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A study found that consumption of bayberry juice, as a source of anthocyanins, for 4 weeks decreased the levels of TNF-α and CK-18 M30 among NAFLD patients. In addition, another research reported that intake of Hibiscus sabdariffa extract, rich in anthocyanins, for 12 weeks improved liver steatosis in patients with fatty liver. However, it improved the fibrosis scores of NAFLD patients. For example, supplementation with purified anthocyanins for 12 weeks was associated with a significant decrease in the level of Alanine Aminotransferase (ALT) and cytokeratin-18 fragment M30 (CK-18 M30). However, very few clinical trials evaluated the effect of anthocyanins on NAFLD. Moreover, some human studies reported useful effects of anthocyanins on the levels of liver enzymes such as ALT and AST, oxidative stress markers such as MDA, inflammatory markers such as TNF-α, lipid profile, glycemic control, insulin resistance and adiponectin. According to the literature, the effects of anthocyanins on NAFLD include decrease of lipid accumulation in the liver, improvement of insulin resistance, decrease of lipid profile, inflammation, and oxidative stress. A study suggested that flavonoids such as anthocyanins, found in plant sources with red, purple, and blue colors were effective in treating NAFLD. Since no definite treatment has been found for this disease, identification of new therapeutic approaches is one of the current challenges. The low level of serum adiponectin was also observed in NAFLD patients, which was related to the rate of steatosis, fibrosis, and severity of NAFLD. Moreover, mitochondrial dysfunction, oxidative stress, and increased inflammatory responses are related to damaged liver.
U 26 CORNUS MAS FREE
Insulin resistance increases lipolysis in adipose tissue, releases free fatty acids to liver, and causes inflammation in liver. Nevertheless, NAFLD may be associated with factors such as insulin resistance, oxidative stress, and adipokines such as adiponectin, cytokines, and other inflammatory mediators. The detailed pathogenesis and etiology of the disease are still unknown. However, a recent systematic review showed that its total prevalence was 33.9% among Iranian people. The overall prevalence of NAFLD was from 5 to 20% among the healthy populations and more than 40% in the diabetic patients. Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases. Iranian Registry of Clinical Trials ( IRCT20180419039359N1). DiscussionĬonsidering evidences about the useful impacts of anthocyanins on NAFLD, the effects of supplementation with cornelian cherry extract will be investigated on the important variables related to NAFLD.
U 26 CORNUS MAS TRIAL
Liver function (Serum levels of AST, ALT and CK-18 M30 steatosis and fibrosis of liver), serum levels of TNF-α, MDA, and adiponectin will be measured at the baseline and the end of trial for both groups and their results will be compared. The control group will also take the placebo daily for 12 weeks. The intervention group will receive the cornelian cherry extract, containing 320 mg.d − 1 anthocyanins, per day for 12 weeks. The patients will be randomly assigned into two groups. In a double-blind randomized clinical trial, 80 NAFLD patients will be studied. Thus, the aim of this research will be to evaluate the effect of supplementation with total anthocyanin-base standardized cornelian cherry fruit extract on liver function (Serum levels of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), cytokeratin-18 fragment M30 (CK-18 M30), as well as steatosis and fibrosis of liver), tumor necrosis factor α (TNF-α), malondealdehyde (MDA), and adiponectin in patients with NAFLD. However, very few clinical trials were conducted in this regard.
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Protective effects of Cornelian cherry ( Cornus mas L.) extract, as an anthocyanins-rich source, on liver were reported in animal studies. Evidence showed that anthocyanins might have effects on NAFLD. Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide.