the Web of Science, Pubmed, Embase and Cochrane library databases for relavent studies published before March 1, 2019. We examined 134 randomized controlled trials (RCTs) that investigated the effectiveness of UDCA in NAFLD against placebo or other treatments. Next, we conducted meta-analysis by Stata(version 12.0) to examine the change among several indices: Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), Alkaline phosphatase (AP), total bilirubin and albumin. Results Following the application of different inclusion and exclusion criteria, 9 articles with 1106 participants were finally selected. The forest plot displayed that UDCA treatment can significantly decrease the ALT levels among the NAFLD patients (SMD=0.17,95%CI [0.03 to 0.3], P=0.07). However, UDCA treatment did not significantly affect the AST, GGT, AP, total bilirubin and albumin levels. Further, the subgroup analyses suggested the significant role of UDCA treatment in different geographical regions, age group and treatment duration (P=0.003 in people from Europe, P=0.001 in people older than 50 years and P=0.008 in longer duration(>6 months)). Conclusion In this study, several indices we analyzed among 9 articles. UDCA treatment was found beneficial in lowering the ALT levels in NAFLD patients. The remaining indices like AST, GGT, AP showed non-significant changes in this analysis. This could be attributed for the insufficient number of trials because all parameters were not analyzed in each individual RCT. Therefore, future meta-analysis will be required to fully confirm and validate the efficacy of UDCA in NAFL.

scholarly journals The Therapeutic Effect of Berberine in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Xiaoyun Wei ◽  
Chunyan Wang ◽  
Shijun Hao ◽  
Haiyan Song ◽  
Lili Yang
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Fatty Liver ◽  
Randomized Controlled Trials ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Nonalcoholic Fatty Liver ◽  
Randomized Controlled

Aim. To assess the efficacy of berberine in the treatment of nonalcoholic fatty liver disease through meta-analysis.Method. We searched Embase, Pubmed, Cochrane Library, and so forth, until March 2016 for randomized controlled trials using berberine to treat NAFLD.Result. Six randomized controlled trials involving 501 patients were included in this study. The results showed that the efficacy of reducing TC, LDL, ALT, 2hPG, and HbA1c in NAFLD patients of the berberine group were significantly higher than that of control group. The subgroup analyses on TG, AST, and FBG indicated that treatment combined with berberine decreased TG level in NAFLD patients significantly. Compared with other drugs, berberine alone decreased TG level in NAFLD patients significantly. We also conducted a descriptive analysis on insulin resistance and radiography results that berberine can improve NAFLD patients’ insulin resistance and fatty liver.Conclusion. According to analysis result, berberine has positive efficacy on blood lipids, blood glucose, liver function, insulin resistance, and fatty liver condition of NAFLD patients. However, due to the limitation of number and quality of trials included, more clinical randomized controlled trials with high quality are needed for further verification of the efficacy of berberine on NAFLD patients.

scholarly journals Role of Probiotics in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-analysis

2017 ◽  
Vol 7 (2) ◽  
pp. 130-137 ◽  
Author(s):  
Anurag S Lavekar ◽  
Dhananjay V Raje ◽  
Amarja A Lavekar
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Meta Analysis ◽  
Model Assessment ◽  
Ongoing Research ◽  
Nonalcoholic Fatty Liver ◽  
Probiotic Treatment

ABSTRACT Aim Despite extensive ongoing research, there is scarcity of widely accepted therapeutic options for the treatment of nonalcoholic fatty liver disease (NAFLD). Probiotics are a promising treatment option for treating NAFLD; however, their effectiveness needs to be established. Since any single randomized controlled trial (RCT) cannot establish the role of probiotics in the treatment of NAFLD, this study aims at meta-analysis of different RCTs. Materials and methods Extensive search was done by two independent observers for RCTs studying the role of probiotics in the treatment of NAFLD. The parameters under consideration were body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), homeostatic model assessment of insulin resistance (HOMA-IR), serum triglycerides (TGs), and ultrasonographic grades of fatty liver. Jadad scale was used to select the articles for meta-analysis. Heterogeneity in the results was evaluated using chi-square test and I2. Significant heterogeneity in the results was decided based on p-value < 0.05 and the corresponding I2 close to 0%. Results Seven studies qualified for meta-analysis. Use of probiotics significantly caused reduction in BMI (p < 0.0001), ALT (p < 0.0001), AST (< 0.0001), HOMA-IR (p = 0.006), and ultrasonographic grade of fatty liver (p = 0.0051). Heterogeneity in other parameters was contributed mainly by couple of previous studies. Conclusion Meta-analysis shows that variety of parameters has significant improvement after probiotic treatment in different RCTs. However, the magnitude of improvement is not uniform across studies due to varying strains, dose patterns, and treatment duration. In future, probiotics remain a promising option for treating NAFLD. How to cite this article Lavekar AS, Raje DV, Manohar T, Lavekar AA. Role of Probiotics in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-analysis. Euroasian J Hepato-Gastroenterol 2017;7(2):130-137.

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