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World J Hepatol. 2013 Mar 27;5(3):109-13. doi: 10.4254/wjh.v5.i3.109.

Silymarin in non alcoholic fatty liver disease.

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Fulvio Cacciapuoti, Anna Scognamiglio, Rossella Palumbo, Raffaele Forte, Federico Cacciapuoti, Department of Internal Medicine and Geriatrics, Second University of Naples, 80138 Naples, Italy.



This study was undertaken to evaluate the hepatic effects of silybum marianum on non alcoholic fatty liver disease (NAFLD).


In 72 patients affected by NAFLD, main metabolic, hepatic and anti-inflammatory parameters were assayed after 3 mo of a restricted diet and before silymarin treatment (twice a day orally). The brightness of liver echography texture (hepatorenal ratio brightness) was also defined at same time. These evaluations were repeated after 6 mo of treatment.


Serum levels of some metabolic and anti-inflammatory data nonsignificantly lowered after 6 mo of silymarin. On the contrary, Steato test, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase were significantly (P < 0.001) reduced. Instead, the AST/ALT ratio unchanged. Finally, the hepatorenal brightness ratio, as an index of hepatic steatosis, significantly (P < 0.05) dropped.


The obtained results indicate that silymarin appears to be effective to reduce the biochemical, inflammatory and ultrasonic indices of hepatic steatosis. Some parameters indicative of early stage of atherosclerosis were also lowered.


Alanine aminotransferase; Aspartate aminotransferase; Fasting glucose level; Gamma-glutamyl transpeptidase; Hepatorenal ultrasonographic index; High density lipoprotein and low density lipoprotein cholesterol; Homeostatic model assessment insulin resistance test; Non alcoholic fatty liver disease; Silymarin; Steato test; Total cholesterol

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