Efficacy of Silymarin in Patients With Non-alcoholic Fatty Liver Disease - The SILIVER Trial
- Conditions
- Non-Alcoholic Fatty Liver Disease
- Interventions
- Dietary Supplement: Silymarin
- Registration Number
- NCT03749070
- Lead Sponsor
- Camila Ribeiro de Avelar
- Brief Summary
Non-Alcoholic Fatty Liver Disease (NAFLD) is one of the most prevalent chronic liver diseases in Brazil and its treatment is still limited. Thus, this project aims to conduct a double-blind, controlled, randomized clinical trial to evaluate the effect of silymarin on laboratory markers and clinical evolution of adult patients with NAFLD treated at Edgard Santos Hospital, as well as identify the dietary pattern of these individuals.
- Detailed Description
Non-Alcoholic Fatty Liver Disease (NAFLD) is one of the most prevalent chronic liver diseases in Brazil. It has a significantly increasing incidence today and is considered an important global health problem. It affects approximately 20 to 30% of the adult population and increases according to the severity of the risk factors. The diagnosis of this disease usually occurs in 10 to 20% of the non-obese individuals, 50% in the overweight and 80 to 90% in the obese, being twice as present in individuals with Metabolic Syndrome. Pharmacological treatment options for NAFLD are still limited and Silybum marianum, one of the most sought-after herbal remedies in patients with liver disease, is commonly used by patients because of the claim of the hepatoprotective effect of silymarin. Studies have demonstrated the therapeutic potential of silymarin in patients with NAFLD, but clinical trials with more judicious methodological designs is still needed to prove these effects. Thus, this project aims to evaluate the efficacy of silymarin in adult patients with NAFLD seen at the Clinic of Nutrition and Hepatology of Edgard Santos Hospital. A randomized, double-blind, controlled clinical trial lasting 12 weeks will be performed.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 132
- Adults between 20 and 60 years of age, both men and women,
- Clinical diagnosis of NAFLD, confirmed by imaging exams,
- Women in the menacing period, with the exception of those who have performed definitive sterilization, such as hysterectomy or tubal ligation.
- Patients with established prior diagnosis of chronic noncommunicable disease (congestive heart failure, decompensated or severe lung disease, neoplasms, renal disease, advanced liver disease - Child Pugh C classification)
- Patients with schistosomiasis;
- Hemochromatosis
- Wilson's disease
- Viral or autoimmune hepatitis
- HIV virus carriers
- Woman who is breastfeeding
- Users of illicit drugs
- Patients with an intake of more than 20 g / day of alcohol and / or past alcoholism with abstention less than 6 months;
- Patients with ingestion of medications such as steroids, estrogens, amiodarone, warfarin, anti-convulsants, antipsychotics, tamoxifen or other chemotherapeutic agents in the last 6 months
- Patients with clinically manifest infections or inflammation, surgery, trauma or hospitalization in the last 30 days
- Chronic non-hepatic degenerative diseases (sclerosis, Parkinson's disease or Alzheimer's disease)
- Patients who do not participate in all stages of the research.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Silymarin Silymarin Patients will receive 2 capsules containing a total of 700mg of silymarin, 8mg of vitamin E and 50mg of phosphatidylcholine, in addition to the excipient, which should be ingested daily for 12 weeks. Placebo Silymarin Patients will also receive similarly 2 capsules per day, but without the bioactive principle tested (silymarin). Therefore, the capsules in the control group will contain only 700 mg of maltodextrin, a neutral food component derived from starch, in addition to the excipient and the same amount of vitamin E and phosphatidylcholine to balance the two groups.
- Primary Outcome Measures
Name Time Method Absence or change in NAFLD degree They will be dosed at baseline and after 12 weeks of intervention. Absence or change in NAFLD degree, assessed by the value of the difference in the attenuation coefficient between liver and spleen obtained by computed tomography of the upper abdomen performed at the beginning and at the end of the study.
- Secondary Outcome Measures
Name Time Method Lipid profile They will be dosed at baseline and after 12 weeks of intervention. Total cholesterol (mg/dL), LDL-cholesterol (mg/dL), HDL-cholesterol (mg/dL), VLDL-cholesterol (mg/dL) and triglycerides (mg/dL) will be measured before and after the intervention.
Fasting blood glucose They will be dosed at baseline and after 12 weeks of intervention. Fasting blood glucose (mg/dL) will be measured before and after the intervention.
Glycated haemoglobin They will be dosed at baseline and after 12 weeks of intervention. Hb A1c (%) will be measured before and after the intervention.
Insulin They will be dosed at baseline and after 12 weeks of intervention. Insulin (µU/mL) will be measured before and after the intervention.
Serum Iron They will be dosed at baseline and after 12 weeks of intervention. Serum iron (mcg/dL) will be measured before and after intervention.
Transferrin saturation They will be dosed at baseline and after 12 weeks of intervention. Transferrin saturation (%) will be measured before and after intervention.
Serum ferritin They will be dosed at baseline and after 12 weeks of intervention. Serum ferritin will be evaluated in µg/L before and after intervention.
Hepatic transaminases They will be dosed at baseline and after 12 weeks of intervention. Alanine aminotransferase (ALT) and Aspartate Aminotransferase (AST) will be evaluated in U/L before and after intervention.
gamma glutamyl transferase They will be dosed at baseline and after 12 weeks of intervention. Gamma glutamyl transferase will be evaluated in U/L before and after intervention.
Trial Locations
- Locations (1)
Camila Ribeiro de Avelar
🇧🇷Salvador, Bahia, Brazil