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The clinical trial was based on patients randomly divided into three groups involving metformin\u2010vitamin E (ME), metformin\u2010ALES (MA), and vitamin E\u2010ALES (EA). The effectiveness of treatment in the treated groups was evaluated using liver ultrasonography and biochemical markers. After 12\u2009weeks of treatment, the results showed that the rate of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was significantly reduced within all the study groups (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.05). Liver ultrasonographic findings revealed that the rate of fat accumulation in liver of patients was decreased significantly within all the study groups and it was increased in the subjects with grade 0 fatty liver (without fat accumulation) in the MA and EA groups by 23.3 and 17.2%, respectively. In summary, the results of the present study showed that the concomitant use of ALES with metformin and vitamin E can have beneficial effects on amelioration of complications in patients with NAFLD. However, larger\u2010scale clinical trial studies are required in this regard.<\/jats:p>","DOI":"10.1002\/ptr.7279","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T10:21:42Z","timestamp":1631874102000},"page":"6324-6334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The effects of co\u2010administration of artichoke leaf extract supplementation with metformin and vitamin E in patients with nonalcoholic fatty liver disease: A randomized clinical trial"],"prefix":"10.1002","volume":"35","author":[{"given":"Mohammad Bagher","family":"Majnooni","sequence":"first","affiliation":[{"name":"Student Research Committee Kermanshah University of Medical Sciences Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Ataee","sequence":"additional","affiliation":[{"name":"Clinical Research Development Center Imam Khomeini and Dr Mohammad 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