Does silymarin improve outcomes in patients with nonalcoholic fatty liver disease (NAFLD)?
Silymarin, a meta-analysis in 2,375 patients (Ann Hepatol 2023, PMID 38579127) — specifically, ALT decreased by an SMD of -12.39, AST by -10.97, and hepatic steatosis showed an OR of 3.25 for improvement. The abstract states that the effects of silymarin will need to be confirmed by further research.
Source: Ann Hepatol 2023, PMID 38579127 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
Ann Hepatol · 2023 · PMID 38579127 · DOI 10.1016/j.aohep.2023.101174
Silymarin supplementation may improve liver enzymes, lipid profiles, and liver histology in individuals with nonalcoholic fatty liver disease.
The question
Does silymarin improve outcomes in patients with nonalcoholic fatty liver disease (NAFLD)?
What they tested
The study implicitly hypothesizes that silymarin, a hepatoprotective extract, may be effective in slowing NAFLD progression.
How they did it
This meta-analysis included 26 randomized controlled trials with 2,375 patients. Data were extracted from PubMed, Embase, Cochrane Library, Web of Science, clinicaltrials.gov, and China National Knowledge Infrastructure. Continuous values were pooled using standard mean difference (SMD) and dichotomous values using odds ratio (OR). Heterogeneity was assessed with Cochran's Q test (Istatistic), and statistical significance was set at P<0.05.
What they found
Silymarin significantly reduced total cholesterol (TC), triglycerides (TG), LDL-C, FI, HOMA-IR, ALT, AST, fatty liver index, and fatty liver score. It also increased HDL-C and significantly improved hepatic steatosis based on liver histology. Specifically, ALT decreased by an SMD of -12.39, AST by -10.97, and hepatic steatosis showed an OR of 3.25 for improvement.
| ALT | -12.39 | |
|---|---|---|
| AST | -10.97 | |
| TC | -0.85 | |
| LDL-C | -0.81 | |
| TG | -0.62 | |
| FI | -0.59 | |
| Fatty Liver Score | -0.51 | |
| HOMA-IR | -0.37 | |
| HDL-C | 0.46 |
Silymarin significantly reduced levels of ALT, AST, TC, LDL-C, TG, FI, fatty liver score, and HOMA-IR, while increasing HDL-C. The effect on hepatic steatosis (OR=3.25) is not directly comparable on this SMD scale.
What it means
Silymarin can regulate energy metabolism, attenuate liver damage, and improve liver histology in patients with NAFLD.
Limitations
The abstract states that the effects of silymarin will need to be confirmed by further research.
The paper at a glance
| Magellan’s evidence label | improves liver enzymes, lipids (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | Ann Hepatol |
| Year | 2023 |
| PMID | 38579127 ↗ |
| DOI | 10.1016/j.aohep.2023.101174 ↗ |
| Topic | Cardiovascular & vascular aging |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
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Silymarin (Milk Thistle)
In non-alcoholic fatty liver disease (NAFLD/MASLD), multiple meta-analyses of randomized trials find that silymarin modestly lowers the liver enzymes ALT and AST and improves metabolic markers including cholesterol, triglycerides, and fasting insulin, though reviewers caution that the underlying trials are small and…
Silymarin is a mixture of flavonolignans—principally silybin (silibinin), along with silychristin…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). Does silymarin improve outcomes in patients with nonalcoholic fatty liver disease (NAFLD)? [Plain-English summary of Ann Hepatol 2023, PMID 38579127, DOI 10.1016/j.aohep.2023.101174]. Magellan Longevity. https://magellanlongevity.com/study/s112.html@misc{magellan_s112,
title = {Does silymarin improve outcomes in patients with nonalcoholic fatty liver disease (NAFLD)?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s112.html}},
note = {Plain-English summary of PubMed PMID 38579127; DOI 10.1016/j.aohep.2023.101174; Ann Hepatol 2023. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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