title: 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.
abstract: Chlorella vulgaris (C. vulgaris) is reported to improve dyslipidemia and hypertension; however, its effect on inflammatory biomarkers and insulin resistance has not been noticed thus far. Non-alcoholic fatty liver disease (NAFLD) as a hepatic symptom of metabolic syndrome is strongly associated with insulin resistance and inflammation.
  
  
  
  In the current interventional trial, we aimed to study the effects of C. vulgaris supplementation on glucose homeostasis, insulin resistance and inflammatory biomarkers in patients with NAFLD.
  
  
  
  Seventy NAFLD patients confirmed by ultra-sonographic findings were randomly assigned into intervention group (four 300 mg tablets of C. vulgaris) or placebo group (four 300 mg tablets of placebos) for 8 weeks. Anthropometric measurements, liver enzymes, fasting serum glucose (FSG), insulin, high sensitive C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-α) were assessed and homeostatic model assessment (HOMA) score for insulin resistance was estimated before and after the intervention.
  
  
  
  Anthropometric measurements decreased significantly in both group (p < 0.001). However, mean reduction in weight was significantly higher in C. vulgaris - treated group compared to placebo group. Serum concentrations of liver enzymes, FSG and hs-CRP also significantly decreased and serum insulin concentration and HOMA score increased significantly only in C. vulgaris-treated group (P < 0.001, P < 0.006 and P < 0.025, respectively). Mean change in serum glucose and TNF-α levels were significant between the groups even after adjusting for the serum insulin and baseline values of variables (P = 0.014, P = 0.005, P = 0.014, respectively); between-group differences were not significant for the other variables by the end of study.
  
  
  
  To our finding, C. vulgaris supplementation could be considered as an adjunctive therapy to decrease weight and improve glycemic status and reducing hs-CRP as well as improving liver function in patients with NAFLD.
  
  
  
  201202233320N7.
authors.affiliation: Nutrition Research Center, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mehrangiz
authors.initials: M
authors.lastname: Ebrahimi-Mameghani
authors.affiliation: University of Payamnoor, Mashad, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Sadeghi
authors.affiliation: School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mahdieh
authors.initials: M
authors.lastname: Abbasalizad Farhangi
authors.affiliation: Student Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Elnaz
authors.initials: E
authors.lastname: Vaghef-Mehrabany
authors.affiliation: Student Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: SA.NUT89@yahoo.com.
authors.forename: Soodabeh
authors.initials: S
authors.lastname: Aliashrafi
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000975:Antioxidants / Q000009:adverse effects / Q000627:therapeutic use*; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D048408:Chlorella vulgaris / Q000737:chemistry*; D019587:Dietary Supplements / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007333:Insulin Resistance; D057194:Intention to Treat Analysis; D007492:Iran; D008082:Lipotropic Agents / Q000009:adverse effects / Q000627:therapeutic use; D008099:Liver / Q000000981:diagnostic imaging / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D059012:Lost to Follow-Up; D008297:Male; D058086:Microalgae / Q000737:chemistry*; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000178:diet therapy* / Q000276:immunology / Q000378:metabolism; D010352:Patient Dropouts
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000975:Antioxidants; D001688:Biological Products; D015415:Biomarkers; D018836:Inflammation Mediators; D008082:Lipotropic Agents
keywords: Chlorella vulgaris; Inflammation; Insulin resistance; Non-alcoholic fatty liver disease