Evidence mapPaperPMID 40933261Full record

SynthesisFrontiers in nutrition2025

Low-carbohydrate diets reduce cardiovascular risk factor levels in patients with metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis of randomized controlled trials.

Shanshan Pi, Shuwen Zhang, Junjie Zhang, Yi Guo, Yue Li, Jinyan Deng, Hongbo Du

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
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

7 authors.

Shanshan PiDepartment of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Shuwen ZhangBeijing University of Chinese Medicine, Beijing, China.
Junjie ZhangDepartment of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Yi GuoDepartment of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Yue LiDepartment of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Jinyan DengDepartment of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Hongbo DuDepartment of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Low-carbohydrate diets (LCDs) are increasingly advocated for the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD); however, their cardiovascular safety profile remains controversial. This analysis aims to evaluate the effects of LCDs on cardiovascular risk factors in MASLD patients. Methods: PubMed, Cochrane Library, Web of Science, and Scopus were searched from inception to March 19, 2025. Two reviewers independently conducted data extraction. Meta-analyses were performed using fixed-effects or random-effects models, as determined by the heterogeneity of the included studies. Outcomes included blood pressure, glycemic markers, lipid profiles, and anthropometric indicators. Subgroup analyses explored carbohydrate thresholds (<26% vs. ≥26%) and intervention durations (<24 weeks vs. ≥24 weeks). Results: Sixteen RCTs comprising 1,056 participants were included. LCDs significantly reduced glycated hemoglobin (HbA1c: SMD, -0.27; 95% CI, -0.47 to -0.07), triglyceride (TG: SMD, -0.20; 95% CI, -0.34 to -0.06), body weight (SMD, -0.19; 95% CI, -0.36 to -0.03), and body mass index (BMI: SMD, -0.28; 95% CI, -0.42 to -0.14). Stricter carbohydrate restriction (<26% energy) further improved systolic/diastolic blood pressure, homeostatic model assessment insulin resistance index (HOMA-IR), HbA1c, TG, body weight, BMI, and waist circumference. Short-term interventions (<24 weeks) lowered HbA1c, TG, and BMI. Conclusion: This systematic review and meta-analysis found that LCDs are associated with improvements in cardiometabolic risk factors among patients with MASLD. Furthermore, short-term implementation of a strict carbohydrate-restricted dietary regimen may yield additional clinical benefits. Future research should prioritize: standardized nutrient assessment, enhanced adherence strategies, and cardiovascular endpoint trials. Systematic review registration: PROSPERO: CRD42024603432; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024603432.

Indexed as

cardiovascular risk factorlow-carbohydrate dietmetabolic dysfunction-associated fatty liver diseasemetabolic dysfunction-associated steatotic liver diseasenonalcoholic fatty liver disease

Identifiers

PMID40933261
PMCPMC12417190

What Socratic holds

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Registered trials

None linked

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.