Effect of Beta vulgaris Extract on Liver Enzymes in Patients with Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial

Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has increased in recent decades. There are some concerns about the efficacy and side effects of drugs used for the treatment of NAFLD. Objectives: Therefore, new treatment methods and modalities are needed. This study aimed to determine the efficacy of Beta vulgaris extract in the treatment of NAFLD. Methods: This is a double-blind, parallel-group, randomized clinical trial. This clinical trial was conducted from November 2018 to April 2019 in Shahid Beheshti Hospital of Kashan, Iran. Among 143 NAFLD patients who met the inclusion criteria, 120 patients agreed to participate in the study. Subsequently, they were divided into two equal groups via simple randomization. The Beta vulgaris group received Beta vulgaris extract, alongside standard NAFLD treatment, including vitamin E and Silybum marianum extract (Livergol). The placebo group received standard NAFLD treatment, as well as a placebo instead of Beta vulgaris extract. The levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), fasting blood sugar (FBS), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were evaluated and compared between the groups. Variables were measured at the beginning of the study and after three and six months. Results: Overall, 52% of the participants were male. The mean (SD) age of Beta vulgaris and placebo groups was 47.5 (10.5) and 46.4 (8.7) years, respectively. The results of between-group analysis revealed that AST significantly reduced in the Beta vulgaris group, compared to the placebo group (P = 0.04). Conversely, ALT reduction was not significant in the groups. The significant interaction between time and groups indicated that the effect of Beta vulgaris on ALT increased over time (P < 0.001). Moreover, the ALP, FBS, LDL, and HDL levels significantly improved in the Beta vulgaris group compared to the placebo group (P < 0.05). Conclusions: Integration of Beta vulgaris extract in the standard treatment of NAFLD could significantly improve AST, ALP, FBS, LDL, and HDL. This study also revealed that the effect of Beta vulgaris on ALT increased over time.