{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:39:07Z","timestamp":1787071147649,"version":"build-2736575974"},"reference-count":80,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Nonalcoholic fatty liver is the most common chronic liver disease. Regarding the side effects of synthetic medicines and the variety of natural products in Iran climate, the present study aimed to investigate the effect of medicinal plants and natural products on liver enzymes in patients with non-alcoholic fatty liver disease in Iran using meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>To extract the intended studies, internal and external databases, including SID, Magiran, IranDoc, PubMed, Scopus, Web of Science, Embase, Cochrane, and Clinical Trial Registration System of Clinical trial.gov, the ISRCTN system, as well as Clinical Trial Registration System affiliated to the World Health Organization were searched. The obtained data were analyzed in STATA.14 software. A P value less than 0.05 was considered statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 44 rstudies were reviewed with a sample size of 1298 participant; they were published in the period from 2009 to 2018, silymarin had the highest effect on the reduction of AST (SMD = -2.68), cinnamon excreted the most profound effect on ALT (SMD = -2.69). In addition, cinnamon had the highest effect on gamma-glutamyl transferase (GGT) (SMD:-3.17), and curcumin had the highest effect on alkaline phosphatase (ALP) (SMD = -1.88). In the lipid profile, the effect of medicinal herbs and natural products on lowering total cholesterol and LDL was statistically significant. In the glycemic profile, the effect of medicinal plants and natural products on the reduction of fasting blood sugar, insulin, and hemoglobin A1c levels was statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>As evidenced by the obtained results, the highest effect of using natural products was observed in the reduction of GGT, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels, respectively; nonetheless, the effect of natural products on ALP reduction was not statistically significant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijpvm.ijpvm_313_20","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T09:07:10Z","timestamp":1716973630000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Effect of Medicinal Plants and Natural Products on Liver Enzymes in Non-alcoholic Fatty Liver Patients in Iran: A Systematic Review and Meta-Analysis"],"prefix":"10.4103","volume":"13","author":[{"given":"Moloud","family":"Fakhri","sequence":"first","affiliation":[{"name":"Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran"},{"name":"School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafez","family":"Fakheri","sequence":"additional","affiliation":[{"name":"Gut and Liver Research Center, Non-communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Azadbakht","sequence":"additional","affiliation":[{"name":"Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran"},{"name":"Department of Pharmacognosy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmood","family":"Moosazadeh","sequence":"additional","affiliation":[{"name":"Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyde Sedighe","family":"Yousefi","sequence":"additional","affiliation":[{"name":"Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran"},{"name":"Department of Persian Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"key":"R1-20250813","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1056\/NEJMra011775","article-title":"Nonalcoholic fatty liver disease","volume":"346","author":"Angulo","year":"2002","journal-title":"N Engl J Med"},{"key":"R2-20250813","doi-asserted-by":"crossref","first-page":"145754","DOI":"10.1155\/2012\/145754","article-title":"Diagnosis and evaluation of nonalcoholic fatty liver disease","volume":"2012","author":"Obika","year":"2012","journal-title":"Exp Diabetes Res"},{"key":"R3-20250813","doi-asserted-by":"crossref","first-page":"7006","DOI":"10.3748\/wjg.v22.i31.7006","article-title":"Metabolic aspects of adult patients with nonalcoholic fatty liver disease","volume":"22","author":"Abenavoli","year":"2016","journal-title":"World J Gastroenterol"},{"key":"R4-20250813","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1136\/flgastro-2013-100403","article-title":"Non-alcoholic fatty liver disease: A practical approach to diagnosis and staging","volume":"5","author":"Dyson","year":"2014","journal-title":"Frontline Gastroenterol"},{"key":"R5-20250813","doi-asserted-by":"crossref","first-page":"e25067","DOI":"10.5812\/hepatmon.25067","article-title":"The effect of berberis vulgaris extract on transaminase activities in non-alcoholic Fatty liver disease","volume":"15","author":"Iloon Kashkooli","year":"2015","journal-title":"Hepat Mon"},{"key":"R6-20250813","first-page":"149","article-title":"Prevalence of non-alcoholic fatty liver disease and its related factors in Iran","volume":"7","author":"Moghaddasifar","year":"2016","journal-title":"Int J Organ Transplant Med"},{"key":"R7-20250813","first-page":"e9248","article-title":"Non alcoholic fatty liver disease in southern Iran: A population based study","volume":"13","author":"Lankarani","year":"2013","journal-title":"Hepat Mon"},{"key":"R8-20250813","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s11655-007-0275-6","article-title":"Effect of Tiaozhi Yanggan Decoction in treating patients with non-alcoholic fatty liver","volume":"13","author":"Gu","year":"2007","journal-title":"Chin J Integr Med"},{"key":"R9-20250813","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1042\/BJ20150125","article-title":"Metformin and salicylate synergistically activate liver AMPK, inhibit lipogenesis and improve insulin sensitivity","volume":"468","author":"Ford","year":"2015","journal-title":"Biochem J"},{"key":"R10-20250813","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1016\/j.jnutbio.2012.11.007","article-title":"Involvement of SIRT1-AMPK signaling in the protective action of indole-3-carbinol against hepatic steatosis in mice fed a high-fat diet","volume":"24","author":"Choi","year":"2013","journal-title":"J Nutr Biochem"},{"key":"R11-20250813","doi-asserted-by":"crossref","first-page":"e99245","DOI":"10.1371\/journal.pone.0099245","article-title":"Peroxisome proliferator-activated receptor \u03b1 activation induces hepatic steatosis, suggesting an adverse effect","volume":"9","author":"Yan","year":"2014","journal-title":"PLoS One"},{"key":"R12-20250813","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S1995-7645(14)60200-5","article-title":"A review on most important herbal and synthetic antihelmintic drugs","volume":"7","author":"Bahmani","year":"2014","journal-title":"Asian Pac J Trop Med"},{"key":"R13-20250813","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S2222-1808(14)60742-8","article-title":"A review of the health effects and uses of drugs of plant licorice (Glycyrrhiza glabra L.) in Iran","volume":"4","author":"Bahmani","year":"2014","journal-title":"Asian Pac J Trop Dis"},{"key":"R14-20250813","doi-asserted-by":"crossref","first-page":"e10264","DOI":"10.5812\/ircmj.10264","article-title":"In vitro evaluation of antioxidant properties of ten Iranian medicinal plants","volume":"16","author":"Rafieian-Kopaei","year":"2014","journal-title":"Iran Red Crescent Med J"},{"key":"R15-20250813","doi-asserted-by":"crossref","first-page":"152","DOI":"10.5812\/nephropathol.12116","article-title":"Plants antioxidants: From laboratory to clinic","volume":"2","author":"Rafieian-Kopaei","year":"2013","journal-title":"J Nephropathol"},{"key":"R16-20250813","first-page":"1033","article-title":"Kelussia odoratissima Mozaffarian inhibits ileum contractions through voltage dependent and beta adrenergic receptors","volume":"9","author":"Sedighi","year":"2012","journal-title":"Life Sci"},{"key":"R17-20250813","first-page":"965","article-title":"Medicinal plants in therapy","volume":"63","author":"Farnsworth","year":"1985","journal-title":"Bull World Health Organ"},{"key":"R18-20250813","doi-asserted-by":"crossref","first-page":"15882","DOI":"10.1016\/S0021-9258(18)98491-7","article-title":"Halichondrin B and homohalichondrin B, marine natural products binding in the vinca domain of tubulin. Discovery of tubulin-based mechanism of action by analysis of differential cytotoxicity data","volume":"266","author":"Bai","year":"1991","journal-title":"J Biol Chem"},{"key":"R19-20250813","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1039\/a902202c","article-title":"The influence of natural products upon drug discovery","volume":"17","author":"Newman","year":"2000","journal-title":"Nat Prod Rep"},{"key":"R20-20250813","doi-asserted-by":"crossref","first-page":"384","DOI":"10.12669\/pjms.291(Suppl).3539","article-title":"Bioactive components and the effect of hydroalcoholic extract of Vaccinium myrtillus on postprandial atherosclerosis risk factors in rabbits","volume":"29","author":"Madihi","year":"2013","journal-title":"Pak J Med Sci"},{"key":"R21-20250813","first-page":"215","article-title":"Paradoxical effects of atorvastatin on renal tubular cells an experimental investigation","volume":"9","author":"Hasanpour","year":"2015","journal-title":"Iran J Kidney Dis"},{"key":"R22-20250813","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s11064-013-1232-8","article-title":"Effects of Zizyphus jujube extract on memory and learning impairment induced by bilateral electric lesions of the nucleus Basalis of Meynert in rat","volume":"39","author":"Rabiei","year":"2014","journal-title":"Neurochem Res"},{"key":"R23-20250813","first-page":"107","article-title":"Herbal medicines used in treatment of nonalcoholic fatty liver disease: A mini-review","volume":"5","author":"Nikkhajoei","year":"2016","journal-title":"Galen Med J"},{"key":"R24-20250813","doi-asserted-by":"crossref","first-page":"4987","DOI":"10.3748\/wjg.v20.i17.4987","article-title":"NAFLD prevalence differs among hispanic subgroups: The multi-ethnic study of atherosclerosis","volume":"20","author":"Fleischman","year":"2014","journal-title":"World J Gastroenterol"},{"key":"R25-20250813","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst Rev"},{"key":"R26-20250813","doi-asserted-by":"crossref","first-page":"9715","DOI":"10.1007\/s11033-012-1836-0","article-title":"Traditional Chinese medicines benefit to nonalcoholic fatty liver disease: A systematic review and meta-analysis","volume":"39","author":"Shi","year":"2012","journal-title":"Mol Biol Rep"},{"key":"R31-20250813","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat Med"},{"key":"R32-20250813","first-page":"435","article-title":"Does daily intake of orange juice along with weight loss diet affect serum lipoprotein profiles in patients with nonalcoholic fatty liver disease","volume":"15","author":"Ekhlasi","year":"2014","journal-title":"Iranian J Endocrinol Metab"},{"key":"R33-20250813","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.ctim.2018.09.010","article-title":"The effects of Zataria multiflora Boiss.(Shirazi thyme) on nonalcoholic fatty liver disease and insulin resistance: A randomized double-blind placebocontrolled clinical trial","volume":"41","author":"Zamani","year":"2018","journal-title":"Complement Ther Med"},{"key":"R34-20250813","doi-asserted-by":"crossref","first-page":"645","DOI":"10.15171\/apb.2017.077","article-title":"Effect of daily caper fruit pickle consumption on disease regression in patients with non-alcoholic fatty liver disease: A double-blinded randomized clinical trial","volume":"7","author":"Khavasi","year":"2017","journal-title":"Adv Pharm Bull"},{"key":"R35-20250813","first-page":"47","article-title":"Effect of cinnamon on lipid profile, liver enzymes, insulin resistance and hs -CRP inflammatory factor in patients with nonalcoholic fatty liver disease","volume":"10","author":"Askari","year":"2013","journal-title":"J Res Dev Nurs Midw"},{"key":"R36-20250813","first-page":"1","article-title":"Effect of faxseed supplementation on liver enzymes, hepatic fibrosis and steatosis in nonalcoholic fatty liver disease: A randomized-controlled clinical trial","volume":"10","author":"Yari","year":"2016","journal-title":"Iranian journal of nutrition sciences & food technology"},{"key":"R37-20250813","first-page":"1","article-title":"Effect of 8 weeks of aerobic training and using chicory extractive supplementation on serum levels of ALT and AST enzymes in women with fatty liver","volume":"19","author":"Hasani","year":"2016","journal-title":"The Iranian Journal of Obstetrics, Gynecology and Infertility"},{"key":"R38-20250813","first-page":"1","article-title":"Effect of ginger supplementation on liver enzymes, hepatic fibrosis and steatosis in nonalcoholic fatty liver disease: A double blind randomized-controlled clinical trial","volume":"11","author":"Rahimlou","year":"2016","journal-title":"Iran J Nutr Sci Food Technol"},{"key":"R39-20250813","first-page":"142","article-title":"The effect of hydro-alcoholic extract of saffron stigma (crocus sativus l.) on metabolic control parameters, liver enzymes, and renal function parameters in type 2 diabetic patients","volume":"15","author":"Milajerdi","year":"2016","journal-title":"Journal of Medicinal Plants"},{"key":"R40-20250813","first-page":"114","article-title":"The effects of eight weeks aerobic training, green tea supplementation and compound of them on serum liver enzymes and apolipoproteins in inactive overweight women","volume":"59","author":"Fathei","year":"2016","journal-title":"MJMS"},{"key":"R41-20250813","first-page":"636","article-title":"Effect of aerobic training with ginger supplementation on some liver enzymes (AST, ALT, GGT) and resistance to insulin in obese women with type 2 diabetes","volume":"60","author":"Esmaelzadeh Toloee","year":"2017","journal-title":"Medical J Mashhad University of Medical Sciences"},{"key":"R42-20250813","first-page":"890","article-title":"Comparing the effect of flaxseed oil with vitamin E on non-invasive markers of liver in patients with nonalcoholic fatty liver disease","volume":"57","author":"Beheshti Namdar","year":"2015","journal-title":"Medical J Mashhad University of Medical Sciences"},{"key":"R43-20250813","first-page":"161","article-title":"Effect of curcumin supplementation and resistance training in patients with nonalcoholic fatty liver disease","volume":"4","author":"Moradi-Kelardeh","year":"2016","journal-title":"Journal of Medicinal Plants"},{"key":"R44-20250813","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.4236\/health.2014.611148","article-title":"Effects of the mixture of cichorium intybus L. and cinnamomum zeylanicum on hepatic enzymes activity and biochemical parameters in patients with nonalcoholic fatty liver disease","volume":"6","author":"Sheybani Asl","year":"2014","journal-title":"Health"},{"key":"R45-20250813","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1002\/ptr.5659","article-title":"Treatment of non-alcoholic fatty liver disease with curcumin: A randomized placebo-controlled trial","volume":"30","author":"Rahmani","year":"2016","journal-title":"Phytother Res"},{"key":"R46-20250813","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1055\/s-0043-100019","article-title":"Efficacy and safety of phytosomal curcumin in non-alcoholic fatty liver disease: A randomized controlled trial","volume":"67","author":"Panahi","year":"2017","journal-title":"Drug Res (Stuttg)"},{"key":"R47-20250813","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1016\/j.clnu.2016.07.004","article-title":"Glucose homeostasis, insulin resistance and inflammatory biomarkers in patients with non-alcoholic fatty liver disease: Beneficial effects of supplementation with microalgae Chlorella vulgaris: A double-blind placebo-controlled randomized clinical trial","volume":"36","author":"Ebrahimi-Mameghani","year":"2017","journal-title":"Clin Nutr"},{"key":"R48-20250813","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.nutres.2014.09.005","article-title":"Resveratrol supplementation improves inflammatory biomarkers in patients with nonalcoholic fatty liver disease","volume":"34","author":"Faghihzadeh","year":"2014","journal-title":"Nutr Res"},{"key":"R49-20250813","first-page":"16","article-title":"The effect of silymarin on non-alcoholic fatty liver disease of children","volume":"6","author":"Famouri","year":"2017","journal-title":"J Herbmed Pharmacol"},{"key":"R50-20250813","first-page":"1","article-title":"Effect of genistein supplementation on insulin sensitivity, insulin resistance, and beta cells function index in patients with non-alcoholic fatty liver disease: A randomized, controlled trial","volume":"13","author":"Amanat","year":"2018","journal-title":"Iran J Nutr Sci Food Technol"},{"key":"R51-20250813","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1002\/ptr.3728","article-title":"The efficacy of licorice root extract in decreasing transaminase activities in non-alcoholic fatty liver disease: A randomized controlled clinical trial","volume":"26","author":"Hajiaghamohammadi","year":"2012","journal-title":"Phytother Res"},{"key":"R52-20250813","first-page":"2099","article-title":"Investigation of the effects of Chlorella vulgaris supplementation in patients with non-alcoholic fatty liver disease: A randomized clinical trial","volume":"59","author":"Panahi","year":"2012","journal-title":"Hepatogastroenterol"},{"key":"R53-20250813","doi-asserted-by":"crossref","first-page":"28","DOI":"10.4103\/2008-7802.173051","article-title":"The effect of green tea extract supplementation on liver enzymes in patients with nonalcoholic fatty liver disease","volume":"7","author":"Pezeshki","year":"2016","journal-title":"Int J Prev Med"},{"key":"R54-20250813","first-page":"265","article-title":"A Placebo-controlled trial of silymarin in patients with nonalcoholic fatty liver disease","volume":"9","author":"Hashemi","year":"2009","journal-title":"Hepat Mon"},{"key":"R55-20250813","article-title":"PhD Thesis pills on nonalcoholic fatty liver [persian] 2013","author":"Ahmadian"},{"key":"R56-20250813","first-page":"36","article-title":"The effect of Chlorella Vulgaris vs. Artichoke on patients with non-alcoholic fatty liver disease (NAFLD): A randomized clinical trial","volume":"23","author":"Talebi Pour","year":"2015","journal-title":"J Adv Med Biomed Res"},{"key":"R57-20250813","first-page":"113","article-title":"The effect of microalgae chlorella vulgaris supplementation on inflammatory factors in non-alcoholic fatty liver disease (NAFLD): A double-blind randomized clinical trial [persian]","volume":"24","author":"Aliashrafi","year":"2014","journal-title":"J Mazand Univ Med Sci"},{"key":"R58-20250813","first-page":"164","article-title":"Efficacy of silymarin on treatment of nonalcoholic steatohepatitis [persian]","volume":"23","author":"Taghvaei","year":"2013","journal-title":"J Mazand Univ Med Sci"},{"key":"R59-20250813","first-page":"119","article-title":"Effects of silymarin on nonalcoholic fatty liver disease in children: A crossover clinical trial [persian]","volume":"26","author":"Iranikhah","year":"2016","journal-title":"J Mazandaran Univ Med Sci"},{"key":"R60-20250813","first-page":"191","article-title":"The efficacy of silymarin in decreasing transaminase activities in non-alcoholic fatty liver disease: A randomized controlled clinical trial","volume":"8","author":"Hajaghamohammadi","year":"2008","journal-title":"Hepat Mon"},{"key":"R61-20250813","doi-asserted-by":"crossref","first-page":"e6099","DOI":"10.5812\/hepatmon.6099","article-title":"Effects of metformin, pioglitazone, and silymarin treatment on non-alcoholic fatty liver disease: A randomized controlled pilot study","volume":"12","author":"Hajiaghamohammadi","year":"2012","journal-title":"Hepat Mon"},{"key":"R62-20250813","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1097\/MEG.0000000000001369","article-title":"Treatment options for nonalcoholic fatty liver disease: A double-blinded randomized placebo-controlled trial","volume":"31","author":"Anushiravania","year":"2019","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"R63-20250813","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s12876-019-1055-4","article-title":"Curcumin and inflammation in nonalcoholic fatty liver disease: A randomized, placebo controlled clinical trial","volume":"19","author":"Saadati","year":"2019","journal-title":"BMC Gastroenterol"},{"key":"R64-20250813","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1038\/s41430-018-0382-9","article-title":"The effects of curcumin supplementation on liver enzymes, lipid profile, glucose homeostasis, and hepatic steatosis and fibrosis in patients with non-alcoholic fatty liver disease","volume":"73","author":"Saadati","year":"2019","journal-title":"Eur J Clin Nutr"},{"key":"R65-20250813","doi-asserted-by":"crossref","first-page":"183","DOI":"10.15403\/jgld-179","article-title":"Effect of phytosomal curcumin on circulating levels of adiponectin and leptin in patients with non-alcoholic fatty liver disease: A randomized, double-blind, placebo-controlled clinical trial","volume":"28","author":"Mirhafez","year":"2019","journal-title":"J Gastrointestin Liver Dis"},{"key":"R66-20250813","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12986-019-0331-1","article-title":"Nano-curcumin improves glucose indices, lipids, inflammation, and Nesfatin in overweight and obese patients with nonalcoholic fatty liver disease (NAFLD): A double-blind randomized placebocontrolled clinical trial","volume":"16","author":"Jazayeri-Tehrani","year":"2019","journal-title":"Nutr Metab"},{"key":"R67-20250813","first-page":"31","article-title":"Effect of pomegranate juice intake on lipid profile in patients with nonalcoholic fatty liver disease","volume":"20","author":"Ekhlasi","year":"2013","journal-title":"Razi J Med Sci"},{"key":"R68-20250813","first-page":"e63446","article-title":"Daily consumption of the capparis spinosa reduces some atherogenic indices in patients with non-alcoholic fatty liver disease: A randomized, double-blind, clinical trial","volume":"20","author":"Khavasi","year":"2018","journal-title":"Iran Red Crescent Med J"},{"key":"R69-20250813","doi-asserted-by":"crossref","first-page":"e14993","DOI":"10.5812\/hepatmon.14993","article-title":"Green tea in non-alcoholic fatty liver disease: A double blind randomized clinical trial","volume":"17","author":"Tabatabaee","year":"2017","journal-title":"Hepat Mon"},{"key":"R70-20250813","doi-asserted-by":"crossref","first-page":"204","DOI":"10.3923\/ijp.2012.204.208","article-title":"Effects of mixture of melissa officinalis L., cinnamomum zeylanicum and Urtica dioica on hepatic enzymes activity in patients with nonalcoholic fatty liver disease","volume":"8","author":"Malekirad","year":"2012","journal-title":"Int J Pharmacol"},{"key":"R71-20250813","first-page":"9","article-title":"Silymarin in treatment of non-alcoholic steatohepatitis: A randomized clinical trial","volume":"5","author":"Solhi","year":"2014","journal-title":"Caspian J Intern Med"},{"key":"R72-20250813","doi-asserted-by":"crossref","first-page":"4030476","DOI":"10.1155\/2016\/4030476","article-title":"The effect of artichoke leaf extract on alanine aminotransferase and aspartate aminotransferase in the patients with nonalcoholic steatohepatitis","volume":"2016","author":"Rangboo","year":"2016","journal-title":"Int J Hepatol"},{"key":"R73-20250813","first-page":"181","article-title":"Effects of silymarin on reducing liver aminotransferases in patients with nonalcoholic fatty liver diseases","volume":"18","author":"Masoodi","year":"2013","journal-title":"Govaresh"},{"key":"R74-20250813","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1002\/ptr.6073","article-title":"Efficacy of artichoke leaf extract in non-alcoholic fatty liver disease: A pilot double-blind randomized controlled trial","volume":"32","author":"Panahi","year":"2018","journal-title":"Phytother Res"},{"key":"R75-20250813","first-page":"114","article-title":"The effects of eight weeks aerobic training, green tea supplementation and compound of them on serum liver enzymes and apolipoproteins in inactive overweight women","volume":"59","author":"Fathi","year":"2016","journal-title":"Medical J Mashhad University of Medical Sciences"},{"key":"R76-20250813","first-page":"1417","article-title":"Influence of yoga and aerobics exercise on fatigue, pain and psychosocial status in patients with multiple sclerosis: A randomized trial","volume":"56","author":"Hasanpour","year":"2016","journal-title":"J Sports Med Phys Fitness"},{"key":"R77-20250813","doi-asserted-by":"crossref","first-page":"855","DOI":"10.3390\/nu10070855","article-title":"Curcumin in liver diseases: A systematic review of the cellular mechanisms of oxidative stress and clinical perspective","volume":"10","author":"Farzaei","year":"2018","journal-title":"Nutrients"},{"key":"R78-20250813","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.imr.2018.07.004","article-title":"Efficacy of curcumin\/turmeric on liver enzymes in patients with non-alcoholic fatty liver disease: Asystematic review of randomized controlled trials","volume":"8","author":"Mansour-Ghanaei","year":"2019","journal-title":"Integr Med Res"},{"key":"R79-20250813","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/S2221-1691(15)30002-2","article-title":"Liver tonics: Review of plants used in Iranian traditional medicine","volume":"5","author":"Akbarzadeh","year":"2015","journal-title":"Asian Pac J Trop Biomed"},{"key":"R80-20250813","first-page":"407","article-title":"Medicinal plants used for liver disorders based on the Ethnobotanical documents of Iran: A Review","volume":"9","author":"Moradi","year":"2016","journal-title":"Int J Pharmtech Res"},{"key":"R81-20250813","doi-asserted-by":"crossref","first-page":"5004","DOI":"10.3748\/wjg.v23.i27.5004","article-title":"Effect of silymarin on biochemical indicators in patients with liver disease: Systematic review with meta-analysis","volume":"23","author":"de Avelar","year":"2017","journal-title":"World J Gastroenterol"},{"key":"R82-20250813","doi-asserted-by":"crossref","first-page":"e9061","DOI":"10.1097\/MD.0000000000009061","article-title":"The therapeutic effect of silymarin in the treatment of nonalcoholic fatty disease: A meta-analysis (PRISMA) of randomized control trials","volume":"96","author":"Zhong","year":"2017","journal-title":"Medicine"},{"key":"R83-20250813","first-page":"8339","article-title":"The effect of green tea intake on risk of liver disease: A meta analysis","volume":"8","author":"Yin","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"R84-20250813","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1111\/j.1478-3231.2008.01776.x","article-title":"Green tea consumptionand liver disease: A systematic review","volume":"28","author":"Jin","year":"2008","journal-title":"Liver Int"}],"container-title":["International Journal of Preventive Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpvm.IJPVM_313_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:42:12Z","timestamp":1787067732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijpvm.IJPVM_313_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":80,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijpvm.ijpvm_313_20","relation":{},"ISSN":["2008-7802","2008-8213"],"issn-type":[{"value":"2008-7802","type":"print"},{"value":"2008-8213","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"2020-06-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}