{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:49:02Z","timestamp":1793227742228,"version":"4.5.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This umbrella review aimed to systematically synthesize and evaluate evidence from published meta-analyses regarding the efficacy of ursodeoxycholic acid in metabolic dysfunction\u2013associated steatotic liver disease, focusing on its impact on liver-specific biochemical markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following Joanna Briggs Institute methodology and registered in PROSPERO (ID: CRD420251250211), a comprehensive search of MEDLINE, EMBASE, Cochrane Library, and Scopus (1985\u20132025) identified systematic reviews and meta-analyses evaluating UDCA therapy in MASLD. Methodological quality was appraised using AMSTAR-2, ROBIS, and GRADE frameworks. Data on hepatic biomarkers were extracted and synthesized using fixed- or random-effects models depending on heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      statistic). Overlap among primary studies was assessed using the GROOVE tool, and meta-regression explored the influence of treatment duration on ALT dynamics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five meta-analyses (33 primary studies; 5,015 participants) were eligible. UDCA demonstrated consistent and statistically significant improvements in key markers of hepatocellular injury, including ALT (SMD\u202f=\u202f\u22120.36; 95% CI: \u22120.69 to \u22120.03) and AST (SMD\u202f=\u202f\u22120.16; 95% CI: \u22120.22 to \u22120.10), as well as cholestatic markers such as GGT (SMD\u202f=\u202f\u22120.40; 95% CI: \u22120.63 to \u22120.18) and ALP (SMD\u202f=\u202f\u22120.23; 95% CI: \u22120.31 to \u22120.14), total bilirubin decreased modestly (SMD\u202f=\u202f\u22120.08; 95% CI: \u22120.15 to \u22120.01), while albumin level remained unchanged. Meta-regression showed that longer treatment duration was significantly associated with greater ALT reduction (\u22120.04 SMD per 6\u202fmonths;\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>UDCA demonstrates consistent hepatoprotective and cholestasis-modifying effects in MASLD. Longer treatment duration may enhance biochemical responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>CRD420251250211.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1771830","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T06:40:09Z","timestamp":1770964809000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of ursodeoxycholic acid in metabolic dysfunction-associated steatotic liver disease: an umbrella review of meta-analyses on liver enzymes"],"prefix":"10.3389","volume":"13","author":[{"given":"Alsu R.","family":"Khurmatullina","sequence":"first","affiliation":[{"name":"Department of Internal Disease Propaedeutics and Gastroenterology, Russian University of Medicine","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitrii N.","family":"Andreev","sequence":"additional","affiliation":[{"name":"Department of Internal Disease Propaedeutics and Gastroenterology, Russian University of Medicine","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor V.","family":"Maev","sequence":"additional","affiliation":[{"name":"Department of Internal Disease Propaedeutics and Gastroenterology, Russian University of Medicine","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrey V.","family":"Zaborovsky","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Russian University of Medicine","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yury A.","family":"Kucheryavyy","sequence":"additional","affiliation":[{"name":"Ilyinskaya Hospital","place":["Krasnogorsk, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr A.","family":"Beliy","sequence":"additional","affiliation":[{"name":"Department of Internal Disease Propaedeutics and Gastroenterology, Russian University of Medicine","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp S.","family":"Sokolov","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Russian University of Medicine","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1016\/j.amjmed.2025.04.027","article-title":"Longitudinal clinical outcomes and mortality from steatotic liver disease: a meta-analysis","volume":"138","author":"Kim","year":"2025","journal-title":"Am J 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