Essential phospholipids for nonalcoholic fatty liver disease associated with metabolic syndrome: A systematic review and network meta-analysis  

作　　者：Asad Izziddin Dajani Branko Popovic 

机构地区：[1]ADSC,Medcare Hospital and Saudi German Hospital,Sharjah,Al Khan,PO Box 6328,United Arab Emirates [2]Sanofi-Aventis Deutschland GmbH,CHC Global Medical Affairs,Frankfurt am Main 65926,Germany

出　　处：《World Journal of Clinical Cases》2020年第21期5235-5249,共15页世界临床病例杂志

摘　　要：BACKGROUND Essential phospholipids(EPL)are used for the supportive treatment of nonalcoholic fatty liver disease(NAFLD),but data are mostly from small-scale studies.AIM To evaluate the efficacy of EPL treatment in adult patients with NAFLD and type 2 diabetes and/or obesity.METHODS The MEDLINE,PubMed,Embase,and Cochrane databases were searched up to March 2019 for clinical trials and comparative observational studies.Eligible studies were those published in English or Chinese that enrolled adult patients(≥18 years)with NAFLD and type 2 diabetes mellitus and/or obesity receiving EPL as monotherapy or as add-on therapy to existing therapy,and that included at least one of the efficacy outcomes of interest.A variety of studies were identified;thus,direct,indirect and cohort meta-analyses were performed.Mean difference(MD)and 95%confidence interval(CI)were calculated for continuous variables,and relative risk with 95%CI for disease response and recovery.A random-effects model was used to address between-study heterogeneity.RESULTS Ten studies met the inclusion criteria(n=22-324).EPL treatment duration ranged from 4 to 72 wk.In the direct meta-analysis(four randomized controlled trials),compared with antidiabetic therapy alone,EPL plus antidiabetic therapy was associated with a significantly greater reduction in[alanine aminotransferase(ALT);MD:11.28 U/L(95%CI:-17.33,-5.23),P=0.0003],triglyceride[MD:-49.33 mg/dL(95%CI:-66.43,-32.23),P<0.0001]and total cholesterol levels[MD:-29.74 mg/dL(95%CI:-38.02,-21.45),P<0.0001].There was also a significant increase in the rate of overall improvement[relative risk 1.50(95%CI:1.26-1.79),P<0.0001],and risk of no disease(P=0.0091),and a reduction in moderate disease(P=0.0187);there were no significant differences in severe disease,mild disease,or significant improvement.In the cohort meta-analysis of three non-randomized clinical trials,the MD in ALT levels was-16.71 U/L(95%CI:-24.94,-8.49)and 23%of patients had improved disease.In the cohort meta-analysis of five randomized trials

关 键 词：Non-alcoholic fatty liver disease DIABETES OBESITY Metabolic syndrome Essential phospholipids Systematic review META-ANALYSIS 

分 类 号：R575.5[医药卫生—消化系统]