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.	中华医学会内分泌学分会. 非酒精性脂肪性肝病与相关代谢紊乱诊疗共识(第二版). 临床肝胆病杂志, 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, Găman 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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13.	郑子恢, 潘慧杰, 张亚同, 等. 玉屏风联合枸地氯雷他定治疗慢性荨麻疹有效性和安全性的荟萃分析. 中国药学杂志, 2021, 56(22): 1844-1854.
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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. 青岛地区汉族人群GCKR基因rs780094多态性与非酒精性脂肪肝的相关性研究. 大连: 大连医科大学, 2016.
22.	刘思伽, 陈潇凡, 胡必成, 等. 非酒精性脂肪肝病的发病机制及治疗研究进展. 湖北中医药大学学报, 2019, (2): 4.
23.	柳颖, 林慧铭. ALT、AST、GGT检测在肝脏疾病诊断中的临床价值. 国际检验医学杂志, 2015, (17): 2562-2563.
24.	陈璐, 张钟诠, 陈永昶, 等. 慢性脂肪肝患者血脂、血糖、体重变化及意义. 山东医药, 2000, 40(19): 46.
25.	霍锡俊. 探讨血脂检测在肝脏疾病诊断中的应用价值. 医学食疗与健康, 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. 中华医学会内分泌学分会. 非酒精性脂肪性肝病与相关代谢紊乱诊疗共识(第二版). 临床肝胆病杂志, 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, Găman 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. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 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. 郑子恢, 潘慧杰, 张亚同, 等. 玉屏风联合枸地氯雷他定治疗慢性荨麻疹有效性和安全性的荟萃分析. 中国药学杂志, 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. 青岛地区汉族人群GCKR基因rs780094多态性与非酒精性脂肪肝的相关性研究. 大连: 大连医科大学, 2016.
22. 刘思伽, 陈潇凡, 胡必成, 等. 非酒精性脂肪肝病的发病机制及治疗研究进展. 湖北中医药大学学报, 2019, (2): 4.
23. 柳颖, 林慧铭. ALT、AST、GGT检测在肝脏疾病诊断中的临床价值. 国际检验医学杂志, 2015, (17): 2562-2563.
24. 陈璐, 张钟诠, 陈永昶, 等. 慢性脂肪肝患者血脂、血糖、体重变化及意义. 山东医药, 2000, 40(19): 46.
25. 霍锡俊. 探讨血脂检测在肝脏疾病诊断中的应用价值. 医学食疗与健康, 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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