{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:23:40Z","timestamp":1790083420240,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Previous studies examining the impact of Ramadan fasting on patients with metabolic dysfunction\u2010associated fatty liver disease (MAFLD) have yielded mixed results. Therefore, assessing the health benefits of such fasting in patients with MAFLD through a systematic review and meta\u2010analysis (SR\/MA) is important.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search was conducted on MEDLINE, Scopus, Web of Science, Google Scholar, and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> from their inception to March 5, 2025, to identify relevant studies involving adults with MAFLD fasting during Ramadan. The primary outcome was liver\u2010related parameters, while additional outcomes included changes in anthropometric and metabolic parameters during the peri\u2010Ramadan period. Statistical analysis was performed using R software, and the results were presented as mean differences (MD) with 95% confidence intervals (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight studies (10 reports), mostly with serious risk of bias, involving 603 subjects revealed that Ramadan fasting was associated with reductions in alanine transaminase (ALT [MD \u22124.11\u2009U\/L]), aspartate transaminase (AST [MD \u22124.24\u2009U\/L]), FIB4 index (MD \u22120.09), and nonalcoholic fatty liver disease fibrosis score (MD \u22120.22) from baseline in fasting individuals. However, the changes in ALT and AST were similar in studies comparing fasting and non\u2010fasting groups. Fasting individuals experienced significantly greater weight loss (MD \u22121.44\u2009kg), as well as reductions in body mass index (MD \u22120.66\u2009kg\/m<jats:sup>2<\/jats:sup>) and waist circumference (MD \u22120.91\u2009cm), compared to those who did not fast. Individuals who fasted experienced a glycemic benefit characterized by a reduction in glycated hemoglobin (MD \u22120.4%). However, changes in mean body fat percentage and HOMA\u2010IR were similar in both the fasting and non\u2010fasting groups. Individuals who fasted experienced reductions in both systolic and diastolic blood pressure, along with improved lipid parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This SR\/MA of small existing data suggests that fasting during Ramadan improves certain MAFLD\u2010related outcomes. Larger, multinational studies with wider global representation are needed to improve clinical practice decisions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.70264","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T09:03:27Z","timestamp":1756112607000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impacts of Ramadan Fasting on Metabolic and Hepatic Endpoints in Individuals With Metabolic Dysfunction\u2010Associated Fatty Liver Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5681-6522","authenticated-orcid":false,"given":"A. B. M.","family":"Kamrul\u2010Hasan","sequence":"first","affiliation":[{"name":"Department of Endocrinology Mymensingh Medical College  Mymensingh Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8002-9142","authenticated-orcid":false,"given":"Hamid","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Rajiv Gandhi Centre for Diabetes and Endocrinology Aligarh Muslim University  Aligarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6865-5554","authenticated-orcid":false,"given":"Lakshmi","family":"Nagendra","sequence":"additional","affiliation":[{"name":"Department of Endocrinology JSS Medical College, JSS Academy of Higher Education and Research  Mysore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4915-8805","authenticated-orcid":false,"given":"Deep","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology CEDAR Superspeciality Healthcare  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Nafis","family":"Shahriar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Mymensingh Medical College  Mymensingh Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6306-0858","authenticated-orcid":false,"given":"Md. Saiful","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Hepatology Bangladesh Medical University  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0886-5255","authenticated-orcid":false,"given":"Joseph M.","family":"Pappachan","sequence":"additional","affiliation":[{"name":"Faculty of Science, Manchester Metropolitan University  Manchester UK"},{"name":"Department of Endocrinology Kasturba Medical College, Manipal, Manpal Academy of Higher Education  Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"issue":"5","key":"e_1_2_9_2_1","first-page":"S14","article-title":"Basic Rules of Ramadan: A Medico\u2010Religious Perspective","volume":"65","author":"Laway B. 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