The effect of intermittent fasting on nonalcoholic fatty liver disease: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

MA Lingli ^1,2 , MA Jianbo ² , LI Zhuo ² ,  ZHAO Fei ¹

1. Key Laboratory of Environmental Ecology and Population Health in Northwest Minority Areas, Medical College of Northwest Minzu University, Lanzhou 730030, P. R. China;
2. College of Life Science and Engineering, Northwest Minzu University, Lanzhou 730030, P. R. China;

Corresponding?author：

ZHAO Fei, Email: runfor710@163.com

Keywords：

Intermittent fasting; Nonalcoholic fatty liver disease; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.202301009

Video：

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Objective To systematically review the effect of intermittent fasting on non-alcoholic fatty liver disease (NAFLD). Methods The PubMed, EMbase, Web of Science, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect studies on the effect of intermittent fasting on NAFLD from inception to October 1, 2022. Two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. R software was then used for meta-analysis. Results A total of 7 studies were included. The results of meta-analysis showed that intermittent fasting could reduce liver fibrosis (MD=?0.93, 95%CI 1.67 to 0.19, P<0.05), the levels of glutamic oxaloacetic transaminase (MD=?8.96, 95%CI ?11.83 to ?6.10, P<0.05), glutamyl transpeptidase (MD=?7.86, 95%CI ?12.00 to ?3.73, P<0.05), and inflammatory molecules (MD=?2.03, 95%CI ?3.69 to ?0.36, P<0.05). In addition, it reduced dietary (total energy) intake (MD=?255.99, 95%CI ?333.15 to ?178.82, P<0.05), body weight (MD=?2.42, 95%CI ?3.81 to ?1.02, P<0.05), BMI (MD=?0.52, 95%CI ?0.92 to ?0.13, P<0.05) and fat mass (MD=?2.37, 95%CI ?4.17 to ?0.57, P<0.05). Conclusion Current research evidence shows that intermittent fasting can improve NAFLD and help patients lose weight. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： MA Lingli, MA Jianbo, LI Zhuo, ZHAO Fei. The effect of intermittent fasting on nonalcoholic fatty liver disease: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(9): 1033-1038. doi: 10.7507/1672-2531.202301009 Copy

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2.	中華醫學會內分泌學分會. 非酒精性脂肪性肝病與相關代謝紊亂診療共識(第二版). 臨床肝膽病雜志, 2018, 34(10): 2103-2108.
3.	Michelotti GA, Machado MV, Diehl AM. NAFLD, NASH and liver cancer. Nat Rev Gastroenterol Hepatol, 2013, 10(11): 656-665.
4.	Bedogni G, Miglioli L, Masutti F, et al. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology, 2005, 42(1): 44-52.
5.	Bhushan B, Banerjee S, Paranjpe S, et al. Pharmacologic inhibition of epidermal growth factor receptor suppresses nonalcoholic fatty liver disease in a murine fast-food diet model. Hepatology, 2019, 70(5): 1546-1563.
6.	de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med, 2019, 381(26): 2541-2551.
7.	Ebrahimi S, Gargari P, Izadi A, et a1. The effects of Ramadan fasting on serum concentrations of Vaspin and Omentin-1 in patients with nonalcoholic fatty liver disease. Eur J Integr Med, 2018, 19: 110-114.
8.	Johari MI, Yusoff K, Haron J, et al. A randomised controlled trial on the effectiveness and adherence of modified alternate-day calorie restriction in improving activity of non-alcoholic fatty liver disease. Sci Rep, 2019, 9(1): 11232.
9.	Kord Varkaneh H, Salehi Sahlabadi A, G?man MA, et al. Effects of the 5: 2 intermittent fasting diet on non-alcoholic fatty liver disease: a randomized controlled trial. Front Nutr, 2022, 9: 948655.
10.	Hooijmans CR, Rovers MM, de Vries RB, et al. SYRCLE's risk of bias tool for animal studies. BMC Med Res Methodol, 2014, 14: 43.
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12.	Higgins JP, Thomas J, Chandler J, et a1. Cochrane Handbook for Systematic Reviews of Interventions (2nd edition). Chichester: John Wiley & Sons, 2019.
13.	鄭子恢, 潘慧杰, 張亞同, 等. 玉屏風聯合枸地氯雷他定治療慢性蕁麻疹有效性和安全性的薈萃分析. 中國藥學雜志, 2021, 56(22): 1844-1854.
14.	The Cochrane Collaboration. Cochrane handbook for systematic reviews of intervention version 1.0. 2019.
15.	Cai H, Qin YL, Shi ZY, et al. Effects of alternate-day fasting on body weight and dyslipidaemia in patients with non-alcoholic fatty liver disease: a randomised controlled trial. BMC Gastroenterol, 2019, 19(1): 219.
16.	Aliasghari F, Izadi A, Gargari BP, et al. The effects of ramadan fasting on body composition, blood pressure, glucose metabolism, and markers of inflammation in NAFLD patients: an observational trial. J Am Coll Nutr, 2017, 36(8): 640-645.
17.	Mari A, Khoury T, Baker M, et a1. The impact of ramadan fasting on fatty liver disease severity: a retrospective case control study from Israel. 2021.
18.	Ebrahimi S, Gargari BP, Aliasghari F, et al. Ramadan fasting improves liver function and total cholesterol in patients with nonalcoholic fatty liver disease. Int J Vitam Nutr Res, 2020, 90(1-2): 95-102.
19.	Rahimi H, Habibi ME, Gharavinia A, et a1. Effect of ramadan fasting on alanine aminotransferase (ALT) in non-alcoholic fatty liver disease(NAFLD). 2017.
20.	Yin C, Li Z, Xiang Y, et al. Effect of intermittent fasting on non-alcoholic fatty liver disease: systematic review and meta-analysis. Front Nutr, 2021, 8: 709683.
21.	董全勇. 青島地區漢族人群GCKR基因rs780094多態性與非酒精性脂肪肝的相關性研究. 大連: 大連醫科大學, 2016.
22.	劉思伽, 陳瀟凡, 胡必成, 等. 非酒精性脂肪肝病的發病機制及治療研究進展. 湖北中醫藥大學學報, 2019, (2): 4.
23.	柳穎, 林慧銘. ALT、AST、GGT檢測在肝臟疾病診斷中的臨床價值. 國際檢驗醫學雜志, 2015, (17): 2562-2563.
24.	陳璐, 張鐘詮, 陳永昶, 等. 慢性脂肪肝患者血脂、血糖、體重變化及意義. 山東醫藥, 2000, 40(19): 46.
25.	霍錫俊. 探討血脂檢測在肝臟疾病診斷中的應用價值. 醫學食療與健康, 2018, (9): 253.

1. Cotter TG, Rinella M. Nonalcoholic fatty liver disease 2020: the state of the disease. Gastroenterology, 2020, 158(7): 1851-1864.
2. 中華醫學會內分泌學分會. 非酒精性脂肪性肝病與相關代謝紊亂診療共識(第二版). 臨床肝膽病雜志, 2018, 34(10): 2103-2108.
3. Michelotti GA, Machado MV, Diehl AM. NAFLD, NASH and liver cancer. Nat Rev Gastroenterol Hepatol, 2013, 10(11): 656-665.
4. Bedogni G, Miglioli L, Masutti F, et al. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology, 2005, 42(1): 44-52.
5. Bhushan B, Banerjee S, Paranjpe S, et al. Pharmacologic inhibition of epidermal growth factor receptor suppresses nonalcoholic fatty liver disease in a murine fast-food diet model. Hepatology, 2019, 70(5): 1546-1563.
6. de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med, 2019, 381(26): 2541-2551.
7. Ebrahimi S, Gargari P, Izadi A, et a1. The effects of Ramadan fasting on serum concentrations of Vaspin and Omentin-1 in patients with nonalcoholic fatty liver disease. Eur J Integr Med, 2018, 19: 110-114.
8. Johari MI, Yusoff K, Haron J, et al. A randomised controlled trial on the effectiveness and adherence of modified alternate-day calorie restriction in improving activity of non-alcoholic fatty liver disease. Sci Rep, 2019, 9(1): 11232.
9. Kord Varkaneh H, Salehi Sahlabadi A, G?man MA, et al. Effects of the 5: 2 intermittent fasting diet on non-alcoholic fatty liver disease: a randomized controlled trial. Front Nutr, 2022, 9: 948655.
10. Hooijmans CR, Rovers MM, de Vries RB, et al. SYRCLE's risk of bias tool for animal studies. BMC Med Res Methodol, 2014, 14: 43.
11. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
12. Higgins JP, Thomas J, Chandler J, et a1. Cochrane Handbook for Systematic Reviews of Interventions (2nd edition). Chichester: John Wiley & Sons, 2019.
13. 鄭子恢, 潘慧杰, 張亞同, 等. 玉屏風聯合枸地氯雷他定治療慢性蕁麻疹有效性和安全性的薈萃分析. 中國藥學雜志, 2021, 56(22): 1844-1854.
14. The Cochrane Collaboration. Cochrane handbook for systematic reviews of intervention version 1.0. 2019.
15. Cai H, Qin YL, Shi ZY, et al. Effects of alternate-day fasting on body weight and dyslipidaemia in patients with non-alcoholic fatty liver disease: a randomised controlled trial. BMC Gastroenterol, 2019, 19(1): 219.
16. Aliasghari F, Izadi A, Gargari BP, et al. The effects of ramadan fasting on body composition, blood pressure, glucose metabolism, and markers of inflammation in NAFLD patients: an observational trial. J Am Coll Nutr, 2017, 36(8): 640-645.
17. Mari A, Khoury T, Baker M, et a1. The impact of ramadan fasting on fatty liver disease severity: a retrospective case control study from Israel. 2021.
18. Ebrahimi S, Gargari BP, Aliasghari F, et al. Ramadan fasting improves liver function and total cholesterol in patients with nonalcoholic fatty liver disease. Int J Vitam Nutr Res, 2020, 90(1-2): 95-102.
19. Rahimi H, Habibi ME, Gharavinia A, et a1. Effect of ramadan fasting on alanine aminotransferase (ALT) in non-alcoholic fatty liver disease(NAFLD). 2017.
20. Yin C, Li Z, Xiang Y, et al. Effect of intermittent fasting on non-alcoholic fatty liver disease: systematic review and meta-analysis. Front Nutr, 2021, 8: 709683.
21. 董全勇. 青島地區漢族人群GCKR基因rs780094多態性與非酒精性脂肪肝的相關性研究. 大連: 大連醫科大學, 2016.
22. 劉思伽, 陳瀟凡, 胡必成, 等. 非酒精性脂肪肝病的發病機制及治療研究進展. 湖北中醫藥大學學報, 2019, (2): 4.
23. 柳穎, 林慧銘. ALT、AST、GGT檢測在肝臟疾病診斷中的臨床價值. 國際檢驗醫學雜志, 2015, (17): 2562-2563.
24. 陳璐, 張鐘詮, 陳永昶, 等. 慢性脂肪肝患者血脂、血糖、體重變化及意義. 山東醫藥, 2000, 40(19): 46.
25. 霍錫俊. 探討血脂檢測在肝臟疾病診斷中的應用價值. 醫學食療與健康, 2018, (9): 253.

Chinese Journal of Evidence-Based Medicine

The effect of intermittent fasting on nonalcoholic fatty liver disease: a meta-analysis

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