Pistacia atlantica sub. Kurdica can improve insulin resistance in patients with non-alcoholic fatty liver disease: a randomized clinical trial

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BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), also termed metabolic dysfunction‑associated fatty liver disease is a problem across the world. The most important factor of the increase in NAFLD prevalence is the insulin resistance. This study is the first clinical trial with the aim of determining the effect of Pistacia atlantica Sub. Kurdica gum on glycemic indices especially insulin resistance in patients with nonalcoholic fatty liver disease. METHODS: In this double-blind randomized clinical trial 50 patients with nonalcoholic fatty liver disease were randomized into two groups: those given syrup containing Pistacia atlantica sub. Kurdica gum (Group A), those on placebo (Group B). Over a two-month period, Group A given syrup containing 500 mg of P. atlantica sub. Kurdica gum per each tablespoon and Group B given syrup without P. atlantica sub. Kurdica gum. Anthropometric measures, biochemical indices and physical activity were evaluated at the beginning and end of the intervention. RESULTS: We observed a significant decrease in fatty liver grade in group A (P = 0.03). The mean of fasting serum insulin and the insulin-resistance index (HOMA-IR) decreased significantly (P = 0.002, P < 0.001) and quantitative insulin sensitivity check index (QUICKI) increased from baseline in group A (P = 0.001). Fasting blood sugar (FBS) decreased significantly from baseline in group A (P = 0.019), but the mean changes between group not significant (P = 0.061). Weight had significant decrease in group A (P < 0.001). CONCLUSIONS: Pistacia atlantica sub. Kurdica gum can decrease insulin resistance, increase insulin sensitivity and subsequently improvement NAFLD in patient with nonalcoholic fatty liver disease. It is suggested that clinical trials be conducted in the long duration of the intervention, as well as a larger sample size. TRIAL REGISTRATION: Registration number of Clinical trial: IRCT20231219060466N1 ( https://irct.behdasht.gov.ir/ ).

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