Metabolic syndrome (METS) is a metabolic disorder characterized by a combination of multiple factors including abdominal obesity, hypertension, hyperglycemia, or dyslipidemia. Non-alcoholic fatty liver disease (NAFLD) is an abnormal accumulation of fat in the liver, or steatosis, which can progress to fibrosis and liver dysfunction. NAFLD is the most common cause of chronic liver disease in the United States and is correlated with defining characteristics of METS, such as hyperinsulinemia and dyslipidemia. Turmeric (Curcuma longa, Zingiberaceae) rhizome has been found to have anti-inflammatory, antioxidant, and antimicrobial effects. Inflammation is known to play a part in many chronic diseases, including METS and liver disease. Curcumin is a compound found in turmeric and is thought to play a key role in its therapeutic effects. Curcumin has been demonstrated in animal studies to be hepatoprotective. The goal of this prospective cohort study was to determine the effects of curcumin on morphological characteristics of liver steatosis in patients with METS.
The study was conducted at the Primary Health Care Center in Tuzla, Bosnia from May 2013 to April 2014. Recruited patients were 35-70 years old with a METS diagnosis, including the criterion of impaired glucose tolerance (prediabetes) or type 2 diabetes mellitus (DM) for ≤ 10 years. Patients were excluded if they had an acute illness, severe mental illness, gallstones, used anticoagulants, or a diagnosis of type 2 diabetes mellitus for more than 10 years. Equal numbers of patients with prediabetes and diabetes were recruited. Of 100 recruited patients, 50 were allocated to the experimental group and 50 to the control group, who received “pharmacological and non-pharmacological treatment” (no specifics provided) without curcumin. Additionally, subgroups of 25 were created within each group. One subgroup included those diagnosed as pre-diabetic (PD) and the other included those diagnosed with DM. Patients in the experimental groups received 400 mg/day of “XY curcumin.” [Note: This is the only information given on the type of curcumin provided; an internet search could not identify any dietary supplement by this name.]
Effects were measured by changes in morphological characteristics of the liver as seen by ultrasound at the beginning of the study and after 12 months of treatment. Qualitative liver characteristics were summarized by the following scale: 0 – no steatosis, 1 – “initial” or mild steatosis, 2 – moderate steatosis, and 3 – “expressed” or significant steatosis.
Out of 100 patients, 65 were women and 35 men. The authors state this disparity is consistent with the greater prevalence of metabolic disorders among women. Mean age did not differ significantly among the analyzed groups. The subgroup of patients with PD who used turmeric had a mean baseline steatosis score of 1.60 (between mild and moderate steatosis). After 12 months, the mean score had significantly decreased to 1.04 (mild steatosis; P<0.001). In the second subgroup, patients with DM who used turmeric, the baseline mean score of 2.20 (moderate steatosis) decreased to 1.36 at the end of the study (P<0.001). In the control group, the subgroup with PD had a mean baseline score of 1.44 and a mean score of 1.60 at the end of the study (not statistically significant; P=0.103). There was no change in the control subgroup with DM, with a mean score of 2.00 at the beginning and end of the study.
The authors conclude that consuming 400 mg of curcumin daily in conjunction with standard “pharmacological and non-pharmacological treatment” can significantly improve morphological characteristics of the liver in patients with METS, PD or DM, and NAFLD. Weaknesses of this study include the cohort design and lack of information on what other treatments were provided. Additionally, because curcumin products may vary widely in their direct bioavailability, the lack of information on the product formulation hinders comparisons to other studies or generalized application of the results. The authors declared no conflicts of interest; no sources of funding were acknowledged.
Selmanovic S, Beganlic A, Salihefendic N, Ljuca F, Softic A, Smajic E. Therapeutic effects of curcumin on ultrasonic morphological characteristics of the liver in patients with metabolic syndrome. Acta Inform Med. September 2017;25(3):169-174. doi: 10.5455/aim.2017.25.169-174.