Nano-curcumin improves glucose indices, lipids, inflammation, and Nesfatin in overweight and obese patients with non-alcoholic fatty liver disease (NAFLD): a double-blind randomized placebo-controlled clinical trial

Abstract

BackgroundSince lifestyle changes are main therapies for non-alcoholic fatty liver disease (NAFLD), changing dietary components (nutritional or bioactive) may play a parallel important role. Few studies have assessed the effects of curcumin on NAFLD (mainly antioxidant and anti-inflammatory effects). We aimed to determine the effects of nano-curcumin (NC) on overweight/obese NAFLD patients by assessing glucose, lipids, inflammation, insulin resistance, and liver function indices, especially through nesfatin.MethodsThis double-blind, randomized, placebo-controlled clinical trial was conducted in the Oil Company Central Hospital, Tehran. 84 overweight/obese patients with NAFLD diagnosed using ultrasonography were recruited according to the eligibility criteria (age 25–50 yrs., body mass index [BMI] 25–35 kg/m2). The patients were randomly divided into two equal NC (n = 42) and placebo (n = 42) groups. Interventions were two 40 mg capsules/day after meals for 3 months. Lifestyle changes were advised. A general questionnaire, a 24-h food recall (at the beginning, middle and end), and the short-form international physical activity questionnaire (at the beginning and end) were completed. Also, blood pressure, fatty liver degree, anthropometrics, fasting blood sugar (FBS) and insulin (FBI), glycated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), tumor necrosis factor-alpha (TNF-α), high sensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6), liver transaminases, and nesfatin were determined at the beginning and end.ResultsNC compared with placebo significantly increased HDL, QUICKI, and nesfatin and decreased fatty liver degree, liver transaminases, waist circumference (WC), FBS, FBI, HbA1c, TG, TC, LDL, HOMA-IR, TNF-α, hs-CRP, and IL-6 (P < 0.05). The mean changes in weight, BMI, body composition (BC), and blood pressure were not significant (P > 0.05). After adjustment for confounders, the changes were similar to the unadjusted model.ConclusionNC supplementation in overweight/obese NAFLD patients improved glucose indices, lipids, inflammation, WC, nesfatin, liver transaminases, and fatty liver degree. Accordingly, the proposed mechanism for ameliorating NAFLD with NC was approved by the increased serum nesfatin and likely consequent improvements in inflammation, lipids, and glucose profile. Further trials of nano-curcumin’s effects are suggested.Trial registrationIranian Registry of Clinical Trials, IRCT2016071915536N3. Registered 2016-08-02.

Does turmeric/curcumin supplementation improve serum alanine aminotransferase and aspartate aminotransferase levels in patients with nonalcoholic fatty liver disease? A systematic review and meta‐analysis of randomized controlled trials

“…Among the initial 13,900 publications that were obtained by electronic search (5,535 duplicates), 8,355 were excluded because they were unrelated to present meta‐analysis according to our inclusion criteria. After reading the full text of the remaining 10 studies, four studies were also excluded for the following reasons: two studies did not report data on liver enzymes (Basu et al, ; Jazayeri‐Tehrani et al, ), one study was a duplicate report (Ghaffari, Rafraf, Navekar, & Asghari‐Jafarabadi, ), and one study was published as protocol (Jazayeri‐Tehrani et al, ). Finally, six eligible RCTs (Chirapongsathorn et al, ; Jarahzadeh & Hosain, ; Moradi et al, ; Navekar et al, ; Panahi et al, ; Rahmani et al, ) were included in our analysis.…”

The effects of curcumin supplementation on body mass index, body weight, and waist circumference in patients with nonalcoholic fatty liver disease: A systematic review and dose–response meta‐analysis of randomized controlled trials

“…We excluded nine other studies because of the following reasons: (a) Seven articles were derived from the same trials and reported the same outcomes. We included the most complete ones to avoid double weighting in the estimates derived from the same studies (Jazayeri‐Tehrani et al, ; Navekar et al, ; Saadati et al, ). (b) Trials without placebo or control group were excluded ( n = 2; Panahi, Kianpour, Mohtashami, Soflaei, & Sahebkar, ).…”

“…In the overall pooled estimate of eight trials (Chashmniam et al, ; Cicero et al, ; Jazayeri‐Tehrani et al, ; Mirhafez et al, ; Navekar et al, ; Panahi et al, ; Rahmani et al, ; Saadati et al, ) with 520 participants (a dose ranging from 70 to 3,000 mg/day), it was shown that curcumin supplementation was associated with a significant reduction in BMI (WMD = −0.34 kg/m 2 , 95% CI [−0.64, −0.04], p < .05) compared with the control group (Figure ). The heterogeneity among trials investigating the effect of curcumin supplementation on BMI was high ( I 2 = 63.2%, p < .01).…”

“…Sex studies including a total of 353 participants (curcumin group = 181 and control group = 172) reported body weight as an outcome measure (Chashmniam et al, ; Jazayeri‐Tehrani et al, ; Mirhafez et al, ; Navekar et al, ; Rahmani et al, ; Saadati et al, ). Combined results from the random‐effects model showed that curcumin supplementation had no significant effect on body weight (WMD = −0.60 kg, 95% CI [−2.07, 0.87], p = .423) with significant heterogeneity among the studies ( I 2 = 81.8%, p < .001; Figure ).…”

“…The results from meta‐analysis of four trials (Cicero et al, ; Jazayeri‐Tehrani et al, ; Panahi et al, ; Saadati et al, ) with 301 participants (curcumin group = 153 and control group = 148) showed that daily supplementation of curcumin had a significant reducing effect on WC (WMD = −2.12 cm, 95% CI [−3.26, −0.98], p < .001) as compared with placebo using random‐effect model (Figure ). Nonlinear dose–response meta‐analysis showed a significant effect of supplementation dosage on WC ( p nonlinearity = .005, goodness of fit = 4.13; Figure ).…”