Evidence mapPaperPMID 39097726Full record

Trial reportLipids in health and disease2024

Silymarin decreases liver stiffness associated with gut microbiota in patients with metabolic dysfunction-associated steatotic liver disease: a randomized, double-blind, placebo-controlled trial.

Yufeng Jin, Xin Wang, Ke Chen, Yu Chen, Lixin Zhou, Yupeng Zeng, Yuqing Zhou, Zhijun Pan, Di Wang, Zhongxia Li and 3 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Lipids in health and disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. [Construction norms for the tiered diagnosis and treatment and standardized management center of metabolic-associated fatty liver disease].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Guideline
  2. Pooled it
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  8. Frontiers in microbiology · 2026
    Article
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  11. Daixie recipe ameliorates diet-induced MASH in miceFrontiers in endocrinology · 2026
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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

13 authors.

Yufeng Jin *Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
Xin Wang *Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
Ke ChenShunde Hospital (The First People's Hospital of Shunde), Southern Medical University, Foshan, China.
Yu ChenDepartment of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
Lixin ZhouShunde Hospital (The First People's Hospital of Shunde), Southern Medical University, Foshan, China.
Yupeng ZengDepartment of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
Yuqing ZhouDepartment of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
Zhijun PanDepartment of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
Di WangBYHEALTH Institute of Nutrition & Health, Guangzhou, 510663, China.
Zhongxia LiBYHEALTH Institute of Nutrition & Health, Guangzhou, 510663, China.
Yongqian LiangShunde Hospital (The First People's Hospital of Shunde), Southern Medical University, Foshan, China. 102lyq@163.com.
Wenhua LingDepartment of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. lingwh@mail.sysu.edu.cn.
Dan LiDepartment of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China. lidan58@mail.sysu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite centuries of traditional use of silymarin for hepatoprotection, current randomized controlled trial (RCT) studies on the effectiveness of silymarin in managing metabolic dysfunction-associated steatotic liver disease (MASLD) are limited and inconclusive, particularly when it is administered alone. The low bioavailability of silymarin highlights the possible influence of gut microbiota on the effectiveness of silymarin; however, no human studies have investigated this aspect.

objectiveTo determine the potential efficacy of silymarin in improving MASLD indicators and to investigate the underlying mechanisms related to gut microbiota.

methodIn this 24-week randomized, double-blind, placebo-controlled trial, 83 patients with MASLD were randomized to either placebo (n = 41) or silymarin (103.2 mg/d, n = 42). At 0, 12, and 24 weeks, liver stiffness and hepatic steatosis were assessed using FibroScan, and blood samples were gathered for biochemical detection, while faecal samples were collected at 0 and 24 weeks for 16S rRNA sequencing.

resultsSilymarin supplementation significantly reduced liver stiffness (LSM, -0.21 ± 0.17 vs. 0.41 ± 0.17, P = 0.015) and serum levels of γ-glutamyl transpeptidase (GGT, -8.21 ± 3.01 vs. 1.23 ± 3.16, P = 0.042) and ApoB (-0.02 ± 0.03 vs. 0.07 ± 0.03, P = 0.023) but had no significant effect on the controlled attenuation parameter (CAP), other biochemical indicators (aminotransferases, total bilirubin, glucose and lipid parameters, hsCRP, SOD, and UA), physical measurements (DBP, SBP, BMI, WHR, BF%, and BMR), or APRI and FIB-4 indices. Gut microbiota analysis revealed increased species diversity and enrichment of Oscillospiraceae in the silymarin group.

conclusionThese findings suggest that silymarin supplementation could improve liver stiffness in MASLD patients, possibly by modulating the gut microbiota.

trial registrationThe trial was registered at the Chinese Clinical Trial Registry (ChiCTR2200059043).

Indexed as

Gastrointestinal MicrobiomeLiverSilymarinAdultAgedDietary SupplementsDouble-Blind MethodElasticity Imaging TechniquesFatty LiverFemaleHumansMaleMiddle AgedRNA, Ribosomal, 16SRNA, Ribosomal, 16SSilymarinFlavonoidsGut microbiotaLiver stiffnessMetabolic dysfunction-associated steatotic liver diseasePhytochemicalsRandomized controlled studySilymarin

Identifiers

PMID39097726
PMCPMC11297656

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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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.