An updated meta-analysis of effects of curcumin on metabolic dysfunction-associated fatty liver disease based on available evidence from Iran and Thailand

Abstract

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a common cause of chronic liver disease and can progress to nonalcoholic steatohepatitis and cirrhosis. This study aims to summarize the evidence for the effects of curcumin on MAFLD progression. Studies were identified from Medline and Scopus databases until April 2022. Systematic reviews and meta-analyses (SRMA) and randomized controlled trials (RCT) were selected based on pre-specified criteria. Three reviewers independently extracted data and assessed quality of included studies. Of the 427 identified records, 6 SRMAs and 16 RCTs were included in the analysis. Very high overlap was observed among SRMAs with corrected covered area of 21.9%. From an updated meta-analysis, curcumin demonstrated significant improvement in aspartate and alanine aminotransferase with pooled mean difference [95% confidence interval (CI)] of −3.90 (−5.97, −1.82) and −5.61 (−9.37, −1.85) units/L, respectively. Resolution and improvement of hepatic steatosis was higher in curcumin than control group with pooled relative risk (95% CI) of 3.53 (2.01, 6.22) and 3.41 (1.36, 8.56), respectively. Curcumin supplementation also led to lower fasting blood sugar, body mass index, and total cholesterol. Further trials should be conducted to assess the effect of curcumin on liver histology, especially regarding non-invasive hepatic fibrosis and steatosis.

Potential Benefit of Spices for Glycemic Control

“…The effects of turmeric and different forms of curcumin on blood glucose concentrations were assessed from meta-analyses in which subjects exhibited diverse disorders such as MetS, NAFLD, PCOS, T2DM, and CVD 32,49–68 . Compared with controls, most meta-analyses showed a consistent, statistically significant effect of curcumin in decreasing FBG levels (Table 2).…”

Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review

“…Histological findings from rodent studies showed that curcumin and related substances ameliorated liver fibrosis by inhibiting hepatic stellate cell proliferation, collagen synthesis, and matrix metalloproteinase and reduced the number of necrotic cells in a dose-dependent fashion [254]. In a recent meta-analysis of Asian clinical trials conducted for 8-12 weeks involving supplementation with different forms of curcumin, small but significant reductions in AST and ALT levels (but not in cholestasis markers) were observed, together with a significant reduction in ultrasound-evaluated liver steatosis, BMI, waist circumference, fasting blood glucose and total cholesterol; no significant variation in liver fibrosis at transient elastography was demonstrated, but this parameter was evaluated only in two studies [255]. Recent murine data suggest a possible muscle-specific response to curcumin treatment, with prevention of muscle mass loss, reduction of age-related muscle force loss and overall reduction in mortality in old mice [256,257].…”

Potential Therapeutic Strategies in the Treatment of Metabolic-Associated Fatty Liver Disease

“…In a meta-analysis of 16 randomized clinical trials conducted by Ngu et al, including 1028 patients with MAFLD, the effect of curcumin supplementation on various metabolic parameters was assessed. Curcumin was shown to reduce the severity of MAFLD (RR = 3.52; 95% CI: 1.27-9.72) and increase liver steatosis resolution (RR = 3.96; 95% CI: 1.54-10.17 ], an increase in the resolution of hepatic steatosis (as measured using ultrasonography) (MD = 3.53; 95% CI: 2.01-6.22), and a reduced fasting blood sugar, body-mass index, and total cholesterol concentration [218].…”