title: The role of nutraceuticals for the treatment of non-alcoholic fatty liver disease.
abstract: Non-alcoholic fatty liver disease (NAFLD) represents the most common chronic liver disease. It is characterized by a wide spectrum of hepatic changes, which may progress to liver fibrosis and to cirrhosis. NAFLD is considered as the hepatic component of the metabolic syndrome but mechanisms underlying the onset and progression of NAFLD are still under investigation. The traditional 'two hit hypothesis' has been developed within a more complex 'multiple parallel hit hypothesis' which comprises a wide spectrum of parallel hits. Many therapeutic approaches have been proposed so far and several types of nutraceuticals have been suggested for the treatment of NAFLD and non-alcoholic steatohepatitis (NASH), the most promising of which are those with antioxidant effects. In particular, vitamin E appears to be effective for the treatment of nondiabetic subjects with more advanced NASH, although the high suggested daily dosages are a matter of concern. Moreover, polyphenols reduce liver fat accumulation, mainly by inhibiting lipogenesis. At present, there are insufficient data to support the use of vitamin C supplements in patients with NAFLD. Data on polyunsaturated fatty acid (PUFA) supplementation are heterogeneous, and no well-designed randomized controlled studies (RCTs) of adequate size, with histological assessment of steatosis, have been conducted. Based on the available data, silymarin supplementation for the treatment of NAFLD seems to have a favourable effect. The results with anti-inflammatory agents, such as vitamin D and carnitine are uncertain. In conclusion, there are insufficient data either to support or refute the use of nutraceuticals for subjects with NAFLD. Further RTCs, with histological changes as an outcome measure, are needed.
authors: Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
authors: Maria
authors: M
authors: Del Ben
authors: Department of Internal Medicine and Medical Specialties & Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University, Rome, Italy.
authors: Licia
authors: L
authors: Polimeni
authors: Department of Internal Medicine and Medical Specialties & Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University, Rome, Italy.
authors: Francesco
authors: F
authors: Baratta
authors: Department of Internal Medicine and Medical Specialties & Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University, Rome, Italy.
authors: Daniele
authors: D
authors: Pastori
authors: Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
authors: Francesco
authors: F
authors: Angelico
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D019587:Dietary Supplements; D006801:Humans; D065626:Non-alcoholic Fatty Liver Disease / Q000188:drug therapy*; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D014815:Vitamins
keywords: antioxidants; non-alcoholic fatty liver disease; nutraceuticals; omega-3 fatty acids; polyphenols