The Effects of Realsil (Silybin-Phospholipid-Vitamin E Complex) on Liver Enzymes in Patients with Non-Alcoholic Fatty Liver Disease (Nafld) or Non-Alcoholic Steato-Hepatitis (Nash): A Systematic Review and Meta-Analysis of Rcts

Abstract

Background. The aim of the present study was to systematically review the effects of Realsil (silybin-phospholipid-vitamin E complex) on liver enzymes in patients with NAFLD or NASH. Methods. We searched Web of Science, MEDLINE, Google Scholar, Cochrane Library, Science Direct, ProQuest, Scopus, and 1868 articles were found up to December 2018. Four studies that examined the effect of Realsil intake on liver enzymes among NAFLD or NASH patients were included. Exclusion criteria include - animal studies, studies with the design other than clinical trials, studies on non-adult individuals, studies that assess the effect of vitamin E, silybin, or phospholipid solely, studies that examined the effect of Realsil on other outcomes, or studies with insufficient data. Results. The analysis demonstrated that Realsil intake led to a significant decrease in Gamma-Glutamyl Transpeptidase (GGT) levels (standardized mean difference (SMD) =-0.37; 95 confidence interval (CI]): -0.68 to -0.06). Realsil intake non-significantly decrease alanine transaminase (ALT) levels (SMD=-1.02 U/L; 95 CI: -2.23 to 0.20) and non-significantly increase aspartate aminotransferase (AST) levels (SMD = 0.17 U/L; 95 CI: -0.26-0.61). Conclusion. Realsil intake was associated with a significantly decreased circulating GGT level without any significant effect on AST and ALT levels.