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- Licorice (Glycyrrhiza glabra)
- Non-alcoholic Fatty Liver Disease
| Date:
05-31-2012 | HC# 051231-449
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Re: Licorice Root Extract Decreases Liver Enzyme Levels
Hajiaghamohammadi
AK, Ziaee A, Samimi R. The efficacy of licorice root extract in decreasing
transaminase activities in non-alcoholic fatty liver disease: a randomized
controlled clinical trial. Phytother Res.
2012; [epub ahead of print]. doi:10.1002/ptr.3728.
Non-alcoholic
fatty liver disease (NAFLD) can lead to cirrhosis and possible liver
transplantation. A common liver disorder, NAFLD affects 20-40% of the Western
population1 (the Mayo Clinic Health Letter2 estimates
that the disorder affects "up to 20% of American adults") and 5-35%
of those in Pacific and Asian countries.3 Non-alcoholic
steatohepatitis (NASH), is a type of progressive NAFLD, resulting in
inflammation and liver scarring (fibrosis); such scars can harden the liver and
impair its ability to function properly, a condition known as cirrhosis. Only
about 5% of people with NAFLD develop cirrhosis, liver failure, or
hepatocellular carcinoma. NASH is the third leading cause of cirrhosis in US
adults, becoming a more common reason for liver transplants.2
Major
risk factors for NAFLD are obesity, type 2 diabetes mellitus, dyslipidemia, and
metabolic syndrome. Modification of risk factors is generally recommended for
the disease. Licorice (Glycyrrhiza glabra) root
has been used to treat stomach ulcers, bronchitis, and sore throat, as well as
viral infections. Its major bioactive component, glycyrrhizin, possesses
anti-inflammatory, antioxidant, and immune-modulating properties. Licorice has
also been reported to reduce liver inflammation and hepatic injury; however,
the mechanism for these properties is unclear. These authors conducted a
randomized, double-blind clinical trial to investigate the effects of licorice
on NAFLD.
The
study was conducted at the Gastrointestinal and Liver Clinic of Qazvin in central
Iran. The presence of NAFLD confirmed by sonography and the presence of
elevated levels of the liver enzymes aspartate aminotransferase (AST) and
alanine aminotransferase (ALT) were the inclusion criteria. All subjects
underwent a complete history of drug and alcohol consumption and were checked
for autoimmune hepatitis and viral markers.
Sixty-six
patients (38 men and 28 women) were enrolled and completed the study. They were
divided randomly into 2 groups:
- the treatment
group (n=33), who received 1 capsule containing 2 g aqueous licorice root
extract alone (20% glycyrrhizin) daily for 2 months (no other information
is provided),
- and the control
group (n=33), who received 1 capsule containing 2 g starch daily for 2
months.
Weight,
body mass index (BMI), and liver transaminase levels were measured for each
subject before and after the study. The mean age of the treatment group was 40
years and the mean age of the control group was 40.5 years.
The
authors report that for the treatment group, the mean BMI decreased from 30
kg/m2 at baseline to 29.20 kg/m2 after treatment (P>0.05).
In the control group, mean BMI increased from 29.10 kg/m2 to 29.22
kg/m2 (P>0.05).
The
mean serum ALT level decreased from 65.09 IU/mL at baseline to 51.27 IU/mL
after treatment with licorice (P<0.001). In the control group, the ALT level
decreased (though not significantly) from 66.90 IU/mL to 62.77 IU/mL
(P>0.05). The mean serum AST level decreased in both groups during the
study: a significant drop was seen in the treatment group, from 58.18 IU/mL to
49.45 IU/mL (P<0.001); and a nonsignificant decrease was reported in the
control group, from 57.86 IU/mL to 54.81 IU/mL (P>0.05).
Although
no data are available on NAFLD treatment with licorice root extract, some
studies have shown that glycyrrhizin could improve lipoprotein lipase
expression, insulin sensitivity, and serum lipid levels in rats.4, 5
According
to the authors, the effect of licorice on liver histology (determined by liver
biopsy) was not studied because of the invasiveness of the biopsy. Also, it is
unclear whether the level of reduction in transaminases is clinically
significant and whether transaminases are the best markers of NAFLD, say the
authors.
Although
the authors suggest that future studies could include more detailed tests of
liver function and liver histology in addition to the measurement of liver
enzymes, they conclude that licorice root extract appears safe and may be
considered in the treatment of elevated liver enzymes in NAFLD.
—Shari
Henson
References
1Chitturi S, Farrell
GC, Hashimoto E, et al. Non-alcoholic fatty liver disease in the Asia-Pacific
region: definitions and overview of proposed guidelines. J Gastroenterol Hepatol. 2007;22(6):778-787.
2Mayo Clinic Health
Letter. Nonalcoholic fatty liver disease. A growing health concern. Mayo Clin Health Lett. 2012;30(3):1-3.
3Shen L, Fan JG, Shao
Y, et al. Prevalence of nonalcoholic fatty liver among administrative officers
in Shanghai: an epidemiological survey. World
J Gastroenterol. 2003;9(5):1106-1110.
4Lim WY, Chia YY, Liong
SY, Ton SH, Kadir KA, Husain SN. Lipoprotein lipase expression, serum lipid and
tissue lipid deposition in orally-administered glycyrrhizic acid-treated rats. Lipids Health Dis. 2009;8:31.
doi:10.1186/1476-511X-8-31.
5Eu CH, Lim WY, Ton
SH, Kadir KA. Glycyrrhizic acid improved lipoprotein lipase expression, insulin
sensitivity, serum lipid and lipid deposition in high-fat diet-induced obese
rats. Lipids Health Dis. 2010;9:81.
doi:10.1186/1476-511X-9-81.
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