Artichoke leaf extract reduces steatosis and decreases liver size in prebariatric patients: A randomized placebo-controlled pilot trial-The "SteatoChoke-Study"

Abstract

BACKGROUND/OBJECTIVES The increasing incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) poses a major healthcare challenge. This condition is particularly prevalent in patients with obesity. Artichoke leaf extract (ALE) has known hepatoprotective, antioxidant, and lipid-lowering properties. While ALE has been studied for its impact on liver metabolism, its specific effectiveness in individuals with obesity and MASLD remains unclear. This study investigates the effectiveness of ALE in reducing liver steatosis in patients scheduled for bariatric surgery. To our knowledge, this is the first study to examine ALE's “antisteatotic” efficacy in this clinical context. METHODS Forty participating bariatric surgery candidates received either ALE or a placebo for 6 weeks before measurements. Steatosis was quantified using FibroScan (controlled attenuation parameter, CAP), and liver size was assessed via ultrasound. Secondary outcomes included serum laboratory parameters and body composition, measured through bioelectrical impedance analysis. RESULTS ALE intake significantly reduced CAP values and liver lobe diameters compared to placebo, indicating decreased steatosis and liver volume. Improvements were already evident after 3 weeks. In female participants, total and low-density lipoprotein cholesterol levels improved. However, transaminase levels—particularly aspartate aminotransferase—increased in the ALE group. Body composition improved, with reductions in fat mass percentage. CONCLUSIONS ALE effectively reduces liver steatosis and size and improves body composition in patients with obesity and MASLD. Unlike prior studies, we observed a significant transaminase increase, suggesting a distinct hepatic response in individuals with obesity. Further research is needed to evaluate ALE's metabolic and hepatic effects specifically in this population beyond the prebariatric setting.