Silymarin decreases liver stiffness associated with gut microbiota in patients with metabolic dysfunction-associated steatotic liver disease: a randomized, double-blind, placebo-controlled trial.

Autor: Jin Y; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080, China.; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, 510080, China., Wang X; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080, China.; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, 510080, China., Chen K; Shunde Hospital (The First People's Hospital of Shunde), Southern Medical University, Foshan, China., Chen Y; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080, China.; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, 510080, China., Zhou L; Shunde Hospital (The First People's Hospital of Shunde), Southern Medical University, Foshan, China., Zeng Y; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080, China.; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, 510080, China., Zhou Y; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080, China.; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, 510080, China., Pan Z; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080, China.; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, 510080, China., Wang D; BYHEALTH Institute of Nutrition & Health, Guangzhou, 510663, China., Li Z; BYHEALTH Institute of Nutrition & Health, Guangzhou, 510663, China., Liang Y; Shunde Hospital (The First People's Hospital of Shunde), Southern Medical University, Foshan, China. 102lyq@163.com., Ling W; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. lingwh@mail.sysu.edu.cn.; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080, China. lingwh@mail.sysu.edu.cn.; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, 510080, China. lingwh@mail.sysu.edu.cn.; School of Public Health and Management, Ningxia Medical University, Xingqing District, Yinchuan, China. lingwh@mail.sysu.edu.cn., Li D; Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. lidan58@mail.sysu.edu.cn.; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080, China. lidan58@mail.sysu.edu.cn.; Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, 510080, China. lidan58@mail.sysu.edu.cn.
Jazyk: angličtina
Zdroj: Lipids in health and disease [Lipids Health Dis] 2024 Aug 03; Vol. 23 (1), pp. 239. Date of Electronic Publication: 2024 Aug 03.
DOI: 10.1186/s12944-024-02220-y
Abstrakt: Background: Despite centuries of traditional use of silymarin for hepatoprotection, current randomized controlled trial (RCT) studies on the effectiveness of silymarin in managing metabolic dysfunction-associated steatotic liver disease (MASLD) are limited and inconclusive, particularly when it is administered alone. The low bioavailability of silymarin highlights the possible influence of gut microbiota on the effectiveness of silymarin; however, no human studies have investigated this aspect.
Objective: To determine the potential efficacy of silymarin in improving MASLD indicators and to investigate the underlying mechanisms related to gut microbiota.
Method: In this 24-week randomized, double-blind, placebo-controlled trial, 83 patients with MASLD were randomized to either placebo (n = 41) or silymarin (103.2 mg/d, n = 42). At 0, 12, and 24 weeks, liver stiffness and hepatic steatosis were assessed using FibroScan, and blood samples were gathered for biochemical detection, while faecal samples were collected at 0 and 24 weeks for 16S rRNA sequencing.
Results: Silymarin supplementation significantly reduced liver stiffness (LSM, -0.21 ± 0.17 vs. 0.41 ± 0.17, P = 0.015) and serum levels of γ-glutamyl transpeptidase (GGT, -8.21 ± 3.01 vs. 1.23 ± 3.16, P = 0.042) and ApoB (-0.02 ± 0.03 vs. 0.07 ± 0.03, P = 0.023) but had no significant effect on the controlled attenuation parameter (CAP), other biochemical indicators (aminotransferases, total bilirubin, glucose and lipid parameters, hsCRP, SOD, and UA), physical measurements (DBP, SBP, BMI, WHR, BF%, and BMR), or APRI and FIB-4 indices. Gut microbiota analysis revealed increased species diversity and enrichment of Oscillospiraceae in the silymarin group.
Conclusion: These findings suggest that silymarin supplementation could improve liver stiffness in MASLD patients, possibly by modulating the gut microbiota.
Trial Registration: The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2200059043).
(© 2024. The Author(s).)
Databáze: MEDLINE
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