Therapeutic Efficacy of Silymarin, Vitamin E, and Essential Phospholipid Combination Therapy on Hepatic Steatosis, Fibrosis, and Metabolic Parameters in MASLD Patients: A Prospective Clinical Study
Abstract
1. Introduction
2. Results
2.1. BMI
2.2. ALT
2.3. AST
2.4. GGT
2.5. ALP
2.6. TG
2.7. Total Cholesterol
2.8. Blood Glucose
2.9. Fibrosis Assessment
2.10. Steatosis Assessment
3. Discussion
Limitations
4. Materials and Methods
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
MASLD | Metabolic dysfunction-associated steatotic liver disease |
MASH | Metabolic dysfunction-associated steatohepatitis |
MRE | Magnetic resonance elastography |
VCTE | Vibration-controlled transient elastography |
CAP | Controlled attenuation parameter |
LSM | Liver stiffness measurement |
ROS | Reactive oxygen species |
LDL | Low-density lipoproteins |
TG | Triglycerides |
MG | MILLIGRAMS |
BID | Twice daily |
ID | Identity document |
BMI | Body mass index |
ALT | Alanine transaminase |
AST | Aspartate transaminase |
GGT | Gamma-glutamyl transferase |
ALP | Alkaline phosphatase |
TC | Total cholesterol |
BG | Blood glucose |
CAP | Controlled attenuation parameter |
SD | Standard deviation |
Q1 | First quartile |
Q3 | Third quartile |
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Characteristics | Esentin Trio® (n = 190) |
---|---|
Age, years | |
Mean (SD) | 47.66 ± 10.43 |
Median (Q1, Q3) | 47 (39.75–55.25) |
Sex, male, n (%) | 100 (52.6%) |
BMI, kg·m−2 | |
Mean (SD) | 28.97 ± 4.24 |
Median (Q1, Q3) | 29 (26–32) |
Alcohol consumption, n (%) | |
No | 50 (26.3%) |
Occasional | 109 (57.4%) |
Frequent | 25 (13.2%) |
Daily | 6 (3.2%) |
Type 2 diabetes, n (%) | 67 (35.3%) |
Hypertension, n (%) | 77 (40.5%) |
Dyslipidemia, n (%) | 94 (49.5%) |
Hypothyroidism, n (%) | 29 (15.3%) |
Fibrosis grade, n (%) | |
F0–F1 | 156 (82.1%) |
F2 | 23 (12.1%) |
F3 | 10 (5.3%) |
F4 | 1 (0.5%) |
Steatosis grade, n (%) | |
S1 | 42 (22.1%) |
S2 | 74 (38.9%) |
S3 | 74 (38.9%) |
Clinical Characteristics | Baseline | After 6 Months of Treatment | p-Value |
---|---|---|---|
FibroScan VCTE/LSM, kPa | 0.018 | ||
mean (SD) | 6.14 ± 6.68 | 5 ± 1.42 | |
median (Q1, Q3) | 5.4 (4.6–6.5) | 5 (4.4–6.4) | |
FibroScan CAP, dBm | <0.0001 | ||
mean (SD) | 296.05 ± 36.82 | 269 ± 39.22 | |
median (Q1, Q3) | 293 (271.5–310) | 266 (246.25–286.75) | |
ALT, UI−1 | <0.0001 | ||
mean (SD) | 58.65 ± 38.44 | 37 ± 20.68 | |
median (Q1, Q3) | 46.5 (27.75–84.25) | 30 (20–49.75) | |
AST, UI−1 | <0.0001 | ||
mean (SD) | 49.5 ± 31.07 | 33 ± 16.6 | |
median (Q1, Q3) | 40.5 (23–69) | 28 (20.3–43) | |
GGT, UI−1 | <0.0001 | ||
mean (SD) | 73.47 ± 48.54 | 57 ± 35.96 | |
median (Q1, Q3) | 59 (34–115) | 45 (28–86) | |
ALP, UI−1 | 0.022 | ||
mean (SD) | 79.33 ± 33.03 | 74 ± 24.68 | |
median (Q1, Q3) | 75.5 (57.83–95.5) | 70 (58–88.75) | |
TG, mg·dL−1 | <0.0001 | ||
mean (SD) | 163.04 ± 65.89 | 147 ± 64 | |
median (Q1, Q3) | 163 (126–200.5) | 146 (117–167) | |
TC, mg·dL−1 | <0.0001 | ||
mean (SD) | 222.73 ± 46.22 | 196 ± 35.26 | |
median (Q1, Q3) | 226.5 (195–260) | 200 (178–217.75) | |
BG, mg/dL | <0.0001 | ||
mean (SD) | 108.11 ± 28.55 | 98 ± 21.84 | |
median (Q1, Q3) | 104 (90–117.25) | 96 (86–105.75) |
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Gheonea, D.-I.; Tocia, C.; Sacerdoțianu, V.-M.; Bocioagă, A.-G.; Doica, I.-P.; Manea, N.C.; Turcu-Știolică, A.; Oancea, C.-N.; Dumitru, E. Therapeutic Efficacy of Silymarin, Vitamin E, and Essential Phospholipid Combination Therapy on Hepatic Steatosis, Fibrosis, and Metabolic Parameters in MASLD Patients: A Prospective Clinical Study. Int. J. Mol. Sci. 2025, 26, 5427. https://doi.org/10.3390/ijms26125427
Gheonea D-I, Tocia C, Sacerdoțianu V-M, Bocioagă A-G, Doica I-P, Manea NC, Turcu-Știolică A, Oancea C-N, Dumitru E. Therapeutic Efficacy of Silymarin, Vitamin E, and Essential Phospholipid Combination Therapy on Hepatic Steatosis, Fibrosis, and Metabolic Parameters in MASLD Patients: A Prospective Clinical Study. International Journal of Molecular Sciences. 2025; 26(12):5427. https://doi.org/10.3390/ijms26125427
Chicago/Turabian StyleGheonea, Dan-Ionuț, Cristina Tocia, Victor-Mihai Sacerdoțianu, Alexandra-Georgiana Bocioagă, Irina-Paula Doica, Nicolae Cătălin Manea, Adina Turcu-Știolică, Carmen-Nicoleta Oancea, and Eugen Dumitru. 2025. "Therapeutic Efficacy of Silymarin, Vitamin E, and Essential Phospholipid Combination Therapy on Hepatic Steatosis, Fibrosis, and Metabolic Parameters in MASLD Patients: A Prospective Clinical Study" International Journal of Molecular Sciences 26, no. 12: 5427. https://doi.org/10.3390/ijms26125427
APA StyleGheonea, D.-I., Tocia, C., Sacerdoțianu, V.-M., Bocioagă, A.-G., Doica, I.-P., Manea, N. C., Turcu-Știolică, A., Oancea, C.-N., & Dumitru, E. (2025). Therapeutic Efficacy of Silymarin, Vitamin E, and Essential Phospholipid Combination Therapy on Hepatic Steatosis, Fibrosis, and Metabolic Parameters in MASLD Patients: A Prospective Clinical Study. International Journal of Molecular Sciences, 26(12), 5427. https://doi.org/10.3390/ijms26125427