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In vitro study on HepG2 cells explored potential molecular mechanisms. A retrospective study was conducted on 45 overweight\/obese subjects (19\u00a0M) prescribed MHD with\/without NS. Anthropometric data, biochemical parameters, HSIs, and \u03b3GT were collected at baseline and after 3 months. In vitro, cells were pretreated with single and mixed NS components and then with tumor necrosis factor \u03b1 (TNF\u03b1) or fatty acids (FAs). Antioxidant and antiinflammatory activities were evaluated by fluorescence assays and quantitative polymerase chain reaction or enzyme\u2010linked immunosorbent assay; antiapoptotic effects by Western blot. After 3 months, all subjects improved anthropometric and biochemical parameters but only the combined MHD and NS treatment significantly reduced insulin resistance, HSIs, low\u2010density lipoprotein cholesterol, and \u03b3GT. In vitro, treatment with mixed NS components decreased TNF\u03b1\u2010\/FAs\u2010induced reactive oxygen species. Combined treatment also modulated the inflammatory response by lowering interleukin\u20106 and interleukin\u20101\u03b2, increasing interleukin\u201010 and pro\u2010caspase 8 expression. These findings suggest that NS, due to its antiinflammatory properties, represents a promising strategy for NAFLD management.<\/jats:p>","DOI":"10.1002\/mnfr.70207","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T12:48:18Z","timestamp":1757162898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of Nutraceutical Supplementation and Mediterranean Hypocaloric Diet on Calculated Steatosis Indices and Inflammation: Clinical and In Vitro Evidences"],"prefix":"10.1002","volume":"69","author":[{"given":"Mariana","family":"Di Lorenzo","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Pipicelli","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Aurino","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetta","family":"Sozio","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Palmiero","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna","family":"Guida","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarosaria","family":"Santillo","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Serena","family":"Lonardo","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5704-4408","authenticated-orcid":false,"given":"Giuliana","family":"La Rosa","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Damiano","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery Physiology Unit University of Naples \u201cFederico II\u201d  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,6]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"WHO Obesity and overweight. 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