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Meta-Analysis
. 2021 Jul 19;7(7):CD013157.
doi: 10.1002/14651858.CD013157.pub2.

Nutritional supplementation for nonalcohol-related fatty liver disease: a network meta-analysis

Oluyemi Komolafe  1 , Elena Buzzetti  2 , Audrey Linden  3 , Lawrence Mj Best  3 , Angela M Madden  4 , Danielle Roberts  3 , Thomas Jg Chase  5 , Dominic Fritche  6 , Suzanne C Freeman  7 , Nicola J Cooper  7 , Alex J Sutton  7 , Elisabeth Jane Milne  8 , Kathy Wright  9 , Chavdar S Pavlov  10 , Brian R Davidson  3 , Emmanuel Tsochatzis  2 , Kurinchi Selvan Gurusamy  3   10
Affiliations
Meta-Analysis

Nutritional supplementation for nonalcohol-related fatty liver disease: a network meta-analysis

Oluyemi Komolafe et al. Cochrane Database Syst Rev. .

Abstract

Background: The prevalence of non-alcohol-related fatty liver disease (NAFLD) varies between 19% and 33% in different populations. NAFLD decreases life expectancy and increases risks of liver cirrhosis, hepatocellular carcinoma, and the requirement for liver transplantation. Uncertainty surrounds relative benefits and harms of various nutritional supplements in NAFLD. Currently no nutritional supplement is recommended for people with NAFLD.

Objectives: • To assess the benefits and harms of different nutritional supplements for treatment of NAFLD through a network meta-analysis • To generate rankings of different nutritional supplements according to their safety and efficacy SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Science Citation Index Expanded, Conference Proceedings Citation Index-Science, the World Health Organization International Clinical Trials Registry Platform, and trials registers until February 2021 to identify randomised clinical trials in people with NAFLD.

Selection criteria: We included only randomised clinical trials (irrespective of language, blinding, or status) for people with NAFLD, irrespective of method of diagnosis, age and diabetic status of participants, or presence of non-alcoholic steatohepatitis (NASH). We excluded randomised clinical trials in which participants had previously undergone liver transplantation.

Data collection and analysis: We performed a network meta-analysis with OpenBUGS using Bayesian methods whenever possible and calculated differences in treatments using hazard ratios (HRs), odds ratios (ORs), and rate ratios with 95% credible intervals (CrIs) based on an available-case analysis, according to National Institute of Health and Care Excellence Decision Support Unit guidance.

Main results: We included in the review a total of 202 randomised clinical trials (14,200 participants). Nineteen trials were at low risk of bias. A total of 32 different interventions were compared in these trials. A total of 115 trials (7732 participants) were included in one or more comparisons. The remaining trials did not report any of the outcomes of interest for this review. Follow-up ranged from 1 month to 28 months. The follow-up period in trials that reported clinical outcomes was 2 months to 28 months. During this follow-up period, clinical events related to NAFLD such as mortality, liver cirrhosis, liver decompensation, liver transplantation, hepatocellular carcinoma, and liver-related mortality were sparse. We did not calculate effect estimates for mortality because of sparse data (zero events for at least one of the groups in the trial). None of the trials reported that they measured overall health-related quality of life using a validated scale. The evidence is very uncertain about effects of interventions on serious adverse events (number of people or number of events). We are very uncertain about effects on adverse events of most of the supplements that we investigated, as the evidence is of very low certainty. However, people taking PUFA (polyunsaturated fatty acid) may be more likely to experience an adverse event than those not receiving an active intervention (network meta-analysis results: OR 4.44, 95% CrI 2.40 to 8.48; low-certainty evidence; 4 trials, 203 participants; direct evidence: OR 4.43, 95% CrI 2.43 to 8.42). People who take other supplements (a category that includes nutritional supplements other than vitamins, fatty acids, phospholipids, and antioxidants) had higher numbers of adverse events than those not receiving an active intervention (network meta-analysis: rate ratio 1.73, 95% CrI 1.26 to 2.41; 6 trials, 291 participants; direct evidence: rate ratio 1.72, 95% CrI 1.25 to 2.40; low-certainty evidence). Data were sparse (zero events in all groups in the trial) for liver transplantation, liver decompensation, and hepatocellular carcinoma. So, we did not perform formal analysis for these outcomes. The evidence is very uncertain about effects of other antioxidants (antioxidants other than vitamins) compared to no active intervention on liver cirrhosis (HR 1.68, 95% CrI 0.23 to 15.10; 1 trial, 99 participants; very low-certainty evidence). The evidence is very uncertain about effects of interventions in any of the remaining comparisons, or data were sparse (with zero events in at least one of the groups), precluding formal calculations of effect estimates. Data were probably because of the very short follow-up period (2 months to 28 months). It takes follow-up of 8 to 28 years to detect differences in mortality between people with NAFLD and the general population. Therefore, it is unlikely that differences in clinical outcomes are noted in trials providing less than 5 to 10 years of follow-up.

Authors' conclusions: The evidence indicates considerable uncertainty about effects of nutritional supplementation compared to no additional intervention on all clinical outcomes for people with non-alcohol-related fatty liver disease. Accordingly, high-quality randomised comparative clinical trials with adequate follow-up are needed. We propose registry-based randomised clinical trials or cohort multiple randomised clinical trials (study design in which multiple interventions are trialed within large longitudinal cohorts of patients to gain efficiencies and align trials more closely to standard clinical practice) comparing interventions such as vitamin E, prebiotics/probiotics/synbiotics, PUFAs, and no nutritional supplementation. The reason for the choice of interventions is the impact of these interventions on indirect outcomes, which may translate to clinical benefit. Outcomes in such trials should be mortality, health-related quality of life, decompensated liver cirrhosis, liver transplantation, and resource utilisation measures including costs of intervention and decreased healthcare utilisation after minimum follow-up of 8 years (to find meaningful differences in clinically important outcomes).

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Conflict of interest statement

None known for any of the review authors.

Figures

1
1
Network plots: a high resolution version of this image can be found here. The network plots showing outcomes for which network meta‐analysis was performed. The size of the node (circle) provides a measure of the number of trials in which the particular Intervention was included as one of the intervention groups. The thickness of the line provides a measure of the number of direct comparisons between two nodes (interventions). Abbreviations Please see Appendix 2.
2
2
Study flow diagram. Date of search: 25 February 2021.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
5
5
Forest plots showing the network estimates for outcomes for which a formal analysis was performed. The more conservative random‐effects model was used when there were differences between fixed‐effect and random‐effects models. A higher resolution image of this picture is available here. Abbreviations Please see Appendix 2.
See this image and copyright information in PMC

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References

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Dufour 2006 {published data only}
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    1. Dufour JF, Oneta CM, Gonvers JJ, Bihl F, Cerny A, Cereda JM, et al. Randomized placebo-controlled trial of ursodeoxycholic acid with vitamin E in nonalcoholic steatohepatitis. Clinical Gastroenterology and Hepatology 2006;4(12):1537-43. - PubMed
Duseja 2019 {published data only}
    1. Duseja A, Acharya SK, Mehta M, Chhabra S, Shalimar, Rana S, et al. High potency multistrain probiotic improves liver histology in non-alcoholic fatty liver disease (NAFLD): a randomised, double-blind, proof of concept study. BMJ Open Gastroenterology 2019;6:e000315. - PMC - PubMed
    1. Duseja AK, Acharya SK, Mehta M, Chhabra S, Shalimar, Rana S, et al. Probiotic VSL#3 improves liver histology in patients with nonalcoholic fatty liver disease - a proof of concept study. Hepatology (Baltimore, Md) 2016;64(1 Suppl 1):596a.
Ebrahimi‐Mameghani 2016 {published data only}
    1. Ebrahimi-Mameghani M, Jamali H, Mahdavi R, Kakaei F, Abedi R, Kabir-Mamdooh B. Conjugated linoleic acid improves glycemic response, lipid profile, and oxidative stress in obese patients with non-alcoholic fatty liver disease: a randomized controlled clinical trial. Croatian Medical Journal 2016;57(4):331-42. - PMC - PubMed
Ebrahimi‐Mameghani 2017 {published data only}
    1. Ebrahimi-Mameghani M, Sadeghi Z, Abbasalizad Farhangi M, Vaghef-Mehrabany E, Aliashrafi S. Glucose homeostasis, insulin resistance and inflammatory biomarkers in patients with non-alcoholic fatty liver disease: beneficial effects of supplementation with microalgae chlorella vulgaris: a double-blind placebo-controlled randomized clinical trial. Clinical Nutrition 2017;36(4):1001-6. - PubMed
Eghtesadi 2016 {published data only}
    1. Eghtesadi S, Amiri Moghadam S, Nemati M, Khalili M, Mojarrad M, Jazayeri S, et al. Effects of L-carnitine supplementation on inflammatory factors and malondialdehyde in patients with nonalcoholic steatohepatitis (NASH). Obesity Facts 2016;9:184.
Ekhlasi 2016 {published data only}
    1. Ekhlasi G, Kolahdouz Mohammadi R, Agah S, Zarrati M, Hosseini AF, Arabshahi SS, et al. Do symbiotic and vitamin E supplementation have favorite effects in nonalcoholic fatty liver disease? A randomized, double-blind, placebo-controlled trial. Journal of Research in Medical Sciences 2016;21:106. - PMC - PubMed
    1. Ekhlasi G, Zarrati M, Agah S, Hosseini AF, Hosseini S, Shidfar S, et al. Effects of symbiotic and vitamin E supplementation on blood pressure, nitric oxide and inflammatory factors in non-alcoholic fatty liver disease. Excli Journal 2017;16:278-90. - PMC - PubMed
Eriksson 2018 {published data only}
    1. Eriksson JW, Lundkvist P, Jansson PA, Johansson L, Kvarnstrom M, Moris L, et al. Effects of dapagliflozin and n-3 carboxylic acids on non-alcoholic fatty liver disease in people with type 2 diabetes: a double-blind randomised placebo-controlled study. Diabetologia 2018;61(9):1923-34. - PMC - PubMed
Eslamparast 2014 {published data only}
    1. Eslamparast T, Poustchi H, Zamani F, Sharafkhah M, Malekzadeh R, Hekmatdoost A. Synbiotic supplementation in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled pilot study. American Journal of Clinical Nutrition 2014;99(3):535-42. - PubMed
EUCTR 2008‐008275‐34‐GB {published data only}
    1. EUCTR 2008-008275-34-GB. The effect of omega-3 fatty acids on non-alcoholic fatty liver disease. www.clinicaltrialsregister.eu/ctr-search/trial/2008-008275-34/GB (first received 6 July 2009).
EUCTR 2009‐017080‐41‐GB {published data only}
    1. EUCTR 2009-017080-41-GB. A randomised, partially-blind, placebo-controlled, pilot, dose-ranging study to assess the effect of cannabidiol (CBD) on liver fat levels in subjects with fatty liver disease. www.clinicaltrialsregister.eu/ctr-search/search?query=2009-017080-41 (first received 17 March 2010).
Fabbrini 2010 {published data only}
    1. Fabbrini E, Mohammed BS, Korenblat KM, Magkos F, McCrea J, Patterson BW, et al. Effect of fenofibrate and niacin on intrahepatic triglyceride content, very low-density lipoprotein kinetics, and insulin action in obese subjects with nonalcoholic fatty liver disease. Journal of Clinical Endocrinology and Metabolism 2010;95(6):2727-35. - PMC - PubMed
Faghihzadeh 2015 {published data only}
    1. Faghihzadeh F, Adibi P, Hekmatdoost A. The effects of resveratrol supplementation on cardiovascular risk factors in patients with non-alcoholic fatty liver disease: a randomised, double-blind, placebo-controlled study. British Journal of Nutrition 2015;114(5):796-803. - PubMed
Famouri 2017a {published data only}
    1. Famouri F, Shariat Z, Hashemipour M, Keikha M, Kelishadi R. Effects of probiotics on nonalcoholic fatty liver disease in obese children and adolescents. Journal of Pediatric Gastroenterology and Nutrition 2017;64(3):413-7. - PubMed
Farhangi 2014 {published data only}
    1. Farhangi MA, Alipour B, Jafarvand E, Khoshbaten M. Oral coenzyme q10 supplementation in patients with nonalcoholic fatty liver disease: effects on serum vaspin, chemerin, pentraxin 3, insulin resistance and oxidative stress. Archives of Medical Research 2014;45(7):589-95. - PubMed
Farsi 2016 {published data only}
    1. Farsi F, Mohammadshahi M, Alavinejad P, Rezazadeh A, Zarei M, Engali KA. Functions of coenzyme q10 supplementation on liver enzymes, markers of systemic inflammation, and adipokines in patients affected by nonalcoholic fatty liver disease: a double-blind, placebo-controlled, randomized clinical trial. Journal of the American College of Nutrition 2016;35(4):346-53. - PubMed
Farzin 2020 {published data only}
    1. Farzin L, Asghari S, Rafraf M, Asghari-Jafarabadi M, Shirmohammadi M. No beneficial effects of resveratrol supplementation on atherogenic risk factors in patients with nonalcoholic fatty liver disease. International Journal for Vitamin & Nutrition Research 2020;90(3-4):279-89. - PubMed
Fathi 2020 {published data only}
    1. Fathi M, Alavinejad P, Haidari Z, Amani R. The effect of zinc supplementation on steatosis severity and liver function enzymes in overweight/obese patients with mild to moderate non-alcoholic fatty liver following calorie-restricted diet: a double-blind, randomized placebo-controlled trial. Biological Trace Element Research 2020;197(2):394-404. - PubMed
    1. Fathi M, Alavinejad P, Haidari Z, Amani R. The effects of zinc supplementation on metabolic profile and oxidative stress in overweight/obese patients with non-alcoholic fatty liver disease: a randomized, double-blind, placebo-controlled trial. Journal of Trace Elements in Medicine & Biology 2020;62:126635. - PubMed
Fernandez‐Travieso 2020 {published data only}
    1. Fernandez-Travieso JC, Rodriguez-Perez I, Ruenes-Domech C, lIlnait-Ferrer J, Fernandez-Dorta L, Mendoza-Castano S. Benefits of the therapy with abexol in patients with non-alcoholic fatty liver disease. Gastroenterology Research 2020;13(2):73-80. - PMC - PubMed
Ferolla 2016 {published data only}
    1. Ferolla SM, Couto CA, Armiliato GN, Silva LC, Lima EC, Lisboa QC, et al. Improvement in hepatic steatosis in nonalcoholic steatohepatitis in response to synbiotic supplementation. Hepatology (Baltimore, Md) 2015;62:1280a.
    1. Ferolla SM, Couto CA, Costa-Silva L, Armiliato GN, Pereira CA, Martins FS, et al. Beneficial effect of synbiotic supplementation on hepatic steatosis and anthropometric parameters but not on gut permeability in a population with nonalcoholic steatohepatitis. Nutrients 2016;8(7):28. - PMC - PubMed
Ferro 2020 {published data only}
    1. Ferro Y, Montalcini T, Mazza E, Foti D, Angotti E, Gliozzi M, et al. Randomized clinical trial: Bergamot citrus and wild cardoon reduce liver steatosis and body weight in non-diabetic individuals aged over 50 years. Frontiers in Endocrinology 2020;11:494. - PMC - PubMed
Foroughi 2014 {published data only}
    1. Foroughi M, Maghsoudi Z, Ghiasvand R, Iraj B, Askari G. Effect of vitamin D supplementation on C-reactive protein in patients with nonalcoholic fatty liver. International Journal of Preventive Medicine 2014;5(8):969-75. - PMC - PubMed
Gavrilescu 2017 {published data only}
    1. Gavrilescu O, Savin A, Chiosa AM, Dorobaf A, Mihai C. Effects of prebiotics on non-alcoholic fatty liver disease. Journal of Gastrointestinal and Liver Diseases 2017;26(Suppl 3):10-1.
Geier 2018 {published data only}
    1. Geier A, Eichinger M, Stirnimann G, Semela D, Tay F, Seifert B, et al. Treatment of non-alcoholic steatohepatitis patients with vitamin D: a double-blinded, randomized, placebo-controlled pilot study. Scandinavian Journal of Gastroenterology 2018;53(9):1114-20. - PubMed
Ghaffari 2018 {published data only}
    1. Ghaffari A, Rafraf M, Navekar R, Asghari-Jafarabadi M. Effects of turmeric and chicory seed supplementation on antioxidant and inflammatory biomarkers in patients with non-alcoholic fatty liver disease (NAFLD). Advances in Integrative Medicine 2018;5(3):89-95.
Ghergherehchi 2013 {published data only}
    1. Ghergherehchi R, Hazhir N, Gharehbaghi MM. Lifestyle intervention and vitamin E therapy in obese children with nonalcoholic fatty liver disease. Journal of Comprehensive Pediatrics 2013;4(1):62-5.
Gianturco 2013 {published data only}
    1. Gianturco V, Troisi G, Bellomo A, Bernardini S, D'Ottavio E, Formosa V, et al. Impact of combined therapy with alpha-lipoic and ursodeoxycholic acid on nonalcoholic fatty liver disease: double-blind, randomized clinical trial of efficacy and safety. Hepatology International 2013;7(2):570-6. - PubMed
Gomez 2009 {published data only}
    1. Vilar Gomez E, Rodriguez De Miranda A, Gra Oramas B, Arus Soler E, Llanio Navarro R, Calzadilla Bertot L, et al. Clinical trial: a nutritional supplement viusid, in combination with diet and exercise, in patients with nonalcoholic fatty liver disease. Alimentary Pharmacology & Therapeutics 2009;30(10):999-1009. - PubMed
Gonciarz 2012 {published data only}
    1. Gonciarz M, Gonciarz Z, Bielanski W, Mularczyk A, Konturek PC, Brzozowski T, et al. The effects of long-term melatonin treatment on plasma liver enzymes levels and plasma concentrations of lipids and melatonin in patients with nonalcoholic steatohepatitis: a pilot study. Journal of Physiology and Pharmacology 2012;63(1):35-40. - PubMed
Guo 2016 {published data only}
    1. Guo W, Gao M-s, Li W, Peng C, Xie H-y, Tan Y. Effects of metformin combined with enteric bifid-triple viable capsule on nonalcoholic fatty liver disease. Chinese Journal of New Drugs 2016;25(4):439-42.
Harrison 2003 {published data only}
    1. Harrison SA, Torgerson S, Hayashi P, Ward J, Schenker S. Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis. American Journal of Gastroenterology 2003;98(11):2485-90. - PubMed
Hashemi 2009 {published data only}
    1. Hashemi SJ, Hajiani E, Sardabi EH. A placebo-controlled trial of silymarin in patients with nonalcoholic fatty liver disease. Hepatitis Monthly 2009;9(4):265-70.
Heeboll 2016 {published data only}
    1. Heeboll S, Kreuzfeldt M, Hamilton-Dutoit S, Poulsen MK, Stodkilde-Jorgensen H, Moller HJ, et al. Placebo-controlled, randomised clinical trial: high-dose resveratrol treatment for non-alcoholic fatty liver disease. Scandinavian Journal of Gastroenterology 2016;51(4):456-63. - PubMed
Hong 2016 {published data only}
    1. Hong M, Lee YH, Kim S, Suk KT, Bang CS, Yoon JH, et al. Anti-inflammatory and antifatigue effect of Korean red ginseng in patients with nonalcoholic fatty liver disease. Journal of Ginseng Research 2016;40(3):203-10. - PMC - PubMed
Hong 2021 {published data only}
    1. Hong JT, Lee MJ, Yoon SJ, Shin SP, Bang CS, Baik GH, et al. Effect of Korea red ginseng on nonalcoholic fatty liver disease: an association of gut microbiota with liver function. Journal of Ginseng Research 2021;45(2):316-24. - PMC - PubMed
Hormoznejad 2020 {published data only}
    1. Hormoznejad R, Mohammad Shahi M, Rahim F, Helli B, Alavinejad P, Sharhani A. Combined cranberry supplementation and weight loss diet in non-alcoholic fatty liver disease: a double-blind placebo-controlled randomized clinical trial. International Journal of Food Sciences & Nutrition 2020;71(8):991-1000. - PubMed
Hoseini 2020 {published data only}
    1. Hoseini Z, Behpoor N, Hoseini R. Co-treatment with vitamin D supplementation and aerobic training in elderly women with vitamin D deficiency and NAFLD: a single-blind controlled trial. Hepatitis Monthly 2020;20(2):e96437.
Hosseinabadi 2020 {published data only}
    1. Hosseinabadi S, Rafraf M, Asghari S, Asghari-Jafarabadi M, Vojouhi S. Effect of green coffee extract supplementation on serum adiponectin concentration and lipid profile in patients with non-alcoholic fatty liver disease: a randomized, controlled trial. Complementary Therapies in Medicine 2020;49:102290. - PubMed
    1. Hosseinabadi S, Rafraf M, Mahmoodzadeh A, Asghari-Jafarabadi M, Asghari S. Effects of green coffee extract supplementation on glycemic indexes, leptin, and obesity values in patients with non-alcoholic fatty liver disease. Journal of Herbal Medicine 2020;22:100340. - PubMed
Hosseini 2018 {published data only}
    1. Hosseini SM, Aliashrafi S, Ebrahimi-Mameghani M. The effect of a single intramuscular injection of cholecalciferol on the serum levels of vitamin D, adiponectin, insulin resistance, and liver function in women with non-alcoholic fatty liver disease (NAFLD): a randomized, controlled clinical trial. Iranian Red Crescent Medical Journal 2018;20(10):e60746.
Hussain 2017 {published data only}
    1. Hussain M, Habib Ur R, Akhtar L. Therapeutic benefits of green tea extract on various parameters in non-alcoholic fatty liver disease patients. Pakistan Journal of Medical Sciences 2017;33(4):931-6. - PMC - PubMed
Illnait 2013 {published data only}
    1. Illnait J, Rodriguez I, Mendoza S, Fernandez Y, Mas R, Miranda M, et al. Effects of d-002, a mixture of high molecular weight beeswax alcohols, on patients with nonalcoholic fatty liver disease. Korean Journal of Internal Medicine 2013;28(4):439-48. - PMC - PubMed
Izadi 2021 {published data only}
    1. Izadi F, Farrokhzad A, Tamizifar B, Tarrahi MJ, Entezari MH. Effect of sour tea supplementation on liver enzymes, lipid profile, blood pressure, and antioxidant status in patients with non-alcoholic fatty liver disease: a double-blind randomized controlled clinical trial. Phytotherapy Research 2021;35(1):477-85. - PubMed
Jameshorani 2017 {published data only}
    1. Jameshorani M, Rafiee E, Nayshaburi H, Kamali K. Treatment effects of probiotic in non alcoholic fatty liver disease. Journal of Zanjan University of Medical Sciences and Health Services 2017;25(109):23-35.
Janczyk 2015 {published data only}
    1. Janczyk W, Lebensztejn D, Wierzbicka-Rucinska A, Mazur A, Neuhoff-Murawska J, Matusik P, et al. Omega-3 fatty acids therapy in children with nonalcoholic fatty liver disease: a randomized controlled trial. Journal of Pediatrics 2015;166(6):1358-63.e1-3. - PubMed
Javadi 2017 {published data only}
    1. Javadi L, Ghavami M, Khoshbaten M, Safaiyan A, Barzegari A, Gargari BP. The effect of probiotic and/or prebiotic on liver function tests in patients with nonalcoholic fatty liver disease: a double blind randomized clinical trial. Iranian Red Crescent Medical Journal 2017;19(4):e46017.
Javanmardi 2018 {published data only}
    1. Javanmardi MA, Mohammad Shahi M, Seyedian SS, Haghighizadeh MH. Effects of phytosterol supplementation on serum levels of lipid profiles, liver enzymes, inflammatory markers, adiponectin, and leptin in patients affected by nonalcoholic fatty liver disease: a double-blind, placebo-controlled, randomized clinical trial. Journal of the American College of Nutrition 2018 May 16 [Epub ahead of print]. [DOI: 10.1080/07315724.2018.1466739] - DOI - PubMed
Jazayeri‐Tehrani 2019 {published data only}
    1. Jazayeri-Tehrani SA, Rezayat SM, Mansouri S, Qorbani M, Alavian SM, Daneshi-Maskooni M, et al. Efficacy of nanocurcumin supplementation on insulin resistance, lipids, inflammatory factors and nesfatin among obese patients with non-alcoholic fatty liver disease (NAFLD): a trial protocol. BMJ Open 2017;7(7):e016914. - PMC - PubMed
    1. Jazayeri-Tehrani SA, Rezayat SM, Mansouri S, Qorbani M, Alavian SM, Daneshi-Maskooni M, et al. Nano-curcumin improves glucose indices, lipids, inflammation, and nesfatin in overweight and obese patients with non-alcoholic fatty liver disease (NAFLD): a double-blind randomized placebo-controlled clinical trial. Nutrition & Metabolism 2019;16:8. - PMC - PubMed
Jeong 2017 {published data only}
    1. Jeong JY, Sohn JH, Baek YH, Cho YK, Kim Y, Kim H. New botanical drug, hl tablet, reduces hepatic fat as measured by magnetic resonance spectroscopy in patients with nonalcoholic fatty liver disease: a placebo-controlled, randomized, phase II trial. World Journal of Gastroenterology 2017;23(32):5977-85. - PMC - PubMed
Kanoni 2021 {published data only}
    1. Kanoni S, Kumar S, Amerikanou C, Kurth MJ, Stathopoulou MG, Bourgeois S, et al. Nutrigenetic interactions might modulate the antioxidant and anti-inflammatory status in mastiha-supplemented patients with NAFLD. Frontiers in Immunology 2021;12:683028. - PMC - PubMed
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Kazemi 2020 {published data only}
    1. Kazemi S, Shidfar F, Ehsani S, Adibi P, Janani L, Eslami O. The effects of sumac (Rhus coriaria l) powder supplementation in patients with non-alcoholic fatty liver disease: a randomized controlled trial. Complementary Therapies in Clinical Practice 2020;41:101259. - PubMed
Khoshbaten 2010b {published data only}
    1. Khoshbaten M, Aliasgarzadeh A, Masnadi K, Tarzamani MK, Farhang S, Babaei H, et al. N-acetylcysteine improves liver function in patients with non-alcoholic fatty liver disease. Hepatitis Monthly 2010;10(1):12-6. - PMC - PubMed
Khutsishvili 2020 {published data only}
    1. Khutsishvili N. Prebiotics' plus probiotics' effect on the patients with nonalcoholic fatty liver disease. Hepatology International 2020;14:S329-30.
Kobyliak 2017 {published data only}
    1. Kobyliak N, Abenavoli L, Falalyeyeva T, Mykhalchyshyn G, Boccuto L, Kononenko L, et al. Beneficial effects of probiotic combination with omega-3 fatty acids in NAFLD: a randomized clinical study. Minerva Medica 2018;13:13. - PubMed
Kobyliak 2018 {published data only}
    1. Kobyliak N, Abenavoli L, Mykhalchyshyn G, Kononenko L, Boccuto L, Kyriienko D, et al. A multi-strain probiotic reduces the fatty liver index, cytokines and aminotransferase levels in NAFLD patients: evidence from a randomized clinical trial. Journal of Gastrointestinal and Liver Diseases 2018;27(1):41-9. - PubMed
    1. Kobyliak N, Bosak N, Falalyeyeva T, Beregova T, Bodnar P. Effect of a probiotic on fatty liver index and liver stiffness in NAFLD patients: randomized clinical trial. Journal of Hepatology 2017;66(1 Suppl 1):S426-7.
Kooshki 2020 {published data only}
    1. Kooshki F, Moradi F, Karimi A, Niazkar HR, Khoshbaten M, Maleki V, et al. Chromium picolinate balances the metabolic and clinical markers in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled trial. European Journal of Gastroenterology & Hepatology 2020;14:14. - PubMed
Kugelmas 2003 {published data only}
    1. Kugelmas M, Hill DB, Vivian B, Marsano L, McClain CJ. Cytokines and NASH: a pilot study of the effects of lifestyle modification and vitamin E. Hepatology (Baltimore, Md) 2003;38(2):413-9. - PubMed
Lavine 2011 {published data only}
    1. Bell LN, Molleston JP, Lavine JE, Schwimmer JB, Murray KF, Rosenthal P, et al. Changes in adipose tissue insulin resistance correlate with changes in alt and lobular inflammation in children enrolled in the tonic trial. Hepatology (Baltimore, Md) 2011;54:711a.
    1. Lavine JE, Schwimmer JB, Van Natta ML, Molleston JP, Murray KF, Rosenthal P, et al. Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents: the tonic randomized controlled trial. JAMA 2011;305(16):1659-68. - PMC - PubMed
Lewis 2018 {published data only}
    1. Lewis JE, Atlas SE, Higuera OL, Fiallo A, Rasul A, Farooqi A, et al. Corrigendum to "The Effect of a Hydrolyzed Polysaccharide Dietary Supplement on Biomarkers in Adults with Nonalcoholic Fatty Liver Disease". Evidence-Based Complementary and Alternative Medicine 2020;2020:9575878. - PMC - PubMed
    1. Lewis JE, Atlas SE, Higuera OL, Fiallo A, Rasul A, Farooqi A, et al. The effect of a hydrolyzed polysaccharide dietary supplement on biomarkers in adults with nonalcoholic fatty liver disease. Evidence-Based Complementary and Alternative Medicine 2018;2018:1751583. - PMC - PubMed
Li 2010 {published data only}
    1. Li L, Zhang XJ, Lan Y, Xu L, Zhang XZ, Wang HH. Treatment of non-alcoholic fatty liver disease by qianggan capsule ((sic)). Chinese Journal of Integrative Medicine 2010;16(1):23-7. - PubMed
Li 2016 {published data only}
    1. Li YH, Yang LH, Sha KH, Liu TG, Zhang LG, Liu XX. Efficacy of poly-unsaturated fatty acid therapy on patients with nonalcoholic steatohepatitis. World Journal of Gastroenterology 2016;22(22):7008-13. - PMC - PubMed
Loguercio 2012 {published data only}
    1. Loguercio C, Andreone P, Brisc C, Brisc MC, Bugianesi E, Chiaramonte M, et al. Silybin combined with phosphatidylcholine and vitamin E in patients with nonalcoholic fatty liver disease: a randomized controlled trial. Free Radical Biology and Medicine 2012;52(9):1658-65. - PubMed
Magosso 2013 {published data only}
    1. Magosso E, Ansari MA, Gopalan Y, Shuaib IL, Wong JW, Khan NA, et al. Tocotrienols for normalisation of hepatic echogenic response in nonalcoholic fatty liver: a randomised placebo-controlled clinical trial. Nutrition Journal 2013;12(1):166. - PMC - PubMed
Malaguarnera 2010 {published data only}
    1. Malaguarnera M, Gargante MP, Russo C, Antic T, Vacante M, Malaguarnera M, et al. L-carnitine supplementation to diet: a new tool in treatment of nonalcoholic steatohepatitis - a randomized and controlled clinical trial. American Journal of Gastroenterology 2010;105(6):1338-45. - PubMed
Malaguarnera 2012 {published data only}
    1. Malaguarnera M, Vacante M, Antic T, Giordano M, Chisari G, Acquaviva R, et al. Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis. Digestive Diseases and Sciences 2012;57(2):545-53. - PubMed
Mansour 2020 {published data only}
    1. Mansour A, Mohajeri-Tehrani MR, Karimi S, Sanginabadi M, Poustchi H, Enayati S, et al. Short term effects of coffee components consumption on gut microbiota in patients with non-alcoholic fatty liver and diabetes: a pilot randomized placebo-controlled, clinical trial. Excli Journal 2020;19:241-50. - PMC - PubMed
Manzhalii 2017 {published data only}
    1. Manzhalii E, Virchenko O, Falalyeyeva T, Beregova T, Stremmel W. Treatment efficacy of a probiotic preparation for non-alcoholic steatohepatitis: a pilot trial. Journal of Digestive Diseases 2017;18(12):698-703. - PubMed
Martinez‐Rodriguez 2014 {published data only}
    1. Martínez-Rodríguez Leonardo A, Rojas Serrano J, Torre A. Siliphos selenium methionine alpha lipoic acid for non-alcoholic fatty liver disease: results of a pilot study. Journal of Clinical & Experimental Pharmacology 2014;5(1):1-5.
Miglio 2000 {published data only}
    1. Miglio F, Rovati LC, Santoro A, Setnikar I. Efficacy and safety of oral betaine glucuronate in non-alcoholic steatohepatitis - a double-blind, randomized, parallel-group, placebo-controlled prospective clinical study. Arzneimittel-Forschung-Drug Research 2000;50(8):722-7. - PubMed
Mofidi 2017 {published data only}
    1. Mofidi F, Poustchi H, Yari Z, Nourinayyer B, Merat S, Sharafkhah M, et al. Synbiotic supplementation in lean patients with non-alcoholic fatty liver disease: a pilot, randomised, double-blind, placebo-controlled, clinical trial. British Journal of Nutrition 2017;117(5):662-8. - PubMed
Moradi 2020 {published data only}
    1. Moradi B, Rahmati-Ahmadabad S, Farzanegi P, Helalizadeh M, Azarbayjani MA. Effects of non-linear resistance training and curcumin supplementation on the liver biochemical markers levels and structure in older women with non-alcoholic fatty liver disease. Journal of Bodywork and Movement Therapies 2020;24(3):154-60. - PubMed
    1. Moradi F, Kooshki F, Nokhostin F, Khoshbaten M, Bazyar H, Pourghassem Gargari B. A pilot study of the effects of chromium picolinate supplementation on serum fetuin-a, metabolic and inflammatory factors in patients with nonalcoholic fatty liver disease: a double-blind, placebo-controlled trial. Journal of Trace Elements in Medicine and Biology 2021;63:126659. - PubMed
Morvaridzadeh 2021 {published data only}
    1. Morvaridzadeh M, Nachvak SM, Mohammadi R, Moradi S, Mostafai R, Pizarro AB, et al. Probiotic yogurt fortified with vitamin D can improve glycemic status in non-alcoholic fatty liver disease patients: a randomized clinical trial. Clinical Nutrition Research 2021;10(1):36-47. - PMC - PubMed
Nabavi 2016 {published data only}
    1. Nabavi S, Rafraf M, Somi MH, Homayouni-Rad A, Asghari-Jafarabadi M. Effects of probiotic yogurt consumption on metabolic factors in individuals with nonalcoholic fatty liver disease. Journal of Dairy Science 2014;97(12):7386-93. - PubMed
    1. Nabavi S, Rafraf M, Somi MH, Homayouni-Rad A, Asghari-Jafarabadi M. Probiotic yogurt improves body mass index and fasting insulin levels without affecting serum leptin and adiponectin levels in non-alcoholic fatty liver disease (NAFLD). Journal of Functional Foods 2015;18:684-91.
    1. Nabavi S, Rafraf M, Somi MH, Homayouni-Rad A, Asghari-Jafarabadi M. The effects of probiotic yogurt on metabolic factors in nonalcoholic fatty liver disease. Scientific Journal of Kurdistan University of Medical Sciences 2016;20(6):12-25.
    1. Rafraf M, Nabavi S, Somi MH, Homayouni-Rad A, Asghari-Jafarabadi M. Effect of probiotic yogurt on enzymes and ecogenicity of liver in individuals with non alcoholic fatty liver disease: a double-blind randomized controlled clinical trial. Journal of Zanjan University of Medical Sciences and Health Services 2015;23(99):25-38.
    1. Rafraf M, Nabavi S, Somi MH, Homayouni-Rad A, Asghari-Jafarabadi Rad M. The effect of probiotic and conventional yogurt consumption on anthropometric parameters in individuals with non-alcoholic fatty liver disease. Journal of Babol University of Medical Sciences 2014;16(9):55-62.
Naganuma 2016 {published data only}
    1. Naganuma A, Ogawa Y, Hoshino T, Hatanaka T, Tanaka H, Inagawa M, et al. Effect of the medical walking and leucine enriched amino acid containing food for female nonalcoholic fatty liver disease: randomized controlled trial. Clinical Nutrition 2016;35:S62-3.
Navekar 2017 {published data only}
    1. Navekar R, Rafraf M, Ghaffari A, Asghari-Jafarabadi M, Khoshbaten M. Turmeric supplementation improves serum glucose indices and leptin levels in patients with nonalcoholic fatty liver diseases. Journal of the American College of Nutrition 2017;36(4):261-7. - PubMed
NCT00816465 {published data only}
    1. NCT00816465. Safety and efficacy of Hoodia gordonii for treatment of non-alcoholic fatty liver disease (NAFLD). clinicaltrials.gov/ct2/show/NCT00816465 (first posted 1 January 2009).
NCT00845845 {published data only}
    1. NCT00845845. Fish oil and diet for the treatment of non-alcoholic steatohepatitis (NASH). clinicaltrials.gov/ct2/show/NCT00845845 (first posted 18 February 2009).
NCT00941642 {published data only}
    1. NCT00941642. Placebo controlled study using lovaza as treatment for non-alcoholic fatty liver disease. clinicaltrials.gov/ct2/show/NCT00941642 (first posted 17 July 2009).
NCT00977730 {published data only}
    1. NCT00977730. The effect of protandim on non-alcoholic steatohepatitis. clinicaltrials.gov/ct2/show/NCT00977730 (first posted 16 September 2009).
NCT01083992 {published data only}
    1. NCT01083992. Role of vitagliptin and vitamin D in the treatment of non-alcoholic fatty liver disease (NAFLD). clinicaltrials.gov/ct2/show/NCT01083992 (first posted 10 March 2010).
NCT01623024 {published data only}
    1. NCT01623024. Effect on liver histology of vitamin D in patients with non-alcoholic steatohepatitis. clinicaltrials.gov/ct2/show/NCT01623024 (first posted 19 June 2012).
NCT02690792 {published data only}
    1. NCT02690792. Effect of vitamin E on non-alcoholic fatty liver disease. clinicaltrials.gov/ct2/show/NCT02690792 (first posted 24 February 2016).
NCT04411862 {published data only}
    1. NCT04411862. Efficacy of phosphatidylcholine in NAFLD. clinicaltrials.gov/show/NCT04411862 (first posted 2 June 2020).
Nelson 2009 {published data only}
    1. Nelson JE, Maliken BD, Saunders C, Stevenson J, Richards T, Kowdley KV. A randomized, masked, controlled study of omega-3 polyunsaturated fatty acid vs monounsaturated fatty acid diet supplementation for the treatment of nonalcoholic fatty liver disease. Gastroenterology 2009;136(5):A847-8.
Nobili 2006 {published data only}
    1. Mosca A, Crudele A, Smeriglio A, Braghini MR, Panera N, Comparcola D, et al. Antioxidant activity of hydroxytyrosol and vitamin E reduces systemic inflammation in children with paediatric NAFLD. Digestive & Liver Disease 2020;12:12. - PubMed
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    1. Nobili V, Manco M, Devito R, Ciampalini P, Piemonte F, Marcellini M. Effect of vitamin E on aminotransferase levels and insulin resistance in children with non-alcoholic fatty liver disease. Alimentary Pharmacology & Therapeutics 2006;24(11-12):1553-61. - PubMed
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    1. Nobili V, Manco M, DeVito R, PietroBattista A, Comparcola D, Sartorelli MR, et al. Lifestyle intervention and antioxidants in children with nonalcoholic fatty liver disease: a randomized, controlled trial. Gastroenterology 2008;134(4):A781. - PubMed
Nobili 2013 {published data only}
    1. Nobili V, Alisi A, Della Corte C, Rise P, Galli C, Agostoni C, et al. Docosahexaenoic acid for the treatment of fatty liver: randomised controlled trial in children. Nutrition Metabolism and Cardiovascular Diseases 2013;23(11):1066-70. - PubMed
    1. Nobili V, Bedogni G, Alisi A, Pietrobattista A, Rise P, Galli C, et al. Docosahexaenoic acid supplementation decreases liver fat content in children with non-alcoholic fatty liver disease: double-blind randomised controlled clinical trial. Archives of Disease in Childhood 2011;96(4):350-3. - PubMed
Nogueira 2016 {published data only}
    1. Nogueira MA, Oliveira CP, Alves VAF, Stefano JT, Rodrigues LSD, Torrinhas RS, et al. Omega-3 polyunsaturated fatty acids in treating non-alcoholic steatohepatitis: a randomized, double-blind, placebo-controlled trial. Clinical Nutrition 2016;35(3):578-86. - PubMed
Orang 2020 {published data only}
    1. Orang Z, Mohsenpour MA, Mozaffari-Khosravi H. Effect of omega-3 fatty acid supplementation on inflammatory markers and insulin resistance indices in patient with type 2 diabetes and nonalcoholic fatty liver: a randomized double-blind clinical trial. Obesity Medicine 2020;19:100278.
Orr 2015 {published data only}
    1. Orr DW, Murphy R. Prebiotic supplementation with inulin following metronidazole therapy achieves greater alt reduction in non-alcoholic fatty liver disease (NAFLD): a randomised double-blind placebo controlled trial. Hepatology (Baltimore, Md) 2015;62:1268a-9a.
Oscarsson 2018 {published data only}
    1. Oscarsson J, Onnerhag K, Riserus U, Sunden M, Johansson L, Jansson PA, et al. Effects of free omega-3 carboxylic acids and fenofibrate on liver fat content in patients with hypertriglyceridemia and non-alcoholic fatty liver disease: a double-blind, randomized, placebo-controlled study. Journal of Clinical Lipidology 2018;10:10. - PubMed
Pacifico 2015 {published data only}
    1. Pacifico L, Bonci E, Di Martino M, Versacci P, Andreoli G, Silvestri LM, et al. A double-blind, placebo-controlled randomized trial to evaluate the efficacy of docosahexaenoic acid supplementation on hepatic fat and associated cardiovascular risk factors in overweight children with nonalcoholic fatty liver disease. Nutrition Metabolism and Cardiovascular Diseases 2015;25(8):734-41. - PubMed
Palamaru 2017 {published data only}
    1. Palamaru AL, Dranga M, Ungureanu I, Cucos A, Prelipcean CC. Vitamin E and non-alcoholic fatty liver disease. Journal of Gastrointestinal and Liver Diseases 2017;26(Suppl 3):28.
Panahi 2012 {published data only}
    1. Panahi Y, Ghamarchehreh ME, Beiraghdar F, Zare R, Jalalian HR, Sahebkar A. Investigation of the effects of Chlorella vulgaris supplementation in patients with non-alcoholic fatty liver disease: a randomized clinical trial. Hepato-Gastroenterology 2012;59(119):2099-103. - PubMed
Panahi 2016 {published data only}
    1. Panahi Y, Kianpour P, Mohtashami R, Jafari R, Simental-Mendia LE, Sahebkar A. Curcumin lowers serum lipids and uric acid in subjects with nonalcoholic fatty liver disease: a randomized controlled trial. Journal of Cardiovascular Pharmacology 2016;68(3):223-9. - PubMed
    1. Panahi Y, Kianpour P, Mohtashami R, Jafari R, Simental-Mendia LE, Sahebkar A. Efficacy and safety of phytosomal curcumin in non-alcoholic fatty liver disease: a randomized controlled trial. Drug Research 2017;67(4):244-51. - PubMed
Parsi 2020 {published data only}
    1. Parsi A, Torkashvand M, Hajiani E, Rahimlou M, Sadeghi N. The effects of Crocus sativus extract on serum lipid profile and liver enzymes in patients with non-alcoholic fatty liver disease: a randomized placebo-controlled study. Obesity Medicine 2020;17:100165.
Pasdar 2020 {published data only}
    1. Pasdar Y, Oubari F, Zarif MN, Abbasi M, Pourmahmoudi A, Hosseinikia M. Effects of quercetin supplementation on hematological parameters in non-alcoholic fatty liver disease: a randomized, double-blind, placebo-controlled pilot study. Clinical Nutrition Research 2020;9(1):11-9. - PMC - PubMed
Pervez 2018 {published data only}
    1. Pervez MA, Khan DA, Ijaz A, Khan S. Effects of delta-tocotrienol supplementation on liver enzymes, inflammation, oxidative stress and hepatic steatosis in patients with nonalcoholic fatty liver disease. Turkish Journal of Gastroenterology 2018;29(2):170-6. - PMC - PubMed
Pervez 2020 {published data only}
    1. Pervez MA, Khan DA, Slehria AUR, Ijaz A. Delta-tocotrienol supplementation improves biochemical markers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease: a randomized, placebo-controlled trial. Complementary Therapies in Medicine 2020;52:102494. - PubMed
Pezeshki 2016 {published data only}
    1. Pezeshki A, Safi S, Feizi A, Askari G, Karami F. The effect of green tea extract supplementation on liver enzymes in patients with nonalcoholic fatty liver disease. International Journal of Preventive Medicine 2016;7:28. - PMC - PubMed
Poparn 2020 {published data only}
    1. Poparn H, Chatrproedprai S, Treeprasertsuk S, Sonsiri K, Chongsrisawat V. Effect of synbiotic supplementation in children with nonalcoholic fatty liver disease: a randomized controlled trial. Chotmaihet Thangphaet [Journal of the Medical Association of Thailand] 2020;103(12):S99-104.
Poulos 2021 {published data only}
    1. Poulos JE, Kalogerinis PT, Milanov V, Kalogerinis CT, Poulos EJ. The effects of vitamin E, silymarin and carnitine on the metabolic abnormalities associated with nonalcoholic liver disease. Journal of Dietary Supplements 2021 Jan 25 [Online ahead of print]. [DOI: 10.1080/19390211.2021.1874587] - DOI - PubMed
Pour 2020 {published data only}
    1. Pour FK, Aryaeian N, Mokhtare M, Mirnasrollahi Parsa RS, Jannani L, Agah S, et al. The effect of saffron supplementation on some inflammatory and oxidative markers, leptin, adiponectin, and body composition in patients with nonalcoholic fatty liver disease: a double-blind randomized clinical trial. Phytotherapy Research 2020;34(12):3367-78. - PubMed
Qin 2015 {published data only}
    1. Qin Y, Zhou Y, Chen SH, Zhao XL, Ran L, Zeng XL, et al. Fish oil supplements lower serum lipids and glucose in correlation with a reduction in plasma fibroblast growth factor 21 and prostaglandin e2 in nonalcoholic fatty liver disease associated with hyperlipidemia: a randomized clinical trial. PLOS One 2015;10(7):e0133496. - PMC - PubMed
Rafie 2020 {published data only}
    1. Rafie R, Hosseini SA, Hajiani E, Malehi AS, Mard SA. Effect of ginger powder supplementation in patients with non-alcoholic fatty liver disease: a randomized clinical trial. Clinical and Experimental Gastroenterology 2020;13:35-45. - PMC - PubMed
Rahimlou 2016 {published data only}
    1. Rahimlou M, Yari Z, Hekmatdoost A, Alavian SM, Keshavarz SA. Ginger supplementation in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled pilot study. Hepatitis Monthly 2016;16(1):e34897. - PMC - PubMed
Rahmani 2016 {published data only}
    1. Rahmani S, Asgary S, Askari G, Keshvari M, Hatamipour M, Feizi A, et al. Treatment of non-alcoholic fatty liver disease with curcumin: a randomized placebo-controlled trial. Phytotherapy Research 2016;30(9):1540-8. - PubMed
Ruan 2010 {published data only}
    1. Ruan JW, Yang J. Efficacy of silibin capsules in the treatment of metabolism syndrome-related fatty liver disease: an analysis of 30 cases. World Chinese Journal of Digestology 2010;18(29):3151-4.
Sadrkabir 2020 {published data only}
    1. Sadrkabir M, Jahed S, Sadeghi Z, Isazadeh K. The effect of gerilact on non-alcoholic fatty liver disease. Journal of Kerman University of Medical Sciences 2020;27(1):82-90.
Sakpal 2017 {published data only}
    1. Sakpal M, Mehta M, Duseja A, Bhadada S, Das A, Dhiman RK, et al. Vitamin D supplementation in patients with nonalcoholic fatty liver disease - a randomized controlled trial. Indian Journal of Gastroenterology 2015;34(1 Suppl 1):A106. - PMC - PubMed
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Sangouni 2020 {published data only}
    1. Sangouni AA, Azar MR, Alizadeh M. Effect of garlic powder supplementation on hepatic steatosis, liver enzymes and lipid profile in patients with non-alcoholic fatty liver disease: a double-blind randomised controlled clinical trial. British Journal of Nutrition 2020;124(4):450-6. - PubMed
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Sanyal 2010 {published data only}
    1. Bell LN, Wang J, Muralidharan S, Chalasani S, Fullenkamp AM, Wilson LA, et al. Relationship between adipose tissue insulin resistance and liver histology in nonalcoholic steatohepatitis: a pioglitazone versus vitamin E versus placebo for the treatment of nondiabetic patients with nonalcoholic steatohepatitis trial follow-up study. Hepatology (Baltimore, Md) 2012;56(4):1311-8. - PMC - PubMed
    1. Chalasani NP, Sanyal AJ, Kowdley KV, Robuck PR, Hoofnagle J, Kleiner DE, et al. Pioglitazone versus vitamin E versus placebo for the treatment of non-diabetic patients with non-alcoholic steatohepatitis: Pivens trial design. Contemporary Clinical Trials 2009;30(1):88-96. - PMC - PubMed
    1. Hoofnagle JH, Van Natta ML, Kleiner DE, Clark JM, Kowdley KV, Loomba R, et al. Vitamin E and changes in serum alanine aminotransferase levels in patients with non-alcoholic steatohepatitis. Alimentary Pharmacology & Therapeutics 2013;38(2):134-43. - PMC - PubMed
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Sanyal 2014 {published data only}
    1. Sanyal AJ, Abdelmalek MF, Suzuki A, Cummings OW, Chojkier M. No significant effects of ethyl-eicosapentanoic acid on histologic features of nonalcoholic steatohepatitis in a phase 2 trial. Gastroenterology 2014;147(2):377-84.e1. - PubMed
Saxena 2013 {published data only}
    1. Saxena A, Kaushik N, Vikram NK, Pandey RM, Misra A, Bhushan SM. Double-blind randomized placebo controlled clinical trial of herbal compound livomap (ma-579) in patients with non alcoholic fatty liver disease (NAFLD). Journal of Ayurveda and Integrative Medicine 2013;4:63.
Sayari 2018 {published data only}
    1. Sayari S, Neishaboori H, Jameshorani M. Combined effects of synbiotic and sitagliptin versus sitagliptin alone in patients with nonalcoholic fatty liver disease. Clinical and Molecular Hepatology 2018;24(3):331-8. - PMC - PubMed
Schattenberg 2017 {published data only}
    1. Schattenberg JM, Schlegel L, Nier A, Huber Y, Galle PR, Bergheim I. Dietary counselling focusing only on fructose consumption improves hepatic inflammation in patients with NAFLD-A prospective, controlled, randomized open-label study (Nuces NASH). Hepatology (Baltimore, Md) 2017;66(Suppl 1):1106a-7a.
Scorletti 2014 {published data only}
    1. Bhatia LS, Scorletti E, Shojaee-Moradie F, Umpleby M, Clough GF, Curzen NP, et al. High-dose n-3 fatty acid treatment in non-alcoholic fatty liver disease is independently associated with reduced hepatic steatosis and improved hepatic insulin sensitivity. Diabetic Medicine 2014;31:53.
    1. Scorletti E, Bhatia B, McCormick KG, Clough GF, Nash K, Hodson L, et al. Potential benefits of purified long chain omega-3 fatty acid treatment in non-alcoholic fatty liver disease (NAFLD): a potential treatment for early NAFLD in metabolic syndrome and type 2 diabetes? Results from the Welcome study. Diabetic Medicine 2014;31:1.
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Scorletti 2020 {published data only}
    1. Scorletti E, Afolabi PR, Calder PC, Byrne CD. Investigation of the effects of synbiotic treatment on gut microbiota composition in patients with non-alcoholic fatty liver disease and type 2 diabetes. Diabetic Medicine 2020;37(Suppl 1):55.
    1. Scorletti E, Afolabi PR, Miles EA, Smith DE, Almehmadi A, Alshathry A, et al. Design and rationale of the Insyte study: a randomised, placebo controlled study to test the efficacy of a synbiotic on liver fat, disease biomarkers and intestinal microbiota in non-alcoholic fatty liver disease. Contemporary Clinical Trials 2018;71:113-23. - PubMed
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Sepideh 2016 {published data only}
    1. Sepideh A, Karim P, Hossein A, Leila R, Hamdollah M, Mohammad EG, et al. Effects of multistrain probiotic supplementation on glycemic and inflammatory indices in patients with nonalcoholic fatty liver disease: a double-blind randomized clinical trial. Journal of the American College of Nutrition 2016;35(6):500-5. - PubMed
Shahmohammadi 2017 {published data only}
    1. Shahmohammadi HA, Hosseini SA, Hajiani E, Malehi AS, Alipour M. Effects of green coffee bean extract supplementation on patients with non-alcoholic fatty liver disease: a randomized clinical trial. Hepatitis Monthly 2017;17(4):e12299.
Sharifi 2014 {published data only}
    1. Sharifi N, Amani R, Hajiani E, Cheraghian B. Does vitamin D improve liver enzymes, oxidative stress, and inflammatory biomarkers in adults with non-alcoholic fatty liver disease? A randomized clinical trial. Endocrine 2014;47(1):70-80. - PubMed
Shavakhi 2013 {published data only}
    1. Shavakhi A, Minakari M, Firouzian H, Assali R, Hekmatdoost A, Ferns G. Effect of a probiotic and metformin on liver aminotransferases in non-alcoholic steatohepatitis: a double blind randomized clinical trial. International Journal of Preventive Medicine 2013;4(5):531-7. - PMC - PubMed
Soleimani 2020 {published data only}
    1. Soleimani D, Paknahad Z, Askari G, Iraj B, Feizi A. Effect of garlic powder consumption on body composition in patients with nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled trial. Advanced Biomedical Research 2016;5:2. - PMC - PubMed
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Soleimani 2021 {published data only}
    1. Soleimani D, Rezaie M, Rajabzadeh F, Gholizadeh Navashenaq J, Abbaspour M, Miryan M, et al. Protective effects of propolis on hepatic steatosis and fibrosis among patients with nonalcoholic fatty liver disease (NAFLD) evaluated by real-time two-dimensional shear wave elastography: a randomized clinical trial. Phytotherapy Research 2021;35(3):1669-79. - PubMed
Solhi 2014 {published data only}
    1. Solhi H, Ghahremani R, Kazemifar AM, Yazdi ZH. Silymarin in treatment of non-alcoholic steatohepatitis: a randomized clinical trial. Caspian Journal of Internal Medicine 2014;5(1):9-12. - PMC - PubMed
Somi 2014 {published data only}
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Song 2020 {published data only}
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Spadaro 2008 {published data only}
    1. Spadaro L, Magliocco O, Spampinato D, Piro S, Oliveri C, Alagona C, et al. Effects of n-3 polyunsaturated fatty acids in subjects with nonalcoholic fatty liver disease. Digestive and Liver Disease 2008;40(3):194-9. - PubMed
Tabatabaee 2017 {published data only}
    1. Tabatabaee SM, Alavian SM, Ghalichi L, Miryounesi SM, Mousavizadeh K, Jazayeri S, et al. Green tea in non-alcoholic fatty liver disease: a double blind randomized clinical trial. Hepatitis Monthly 2017;17(12):e14993.
Taghvaei 2018 {published data only}
    1. Taghvaei T, Akha O, Mouodi M, Fakheri HT, Kashi Z, Maleki I, et al. Effects of vitamin D supplementation on patients with non-alcoholic fatty liver disease (NAFLD). Acta Medica Mediterranea 2018;34(2):415-22.
Tan 2011 {published data only}
    1. Tan HH, Low ASC, Lim KH, Wan WK, Goh BB, Wang YT, et al. A randomized, unblinded pilot trial of essential phospholipids in Chinese subjects with nonalcoholic fatty liver disease (NASH). Journal of Gastroenterology and Hepatology 2011;26:162.
Tobin 2018 {published data only}
    1. Tobin D, Brevik-Andersen M, Qin Y, Innes JK, Calder PC. Evaluation of a high concentrate omega-3 for correcting the omega-3 fatty acid nutritional deficiency in non-alcoholic fatty liver disease (condin). Nutrients 2018;10(8):20. - PMC - PubMed
Tutunchi 2020 {published data only}
    1. Tutunchi H, Naeini F, Saghafi-Asl M, Farrin N, Monshikarimi A, Ostadrahimi A. Effects of oleoylethanolamide supplementation on atherogenic indices and hematological parameters in patients with nonalcoholic fatty liver disease: a clinical trial. Health Promotion Perspectives 2020;10(4):373-82. - PMC - PubMed
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Uygun 2000 {published data only}
    1. Uygun A, Kadayifci A, Bagci S, Erdil A, Deveci S, Saka M, et al. L-carnitine therapy in non-alcoholic steatohepatitis. Turkish Journal of Gastroenterology 2000;11(3):196-201.
Vajro 2011 {published data only}
    1. Vajro P, Mandato C, Licenziati MR, Franzese A, Vitale DF, Lenta S, et al. Effects of Lactobacillus rhamnosus strain GG in pediatric obesity-related liver disease. Journal of Pediatric Gastroenterology and Nutrition 2011;52(6):740-3. - PubMed
Wang 2008 {published data only}
    1. Wang CL, Liang L, Fu JF, Zou CC, Hong F, Xue JZ, et al. Effect of lifestyle intervention on non-alcoholic fatty liver disease in Chinese obese children. World Journal of Gastroenterology 2008;14(10):1598-602. - PMC - PubMed
Wang 2017 {published data only}
    1. Wang X, Yao N. Effect of herb formula xiao-zhi-hua-xian-tang against nonalcoholic steatohepatitis with advanced fibrosis: a preliminary clinical study. Hepatology International 2017;11(1 Suppl 1):S939-40.
Wang 2018 {published data only}
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Wong 2013a {published data only}
    1. Wong VW, Won GL, Chim AM, Chu WC, Yeung DK, Li KC, et al. Treatment of nonalcoholic steatohepatitis with probiotics. A proof-of-concept study. Annals of Hepatology 2013;12(2):256-62. - PubMed
Wong 2013b {published data only}
    1. Wong VWS, Wong GLH, Chan AWH, Chu WCW, Choi PCL, Chim AML, et al. Treatment of non-alcoholic steatohepatitis with Phyllanthus urinaria: a randomized trial. Journal of Gastroenterology and Hepatology 2013;28(1):57-62. - PubMed
Yan 2015 {published data only}
    1. Yan H, Xia M, Chang X, Bian H, Lin H, Zhang L, et al. Berberine vs. pioglitazone for treatment of nonalcoholic fatty liver disease and its associated impaired glucose metabolism. Diabetes 2014;63:A513-4.
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Yari 2016 {published data only}
    1. Yari Z, Rahimlou M, Eslamparast T, Ebrahimi-Daryani N, Poustchi H, Hekmatdoost A. Flaxseed supplementation in non-alcoholic fatty liver disease: a pilot randomized, open labeled, controlled study. International Journal of Food Sciences and Nutrition 2016;67(4):461-9. - PubMed
Yari 2020 {published data only}
    1. Yari Z, Cheraghpour M, Alavian SM, Hedayati M, Eini-Zinab H, Hekmatdoost A. The efficacy of flaxseed and hesperidin on non-alcoholic fatty liver disease: an open-labeled randomized controlled trial. European Journal of Clinical Nutrition 2021;75(1):99-111. - PubMed
Youshari 2017 {published data only}
    1. Youshari N, Mehrangiz, Mameghani E. The effect of oral β-glucan supplement on liver echogenicity and enzymes in non-alcoholic fatty liver disease treating with hypocaloric diet and vitamin E. Iranian Journal of Basic Medical Sciences 2017;20(Supp 1):82-3.
Zamani 2018 {published data only}
    1. Zamani N, Shams M, Nimrouzi M, Zarshenas MM, Abolhasani Foroughi A, Fallahzadeh Abarghooei E, et al. The effects of Zataria multiflora boiss (Shirazi thyme) on nonalcoholic fatty liver disease and insulin resistance: a randomized double-blind placebo-controlled clinical trial. Complementary Therapies in Medicine 2018;41:118-23. - PubMed
Zanko 2020 {published data only}
    1. Mikolasevic I, Domislovic V, Trkulja V, Krznaric, Skenderevic N, Mijic A, et al. The efficacy of vitamin D supplementation on NAFLD: a randomized, double-blind, placebo-controlled 12- month trial on 311 patients. Journal of Hepatology 2020;73(Suppl 1):S447-8.
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Zhang 2015 {published data only}
    1. Zhang PW, Chen FX, Li D, Ling WH, Guo HH. A CONSORT-compliant, randomized, double-blind, placebo-controlled pilot trial of purified anthrocyanin in patients with nonalcoholic fatty liver disease. Medicine 2015;94(20):e758. - PMC - PubMed
Zhu 2008 {published data only}
    1. Zhu FS, Liu S, Chen XM, Huang ZG, Zhang DW. Effects of n-3 polyunsaturated fatty acids from seal oils on nonalcoholic fatty liver disease associated with hyperlipidemia. World Journal of Gastroenterology 2008;14(41):6395-400. - PMC - PubMed
Zohrer 2017 {published data only}
    1. Zohrer E, Alisi A, Jahnel J, Mosca A, Della Corte C, Crudele A, et al. Efficacy of docosahexaenoic acid-choline-vitamin E in paediatric NASH: a randomized controlled clinical trial. Applied Physiology, Nutrition, and Metabolism 2017;42(9):948-54. - PubMed

References to studies excluded from this review

Abenavoli 2017 {published data only}
    1. Abenavoli L, Greco M, Milic N, Accattato F, Foti D, Gulletta E, et al. Effect of Mediterranean diet and antioxidant formulation in non-alcoholic fatty liver disease: a randomized study. Nutrients 2017;9(8):12. - PMC - PubMed
    1. Abenavoli L, Milic N, Larussa T, Suraci E, Imeneo M, Medic M, et al. Efficacy of Mediterranean diet and antioxidants in overweight patients with non-alcoholic fatty liver disease. Digestive and Liver Disease 2016;48:e130-1.
Akcam 2011 {published data only}
    1. Akcam M, Boyaci A, Pirgon O, Kaya S, Uysal S, Dundar BN. Therapeutic effect of metformin and vitamin E versus prescriptive diet in obese adolescents with fatty liver. International Journal for Vitamin and Nutrition Research 2011;81(6):398-406. - PubMed
Basu 2014 {published data only}
    1. Basu P, Shah NJ, Aloysius M. Berberine with alfa lipoic acid (ALA) in non alcoholic steato-hepatitis (NASH). A randomized double blinded placebo control trial. A clinical pilot - the Banish Trial. Hepatology (Baltimore, Md) 2014;60:624a.
    1. Basu P, Shah NJ, Aloysius MM. Berberine with alfa lipoic acid (ALA) in non alcoholic steatohepatitis (NASH). A randomized double blinded placebo control trial. A clinical pilot - the Banish Trial. Journal of the International Hepato Pancreato Biliary Association 2015;17:43.
    1. Basu PP, Aloysius MM, Shah NJ, Brown RS Jr. Berberine with alfa lipoic acid (ALA) in non alcoholic steatohepatitis (NASH). A randomized double blinded placebo control trial. A clinical pilot: the Banish Trial. Hepatology International 2014;8(1 Suppl 1):S10.
Chambers 2018 {published data only}
    1. Chambers ES, Byrne CS, Rugyendo A, Morrison DJ, Preston T, Tedford C, et al. The effects of dietary supplementation with inulin and inulin-propionate ester on hepatic steatosis in adults with non-alcoholic fatty liver disease. Diabetes, Obesity and Metabolism 2018;11:11. - PMC - PubMed
Chang 2014 {published data only}
    1. Chang HC, Peng CH, Yeh DM, Kao ES, Wang CJ. Hibiscus sabdariffa extract inhibits obesity and fat accumulation, and improves liver steatosis in humans. Food and Function 2014;5(4):734-9. - PubMed
Dela Cruz 2012 {published data only}
    1. Dela Cruz R, Mappala HT. The efficacy of ursodeoxycholic acid, probiotics vs. diet and exercise in the treatment of NAFLD: an open-labelled prospective randomized trial. Journal of Gastroenterology and Hepatology 2012;27:223.
Ersoz 2005 {published data only}
    1. Ersoz G, Gunsar F, Karasu Z, Akay S, Batur Y, Akarca US. Management of fatty liver disease with vitamin E and C compared to ursodeoxycholic acid treatment. Turkish Journal of Gastroenterology 2005;16(3):124-8. - PubMed
Famouri 2017b {published data only}
    1. Famouri F, Salehi MM, Rostampour N, Hashemi E, Shahsanaee A. The effect of silymarin on non-alcoholic fatty liver disease of children. Journal of Herbmed Pharmacology 2017;6(1):16-20.
Guo 2014 {published data only}
    1. Guo H, Zhong R, Liu Y, Jiang X, Tang X, Li Z, et al. Effects of bayberry juice on inflammatory and apoptotic markers in young adults with features of non-alcoholic fatty liver disease. Nutrition 2014;30(2):198-203. - PubMed
Hajiaghamohammadi 2012 {published data only}
    1. Hajiaghamohammadi AA, Ziaee A, Oveisi S, Masroor H. Effects of metformin, pioglitazone, and silymarin treatment on non-alcoholic fatty liver disease: a randomized controlled pilot study. Hepatitis Monthly 2012;12(8):e6099. - PMC - PubMed
Han 2014 {published data only}
    1. Han Y, Shi JP, Ma AL, Xu Y, Ding XD, Fan JG. Randomized, vitamin E-controlled trial of bicyclol plus metformin in non-alcoholic fatty liver disease patients with impaired fasting glucose. Clinical Drug Investigation 2014;34(1):1-7. - PubMed
Khoshbaten 2010a {published data only}
    1. Khoshbaten M, Aliasgarzadeh A, Masnadi K, Farhang S, Tarzamani MK, Babaei H, et al. Grape seed extract to improve liver function in patients with nonalcoholic fatty liver change. Saudi Journal of Gastroenterology 2010;16(3):194-7. - PMC - PubMed
Mahmoudi 2020 {published data only}
    1. Mahmoudi L, Asadi S, Al-Mousavi Z, Niknam R. A randomized controlled clinical trial comparing calcitriol versus cholecalciferol supplementation to reduce insulin resistance in patients with non-alcoholic fatty liver disease. Clinical Nutrition 2020 Dec 8 [Online ahead of print]. [10.1016/j.clnu.2020.11.037] - PubMed
NCT00820651 {published data only}
    1. NCT00820651. Efficacy and safety of diamel in patients with nonalcoholic steatohepatitis. clinicaltrials.gov/ct2/show/NCT00820651 (first posted 12 January 2009).
NCT04281121 {published data only}
    1. NCT04281121. Omega 3 supplementation in children with non alcoholic fatty liver. clinicaltrials.gov/show/NCT04281121 (first posted 24 February 2020).
Petyaev 2018 {published data only}
    1. Petyaev IM, Dovgalevsky PY, Chalyk NE, Klochkov VA, Kyle NH, Bashmakov YK. Reduction of liver span and parameters of inflammation in nonalcoholic fatty liver disease patients treated with lycosome formulation of phosphatidylcholine: a preliminary report. International Journal of Chronic Diseases Print 2018;2018:4549614. - PMC - PubMed
Podszun 2020 {published data only}
    1. Podszun MC, Alawad AS, Lingala S, Morris N, Huang WA, Yang S, et al. Vitamin E treatment in NAFLD patients demonstrates that oxidative stress drives steatosis through upregulation of de-novo lipogenesis. Redox Biology 2020;37:101710. - PMC - PubMed
Saarinen 2011 {published data only}
    1. Saarinen M, Kotronen A, Yamaki G, Matsuzaki S, Mitsuya N, Tiihonen K. Effects of low dose betaine in subjects with mild fatty liver. Annals of Nutrition and Metabolism 2011;58:112.
Semiserin 2016 {published data only}
    1. Semiserin VA, Karakozov AG, Malkuta MA, Zolotareva LA, Levchenko OB, Kalyagin IE, et al. [Evaluation of the efficiency of hepatoprotective monotherapy using succinic acid and methionine for nonalcoholic fatty liver disease at the stage of steatohepatitis]. Terapevticheskii Arkhiv 2016;88(2):58-63. - PubMed
Singhal 2015 {published data only}
    1. Singhal P, Nesari T, Gupta GS. Efficacy of herbomineral compounds and pathya (ayurvedic dietary regime and physical exercise) in the management of yakrt roga (non-alcoholic fatty liver disease). Ancient Science of Life 2015;34(4):216-22. - PMC - PubMed
Zhang 2008 {published data only}
    1. Zhang SJ, Chen ZX, Jiang KP, Cheng YH, Gu YL. The effect of quyuhuatantongluo decoction on the non-alcoholic steatohepatitis. Complementary Therapies in Medicine 2008;16(4):192-8. - PubMed

References to ongoing studies

ChiCTR2000034740 {published data only}
    1. ChiCTR2000034740. To explore the protective effect of Lycium barbarum polysaccharide combined with exercise intervention on nonalcoholic fatty liver disease based on gut microbiota: a randomized controlled trial. www.chictr.org.cn/hvshowproject.aspx?id=43624 (date of approval by ethics committee 25 July 2019).
ChiCTR2000035899 {published data only}
    1. ChiCTR2000035899. Efficacy and safety of caffeic acid in nonalcoholic fatty liver disease. www.chictr.org.cn/hvshowproject.aspx?id=49625 (date of approval by ethics committee 14 August 2020).
CTRI/2020/05/025322 {published data only}
    1. CTRI/2020/05/025322. Effect of herbal blend in non-alcoholic subjects with elevated fatty liver index. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=41930&EncHid=&u... (first registered 22 May 2020).
CTRI/2020/07/026362 {published data only}
    1. CTRI/2020/07/026362. To evaluate the efficacy of sarvakalpa-ghan-vati in management of non-alcoholic liver disorder. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=44069&EncHid=&u... (first registered 4 July 2020).
Han 2020 {published data only}
    1. Han K, Kwon O, Park HJ, Jung SY, Yang C, Son CG. Effect of daesiho-tang on obesity with non-alcoholic fatty liver disease: a study protocol for a randomised, double-blind, placebo-controlled pilot trial. Trials 2020;21(1):128. - PMC - PubMed
IRCT20131125015536N {published data only}
    1. IRCT20131125015536N. Effects of naringenin supplement on non-alcoholic fatty liver disease. www.irct.ir/trial/49713 (first registered 6 August 2020).
IRCT20191009045043N {published data only}
    1. IRCT20191009045043N. Investigation the effect of the sumac powder consumption on patients with non-alcoholic fatty liver. www.irct.ir/trial/43090 (first registered 20 January 2020).
IRCT20200304046692N {published data only}
    1. IRCT20200304046692N. Evaluating the effect of spirulina in non-alcoholic fatty liver patient. www.irct.ir/trial/46330 (first registered 11 March 2020).
IRCT20200531047614N {published data only}
    1. IRCT20200531047614N. Zinc supplementation in treatment of obese children and adolescents with nonalcoholic fatty liver disease. www.irct.ir/trial/48543 (first registered 19 June 2020).
Lambert 2015 {published data only}
    1. Lambert JE, Parnell JA, Eksteen B, Raman M, Bomhof MR, Rioux KP, et al. Gut microbiota manipulation with prebiotics in patients with non-alcoholic fatty liver disease: a randomized controlled trial protocol. BMC Gastroenterology 2015;15:169. - PMC - PubMed
NCT02289235 {published data only}
    1. NCT02289235. The effects of ginger on nonalcoholic fatty liver disease. clinicaltrials.gov/ct2/show/NCT02289235 (first posted 13 November 2014).
NCT02642172 {published data only}
    1. NCT02642172. Prebiotics in patients with non-alcoholic liver disease. clinicaltrials.gov/ct2/show/NCT02642172 (first posted 30 December 2015).
NCT02647294 {published data only}
    1. NCT02647294. Polyunsaturated fatty acids in patients with NAFLD. clinicaltrials.gov/ct2/show/NCT02647294 (first posted 6 January 2016).
NCT02764047 {published data only}
    1. NCT02764047. Probiotics in the treatment of NAFLD. clinicaltrials.gov/ct2/show/NCT02764047 (first posted 6 May 2016).
NCT03439917 {published data only}
    1. NCT03439917. Effects of carnitine supplementation on liver and muscle. clinicaltrials.gov/ct2/show/NCT03439917 (first posted 20 February 2018).
NCT03467282 {published data only}
    1. NCT03467282. Probiotics in NASH Patients - PROBILIVER TRIAL (NASH). clinicaltrials.gov/ct2/show/NCT03467282 (first posted 15 March 2018).
NCT04175392 {published data only}
    1. NCT04175392. Effect of probiotics in non-alcoholic fatty liver disease and steatohepatitis. clinicaltrials.gov/ct2/show/NCT04175392 (first posted 25 November 2019).
NCT04193982 {published data only}
    1. NCT04193982. An investigator initiated prospective, four arms randomized comparative study of efficacy and safety of saroglitazar, vitamin E and life style modification in patients with nonalcoholic fatty liver disease (NAFLD)/ non-alcoholic steatohepatitis (NASH). clinicaltrials.gov/ct2/show/NCT04193982 (first posted 11 December 2019).
NCT04198805 {published data only}
    1. NCT04198805. Vitamin E and DHA-EE on NAFLD - randomized, double-blind, placebo-controlled, parallel-group clinical trial (PUVENAFLD). clinicaltrials.gov/ct2/show/NCT04198805 (first posted 13 December 2019).
NCT04330326 {published data only}
    1. NCT04330326. Metabolic cofactor supplementation in obese patients with non-alcoholic fatty liver disease. clinicaltrials.gov/show/NCT04330326 (first posted 1 April 2020).
NCT04475276 {published data only}
    1. NCT04475276. Effect of alpha lipoic acid on non-alcoholic fatty liver diseases. clinicaltrials.gov/show/NCT04475276 (first posted 17 July 2020).
NCT04555434 {published data only}
    1. None of the outcomes of interest for this review will be reported in this trial. Effects of probiotics (P pentosaceus, l lactis or l helveticus) in NASH. clinicaltrials.gov/show/NCT04555434 (first posted 18 September 2020).
NCT04671186 {published data only}
    1. NCT04671186. Role of probiotics in treatment of pediatric NAFLD patients by assessing with fibroscan. clinicaltrials.gov/show/NCT04671186 (first posted 17 December 2020).
NCT04704063 {published data only}
    1. NCT04704063. A randomized, double-blind, placebo-controlled study to assess the efficacy and safety of Tocovid Suprabio 200mg in non-alcoholic fatty liver (NAFL). clinicaltrials.gov/ct2/show/NCT04704063 (first posted 11 January 2021).
NCT04718051 {published data only}
    1. NCT04718051. S.P.Pro liver powder is used to improve liver and metabolic indexes in people with non-alcoholic fatty liver disease. clinicaltrials.gov/ct2/show/NCT04718051 (first posted 22 January 2021).
Wicklow 2015 {published data only}
    1. Wicklow B, Wittmeier K, Gw TJ, McGavock J, Robert M, Duhamel T, et al. Proposed trial: safety and efficacy of resveratrol for the treatment of non-alcoholic fatty liver disease (NAFLD) and associated insulin resistance in adolescents who are overweight or obese adolescents - rationale and protocol. Biochemistry and Cell Biology 2015;93(5):522-30. - PubMed
Zang 2018 {published data only}
    1. Zang S, Chen J, Song Y, Bai L, Chen J, Chi X, et al. Haptoglobin genotype and vitamin E versus placebo for the treatment of nondiabetic patients with nonalcoholic steatohepatitis in China: a multicenter, randomized, placebo-controlled trial design. Advances in Therapy 2018;35(2):218-31. - PubMed

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References to other published versions of this review

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