Curcuminoids plus piperine improve nonalcoholic fatty liver disease: A clinical trial

Abstract

Background Nonalcoholic fatty liver disease (NAFLD) as a prevalent hepatic disease is associated with an increased risk of morbidity and mortality related to the liver and cardiovascular disease (CVD). Lifestyle modification and good metabolic control is the first line of treatment, but not always efficacious in reversing NAFLD pathogenesis. Curcumin is a dietary phytochemical with hepatoprotective activities, though its low bioavailability is considered as a major challenge for clinical applications. Therefore, in this study, in order to improve the bioavailability of curcumin, it was coadministered with piperine and we investigated the effects of this bioavailability‐enhanced curcumin on serum hepatic enzymes, lipid profile, and glycemic indices in patients with NAFLD. Methods In this randomized controlled parallel‐group trial, 70 subjects with ultrasound‐determined NAFLD were randomized to either 500 mg curcuminoids coadministered with 5 mg piperine daily or placebo for 12 weeks. NAFLD severity (on the basis of sonography) and hepatic function was assessed at baseline and at the study end. Results Seventy subjects completed the study. Supplementation with curcuminoids plus piperine significantly reduced the hematocrit (P = 0.027), erythrocyte sedimentation rate (P = 0.048) and the serum concentrations of alanine aminotransferase (P = 0.035), aspartate aminotransferase (P = 0.042), alkaline phosphatase (P = 0.004), cholesterol (P < 0.016), low‐density lipoprotein cholesterol (P < 0.017), Iron (P = 0.026), and Hemoglobin (P = 0.025) and increased total iron‐binding capacity (P = 0.003). However, except albumin, changes in other parameters were not statistically different between groups. In addition, administration of curcuminoids plus piperine significantly improved NAFLD severity (P < 0.001), which was statistically different compared with the placebo group (P = 0.022). Also, the percentage of improved patients was marginally higher in the curcuminoids plus piperine group when compared with the placebo group (P = 0.058). Conclusion This study suggested beneficial effects of combined curcuminoids and piperine supplementation on disease severity in patients with NAFLD.

Piperine: A review of its biological effects

“…Similarly, a combined therapy of curcuminoids and piperine was effective against nonalcoholic fatty liver disease (Panahi et al, 2019). In type 2 diabetes mellitus, piperine and curcuminoids mutually modulated the adipokines and controlled the energy metabolism (Panahi et al, 2017).…”

Does naringenin supplementation improve lipid profile, severity of hepatic steatosis and probability of liver fibrosis in overweight/obese patients with NAFLD? A randomised, double‐blind, placebo‐controlled, clinical trial

“…However, a profitable effect was also found on NAFLD severity. 32 Furthermore, Pezeshki et al 33 proposed that green tea, a rich source of catechin, could improve serum levels of liver enzymes in patients with NAFLD and they studied administration of green tea extract (500 mg per day) or a similar placebo for 90 days. At the end of the trial, AST, ALP and ALT levels were significantly reduced in the supplement group.…”

Improving Curcumin Bioavailability: Current Strategies and Future Perspectives

“…Seventy adults were arbitrarily assigned to the placebo or treatment group and consumed one capsule after meals for 12 weeks. Results showed that the administration of Curcumin C 3 Complex ® and Bioperine ® improved liver and lipid profile without altering hematological parameters, thus reducing NAFLD severity compared to placebo [73]. The same research group also considered the effect of the formulation on serum inflammatory factors, namely, TNFα and IL-6, in a randomized double-blind placebo-controlled trial with 55 subjects with NAFLD.…”