![]() Patients who were enrolled in the study underwent screening based on inclusion and exclusion criteria. This clinical trial was registered at the Iranian Registry of Clinical Trials website (ID: IRCT2014110819853N1). The Research Council and Ethics Committee of the Isfahan University of Medical Sciences approved the study protocol (ID: 393,637) under the Declaration of Helsinki Written informed consent forms were completed by all the participants. Participants were recruited from the Metabolic Liver Disease Research Center at Isfahan University of Medical Sciences, Isfahan, Iran. This placebo-controlled, double-blind, parallel-group, randomized clinical trial focused on adults with ultrasound-diagnosed NAFLD. Therefore, the current trial aimed to evaluate the efficacy of garlic supplementation on hepatic steatosis among patients with NAFLD. ![]() 16 However, the therapeutic effect of garlic for hepatic steatosis in NAFLD patients remains unknown. 15 Also, experimental studies show that garlic and its derivatives can mitigate the hepatic steatosis by down-regulating the expression of sterol regulatory element-binding protein-1c (SREBP1c) as a lipogenic gene and up-regulating the expression of peroxisome proliferator-activated receptor α (PPARα) and carnitine palmitoyltransferase-1 (CPT-1) as lipolytic genes. ![]() 12, 13 Numerous studies have indicated the therapeutic potential of garlic and its derivatives against modifiable cardiovascular risk factors 14 and cancer. Nowadays, garlic is considered a functional food with a broad spectrum of organosulfur compounds, such as alliin, allicin, vinyl dithiins, and ajoene, which have antioxidant and anti-inflammatory properties. It has been used as a medicinal plant in complementary medicine in many countries and cultures. Garlic ( Allium sativum L.) is a vegetable belonging to the Liliaceae family. 8 Emerging evidence suggests that some functional foods and nutriceuticals can exert protective roles in the management of NAFLD by regulating inflammation and hepatic lipid metabolism and modulating gut bacteria flora. 7 Current therapeutic approach in patients with NAFLD limits to lifestyle modification which is not feasible and poses a major challenge for most patients. Nevertheless, insulin resistance and inflammation exert critical roles in the progression of NAFLD. The molecular mechanisms involved in the initiation of NAFLD have not been completely elucidated. ![]() 5 Despite these facts, there is no licensed pharmacological treatment for NAFLD patients. 4 It has been predicted NASH-related cirrhosis to be the main indication for liver transplantation by 2020. 3 NAFLD has been recently considered as an independent risk factor for cardiovascular events. 1, 2 This disease involves a broad spectrum of hepatic damage from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH), which can progress to fibrosis or even carcinoma. Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome, affecting nearly a quarter of adults worldwide. ![]()
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