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Efficacy of selected dietary supplements and pharmacological agents on metabolic and oxidative stress outcomes in metabolic dysfunction-associated fatty liver disease (MAFLD): a Bayesian network meta-analysis

Yang Y, He X, Cai J, Qu X, Tan S, You J, He Y, Yao Z et al.

Frontiers in pharmacology, 2025

7,273 participants

Abstract

Objective: This study aimed to compare the relative efficacy of dietary supplements and pharmacological agents in improving metabolic and oxidative stress outcomes in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) through a systematic review and Bayesian network meta-analysis.

Methods: PubMed, Embase, the Cochrane Library, and Web of Science databases were systematically searched to identify randomized controlled trials (RCTs) published between 1 January 2014, and 3 March 2024, that evaluated the effects of dietary supplements or pharmacological agents on MAFLD.

Results: A total of 106 RCTs involving 7,273 participants were included, involving a variety of nutritional and pharmacological interventions. Pharmacological intervention plus bioactive regulator was the most effective in reducing triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C). Nutrient plus pharmacological intervention was the most efficacious in improving glycated hemoglobin (HbA1c) and insulin levels. Pharmacological intervention plus another pharmacological intervention was most effective in reducing alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Phytochemicals significantly reduced interleukin-6 (IL-6), while bioactive metabolic regulators markedly decreased tumor necrosis factor-α (TNF-α). Herbal extracts demonstrated superior effects in enhancing total antioxidant capacity (TAC) and superoxide dismutase (SOD), while oleoylethanolamide (OEA)…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 7,273 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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