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essential phospholipids for nonalcoholic fatty liver disease associated with metabolic syndrome: A systematic review and network meta-analysis

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World Journal of Clinical Cases 2020年第21期8卷 5235-5249页

作者： Asad Izziddin Dajani Branko Popovic ADSC Medcare Hospital and Saudi German HospitalSharjahAl KhanPO Box 6328United Arab Emirates Sanofi-Aventis Deutschland GmbH CHC Global Medical AffairsFrankfurt am Main 65926Germany

BACKGROUND essential phospholipids(EPL)are used for the supportive treatment of nonalcoholic fatty liver disease(NAFLD),but data are mostly from small-scale *** To evaluate the efficacy of EPL treatment in adult patients with NAFLD and type 2 diabetes and/or *** The MEDLINE,PubMed,Embase,and Cochrane databases were searched up to March 2019 for clinical trials and comparative observational *** studies were those published in English or Chinese that enrolled adult patients(≥18 years)with NAFLD and type 2 diabetes mellitus and/or obesity receiving EPL as monotherapy or as add-on therapy to existing therapy,and that included at least one of the efficacy outcomes of interest.A variety of studies were identified;thus,direct,indirect and cohort meta-analyses were *** difference(MD)and 95%confidence interval(CI)were calculated for continuous variables,and relative risk with 95%CI for disease response and recovery.A random-effects model was used to address between-study *** Ten studies met the inclusion criteria(n=22-324).EPL treatment duration ranged from 4 to 72 *** the direct meta-analysis(four randomized controlled trials),compared with antidiabetic therapy alone,EPL plus antidiabetic therapy was associated with a significantly greater reduction in[alanine aminotransferase(ALT);MD:11.28 U/L(95%CI:-17.33,-5.23),P=0.0003],triglyceride[MD:-49.33 mg/dL(95%CI:-66.43,-32.23),P<0.0001]and total cholesterol levels[MD:-29.74 mg/dL(95%CI:-38.02,-21.45),P<0.0001].There was also a significant increase in the rate of overall improvement[relative risk 1.50(95%CI:1.26-1.79),P<0.0001],and risk of no disease(P=0.0091),and a reduction in moderate disease(P=0.0187);there were no significant differences in severe disease,mild disease,or significant *** the cohort meta-analysis of three non-randomized clinical trials,the MD in ALT levels was-16.71 U/L(95%CI:-24.94,-8.49)and 23%of patients had improved *** the

关键词： Non-alcoholic fatty liver disease Diabetes Obesity Metabolic syndrome essential phospholipids Systematic review Meta-analysis

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