Evidence map›Paper›PMID 22278337›Full record

SynthesisDiabetologia2012

Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials.

G Musso, M Cassader, F Rosina, R Gambino

2 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Diabetologia, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 321 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
321citing papers in PubMed, 14 pooled it
33.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04186260 nacompletednot on this mapstarted 2024, after this paper: background citation

A Gender and Culturally Specific Approach to Reduce NAFLD in Mexican-American Men

TypeinterventionalSponsorUniversity of ArizonaRan2024 to 2025Enrolled15ConditionsNAFLDArmsNAFLD-specific weight loss intervention, Wait-list control
NCT07580482 nacompletednot on this mapstarted 2020, after this paper: background citation

The Referral to Hepatology Can be Improved Through an Electronic Medical Record (EMR)-Based Best Practice Alert (BPA) for an Appropriate Referral

TypeinterventionalSponsorUniversity of Kansas Medical CenterRan2020 to 2022Enrolled30ConditionsLiver Diseases, Liver Fat, Diabetes Mellitus, Type 2, Non-Alcoholic SteatohepatitisArmsBest Practice Alert, No Intervention
3 · Its place in the literature

Who cites it

321 citing papers in PubMed, 14 syntheses or guidelines pooled it, 664 citations in OpenAlex.

  1. Guideline
  2. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Guideline
  3. Pharmacotherapy for obesity management in adults: 2025 clinical practice guideline update.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Guideline
  4. Pooled it
  5. Guideline
  6. Pooled it
  7. Pooled it
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  9. Guideline
  10. AGA Clinical Practice Update on Bariatric Surgery in Cirrhosis: Expert Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021
    Guideline
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Trial
  16. Trial
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  18. Exercise training improves serum biomarkers of liver fibroinflammation in patients with metabolic dysfunction-associated steatohepatitis.Liver international : official journal of the International Association for the Study of the Liver · 2024
    Trial
  19. Impact of a Mediterranean diet on hepatic and metabolic outcomes in non-alcoholic fatty liver disease: The MEDINA randomised controlled trial.Liver international : official journal of the International Association for the Study of the Liver · 2022
    Trial
  20. Trial

261 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

G MussoGradenigo Hospital, C.so Regina Margherita 8, Turin, Italy. giovanni_musso@yahoo.it
M Cassader
F Rosina
R Gambino
University of Turin · ITOspedale Regina Margherita · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisNon-alcoholic fatty liver disease (NAFLD) encompasses a spectrum ranging from simple steatosis to non-alcoholic steatohepatitis (NASH): NAFLD causes an increased risk of cardiovascular disease, diabetes and liver-related complications (the latter confined to NASH). The effect of proposed treatments on liver disease, glucose metabolism and cardiovascular risk in NAFLD is unknown. We reviewed the evidence for the management of liver disease and cardio-metabolic risk in NAFLD.

methodsPublications through November 2011 were systematically reviewed by two authors. Outcomes evaluated though standard methods were: histological/radiological/biochemical features of NAFLD, variables of glucose metabolism and cardiovascular risk factors. Seventy-eight randomised trials were included (38 in NASH, 40 in NAFLD): 41% assessed post-treatment histology, 71% assessed glucose metabolism and 88% assessed cardiovascular risk factors. Lifestyle intervention, thiazolidinediones, metformin and antioxidants were most extensively evaluated.

resultsLifestyle-induced weight loss was safe and improved cardio-metabolic risk profile; a weight loss ≥7% improved histological disease activity, but was achieved by <50% patients. Statins and polyunsaturated fatty acids improved steatosis, but their effects on liver histology are unknown. Thiazolidinediones improved histological disease activity, glucose, lipid and inflammatory variables and delayed fibrosis progression. Pioglitazone also improved blood pressure. Weight gain (up to 4.8%) was common. Antioxidants yielded mixed histological results: vitamin E improved histological disease activity when administered for 2 years, but increased insulin resistance and plasma triacylglycerols. CONCLUSIONS/

interpretationWeight loss is safe, and improves liver histology and cardio-metabolic profile. For patients not responding to lifestyle intervention, pioglitazone improves histological disease activity, slows fibrosis progression and extensively ameliorates cardio-metabolic endpoints. Further randomised controlled trials (RCTs) of adequate size and duration will assess long-term safety and efficacy of proposed treatments on clinical outcomes.

Indexed as

Cardiovascular DiseasesFatty LiverGlucoseHumansLiver DiseasesRandomized Controlled Trials as TopicRiskGlucose

Identifiers

PMID22278337
OpenAlexW2157338541

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.