Cheng FY, Chen C, Wang FY, Zhao BH. Combining nutraceuticals and a mediterranean diet for managing metabolic dysfunction associated with steatotic liver disease. World J Hepatol 2025; 17(4): 104622 [DOI: 10.4254/wjh.v17.i4.104622]
Corresponding Author of This Article
Bo-Huan Zhao, Chief Physician, Postdoctoral Fellow, Senior Researcher, Department of general surgery, Zhuji Traditional Chinese Medicine Hospital, No. 521 Donger Road, Huandong Street, Zhuji 311899, Zhejiang Province, China. 448322750@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Fei-Yong Cheng, Department of Hepatobiliary Surgery, Zhuji People's Hospital, Zhuji 311800, Zhejiang Province, China
Cong Chen, Department of General Surgery, Zhuji Third People's Hospital, Zhuji 311825, Zhejiang Province, China
Feng-Yong Wang, Department of General Surgery, Xinhua Hospital of Zhejiang Province, Hangzhou 310005, Zhejiang Province, China
Bo-Huan Zhao, Department of General Surgery, Zhuji Traditional Chinese Medicine Hospital, Zhuji 311899, Zhejiang Province, China
Author contributions: Cheng FY methodology and formal analysis; Chen C and Wang FY data curation, supervision and writing of the original draft; Zhao BH conceptualization, writing, reviewing and editing. All the authors participated in drafting the manuscript, and all the authors read, contributed to, and approved the final version of the manuscript.
Conflict-of-interest statement: No author has stated that there are any commercial, professional, or personal conflicts of interest relevant to the study, proving that it complies with the principles of publishing ethics.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo-Huan Zhao, Chief Physician, Postdoctoral Fellow, Senior Researcher, Department of general surgery, Zhuji Traditional Chinese Medicine Hospital, No. 521 Donger Road, Huandong Street, Zhuji 311899, Zhejiang Province, China. 448322750@qq.com
Received: December 26, 2024 Revised: February 26, 2025 Accepted: March 6, 2025 Published online: April 27, 2025 Processing time: 120 Days and 12.8 Hours
Abstract
This study was performed by Cano Contreras et al, who explored the effects of alpha-lipoic acid (ALA) and Silybum marianum (SM) supplementation combined with a mediterranean diet (MD) on metabolic dysfunction-associated steatotic liver disease (MASLD). The randomized controlled design and use of transient elastography provide methodological strengths, whereas the focus on a Mexican cohort addresses a critical gap in regional MASLD research. Although improvements in visceral fat and controlled attenuation parameters (CAP) were observed, key metabolic markers, including transaminases and lipid profiles, showed no significant changes, raising concerns about the intervention's comprehensive metabolic impact. The reliance on CAP and the absence of mechanistic biomarker analysis limit insights into the antioxidant and anti-inflammatory pathways of ALA and SM. Future research should explore synergistic effects with other nutraceuticals, such as vitamin E and polyphenols, and include extended follow-up and patient stratification to assess long-term benefits and personalized therapeutic outcomes. Addressing these limitations could solidify the role of nutraceuticals in MASLD management and enable the development of more effective and sustainable interventions.
Core Tip: This study demonstrated the therapeutic potential of combining α-lipoic acid and Silybum marianum supplementation with a Mediterranean diet for the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD). While the intervention reduced visceral adiposity and improved hepatic steatosis markers, key metabolic parameters, including transaminase levels and lipid profiles, remained unchanged. Future investigations should prioritize (1) Mechanistic studies on antioxidant and anti-inflammatory pathways; (2) Exploration of synergistic combinations with complementary nutraceuticals; and (3) Extended follow-up periods to evaluate long-term efficacy and safety. Importantly, patient stratification accounting for disease severity and comorbidity profiles will be essential for developing personalized treatment strategies in MASLD management.
