Efficacy of Oral Supplementation with Silymarin and S-Adenosyl-L-Methionine in Patients with Non Alcoholic Fatty Liver Disease – A Pilot Study

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide, affecting up to one-third of the population in industrialized countries. Silymarin and S-Adenosyl-L-Methionine (SAMe) have therapeutic potential for treatment of liver disease. The aim of the present pilot study was to evaluate the possible effect of a supplementation with Silymarin and SAMe in NAFLD patients. Methods: Fifteen NAFLD patients (mean age: 46.3 ± 15 years) confirmed by ultra-sonographic findings were subjected to a 12-month oral supplementation with Silymarin and SAMe. Anthropometric measurements, biochemical parameters, liver function and hepatic fat content were assessed at baseline, at 6 months and at the end of treatment. Results: After a 12-months’ oral supplementation a significant improvement (p<0.05) in several biochemical parameters such as total cholesterol (mean reduction: -8.67 mg/dL), insulin (-1.34 U/L) and HOMA-IR (-1.35) was observed. Similarly, serum levels of alanine aminotransferase (ALT) and alkaline phosphatase (ALP) significantly decreased by 13% (-3.87 U/L and -10.4 U/L respectively), with a small but significant amelioration in the risk profile. Finally, the ultrasonography examination revealed an improvement in liver echo-texture and a regression of the degree of hepatic steatosis, associated with a 22% increase of the Doppler Perfusion Index (DPI), which corresponds to better liver hemodynamic. Conclusion: Our findings suggest that a prolonged Silymarin and SAMe supplementation could be used as an adjunctive therapy to improve metabolic risk profile and hepatic steatosis in patients with NAFLD. Further research is needed to confirm these preliminary results.