The potential of NAFLD to progress to advanced fibrosis, cirrhosis, and hepatocellular carcinoma makes it a formidable disease with high morbidity and mortality. NAFLD is also the second leading cause of liver transplant and the third leading cause of hepatocellular carcinoma ( 3, 4). The prevalence of NAFLD has increased in the past two decades, and the Middle East and South American countries account for the highest prevalence of NAFLD ( 2). Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease around the world ( 1). This study also revealed that the effect of Beta vulgaris on ALT increased over time. Integration of Beta vulgaris extract in the standard treatment of NAFLD could significantly improve AST, ALP, FBS, LDL, and HDL.
Moreover, the ALP, FBS, LDL, and HDL levels significantly improved in the Beta vulgaris group compared to the placebo group (P < 0.05). The significant interaction between time and groups indicated that the effect of Beta vulgaris on ALT increased over time (P < 0.001). Conversely, ALT reduction was not significant in the groups.
The results of between-group analysis revealed that AST significantly reduced in the Beta vulgaris group, compared to the placebo group (P = 0.04). The mean (SD) age of Beta vulgaris and placebo groups was 47.5 (10.5) and 46.4 (8.7) years, respectively. Overall, 52% of the participants were male. Variables were measured at the beginning of the study and after three and six months. The levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), fasting blood sugar (FBS), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were evaluated and compared between the groups. The placebo group received standard NAFLD treatment, as well as a placebo instead of Beta vulgaris extract. The Beta vulgaris group received Beta vulgaris extract, alongside standard NAFLD treatment, including vitamin E and Silybum marianum extract (Livergol). Subsequently, they were divided into two equal groups via simple randomization. Among 143 NAFLD patients who met the inclusion criteria, 120 patients agreed to participate in the study.
This clinical trial was conducted from November 2018 to April 2019 in Shahid Beheshti Hospital of Kashan, Iran. This is a double-blind, parallel-group, randomized clinical trial. This study aimed to determine the efficacy of Beta vulgaris extract in the treatment of NAFLD. Therefore, new treatment methods and modalities are needed. There are some concerns about the efficacy and side effects of drugs used for the treatment of NAFLD. The prevalence of non-alcoholic fatty liver disease (NAFLD) has increased in recent decades.
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