Effect of silymarin on biochemical indicators in patients with liver disease: Systematic review with meta-analysis

Table 2 Results of selected studies for meta-analysis

Ref.	Used Indicators	Results
Loguercio et al[19], 2007	ALT, γGT	There were no adverse events in either group. The intervention group presented a significant reduction of hepatic steatosis in the ultrasonography score (change from 2-3 to 1-2) after 6 mo and 12 mo (P < 0.01). Significant reduction of ALT and γGT after 6 mo and 12 mo only in the intervention group (P < 0.01). Treatment affected the levels of ALT and γGT Range independent of changes in BMI of the participants. We did not evaluate data from the group with HCV patients
Hashemi et al[38], 2009	ALT, AST	There was a significant reduction in the average of ALT levels only in the intervention group (113.54 IU/mL vs 73.14 IU/mL) (P < 0.001). The percentage of patients with normalization (ALT < 40) was 32% after 3 mo and 52% after 6 mo in the intervention group and the difference in these percentage between control and intervention group was significant (P = 0.001). There was also a significant reduction in AST averages only in the intervention group (71.42 IU/mL vs 49.66 IU/mL) (P = 0.006). The percentage of patients with normalization (AST < 40) was 46% after 3 mo and 62% after 6 mo in the intervention group and the difference in these percentages between control group and intervention was also significant (P = 0.0001)
Massodi et al[39], 2013	ALT, AST	There were no serious adverse events and the side effects were similar in frequency and uncommon in both groups. There was a significant reduction in the average of ALT levels only in the intervention group (84.06 IU/mL vs 68.54 IU/mL) (P < 0.001) and in the average AST levels only in the intervention group (71.94 IU/mL vs 54.70 IU/mL) (P < 0.001)
Solhi et al[28], 2014	ALT, AST	There was a significant difference in the mean values of ALT levels only in the intervention group (91.3 IU/mL vs 38.4 IU/mL) (P = 0.026) and in the AST levels only in the intervention group (62.8 IU/mL vs 30.5 IU/mL) (P = 0.038).
Aller et al[34], 2015	ALT, AST, γGT	There were no adverse events in both groups. There was a significant improvement in the fibrosis score in both groups (P < 0.05). There was a significant difference in the reduction of the average γGT levels (81.5 IU/L vs 46.2 IU/L) (P < 0.05) in the intervention group and also in the control group (80.5 IU/L vs 50.3 IU/L) (P < 0.05). There was a significant reduction only in the average of ALT levels (70.8 IU/L vs 54.7 IU/L) (P < 0.05) and AST (41.6 IU/L vs 36 IU/L) (P < 0.05) in the control group.
Sorrentino et al[35], 2015	ALT, AST, γGT	No adverse events were reported in both groups. Mean levels of ALT, AST and γGT were within normal limits at the baseline. There was a significant reduction only in the average values of right lobe size of the liver by the USG (17.24 cm vs -0.96 cm) (P = 0.044)

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; γGT: Gamma glutamyl transpeptidase.