GLUT-F Improves MASLD Liver Function (GLUT-F)
Effects of Enterosoma-delivered Silibin and Glutathione-based Supplementation on Hepatic Steatosis and Liver Function in Patients With MASLD: a Randomized, Double-blind, Placebo-controlled Crossover Clinical Trial
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Yksityiskohtainen kuvaus
Background
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and is closely associated with obesity, insulin resistance, oxidative stress, and chronic low-grade inflammation. Although lifestyle modification remains the cornerstone of treatment, adherence is often poor and effective pharmacological therapies remain limited. GLUT-F is a nutraceutical formulation containing silibin-enriched silymarin, glutathione, and vitamin E encapsulated using Enterosoma® technology to improve the bioavailability of its active components. The combined antioxidant and hepatoprotective properties of these compounds may reduce hepatic steatosis and improve liver function in patients with MASLD.
Objectives
The primary objective was to evaluate the effect of GLUT-F supplementation on hepatic steatosis compared with placebo in adults with MASLD. Secondary objectives were to assess the effects of GLUT-F on liver metabolic function, liver enzymes, anthropometric measures, glucose metabolism, lipid profile, inflammatory biomarkers, and hepatic fibrosis.
Methods
This was a randomized, double-blind, placebo-controlled, two-period crossover clinical trial. Following a 2-week dietary run-in period, participants with ultrasonographically diagnosed MASLD were randomly assigned to receive either GLUT-F or matching placebo for 3 months. After a 1-month washout period, participants crossed over to receive the alternate treatment for an additional 3 months. Throughout the study, participants were instructed to maintain their habitual lifestyle and consume an isocaloric diet.
Clinical assessments were performed at baseline and at the end of each treatment period. Liver steatosis was assessed by ultrasonographic steatosis grading and the hepatorenal index (HRI), while liver stiffness was evaluated by acoustic radiation force impulse (ARFI) elastography. Dynamic liver function was assessed using the ¹³C-methacetin breath test (¹³C-MBT), including cumulative percent dose recovery (cPDR) and delta over baseline (DOB). Additional assessments included anthropometric measurements, serum liver enzymes (ALT, AST, GGT), hepatic steatosis indices (HSI and FLI), fasting glucose, insulin, HOMA-IR, lipid profile, C-reactive protein, and a panel of inflammatory and metabolic mediators.
The primary endpoint was the change in hepatic steatosis assessed by ultrasonography. Secondary endpoints included changes in liver function, liver enzymes, metabolic and inflammatory biomarkers, and safety. Treatment effects were analyzed using linear mixed-effects models accounting for treatment, period, sequence, and baseline values, with participants included as random effects.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
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-
-
Bari, Italia, 70124
- University of Bari
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-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Kuvaus
Inclusion Criteria:
- Evidence of hepatic steatosis (≥ grade 1) at screening.
- Body mass index (BMI) ≥25 kg/m² or presence of metabolic dysfunction consistent with MASLD diagnostic criteria.
- Stable body weight (no significant weight change during the 3 months preceding enrollment).
- Willingness to maintain usual dietary habits, physical activity, and concomitant medications throughout the study.
- Ability to provide written informed consent.
Exclusion Criteria:
- Excessive alcohol consumption (>30 g/day for men or >20 g/day for women). Other known causes of chronic liver disease, including viral hepatitis (HBV or HCV), autoimmune liver disease, hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, or drug-induced liver disease.
- Evidence of liver cirrhosis, hepatic decompensation, hepatocellular carcinoma, or other severe liver disorders.
- Previous bariatric surgery or planned bariatric surgery during the study period.
- Current use of medications or nutritional supplements known to significantly affect hepatic steatosis or liver function unless on a stable dose for at least 3 months before enrollment.
- Pregnancy or breastfeeding.
- Severe renal, cardiovascular, respiratory, endocrine, or malignant disease that could interfere with study participation.
- Known allergy or hypersensitivity to silybin, glutathione, vitamin E, or any component of the study product.
- Any condition that, in the investigator's judgment, could compromise participant safety or adherence to the study protocol
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Crossover-tehtävä
- Naamiointi: Kaksinkertainen
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
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Placebo Comparator: Plasebo
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The placebo consisted of an oral formulation identical to GLUT-F in appearance, taste, packaging, and mode of administration, but containing no active ingredients.
It was administered as one sachet daily for 3 months to maintain participant and investigator blinding.
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Kokeellinen: Hoito
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GLUT-F is an oral nutraceutical formulation containing silibin-enriched silymarin, reduced glutathione, and vitamin E encapsulated using Enterosoma® technology to enhance intestinal absorption and bioavailability.
Participants received one sachet daily for 3 months.
The placebo was identical in appearance, taste, and packaging but contained no active ingredients.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Liver steatosis grade
Aikaikkuna: At baseline and at the end of intervention (3 months)
|
Change in liver steatosis grade from baseline to the end of each treatment period, assessed by abdominal ultrasonography using a standardized semiquantitative steatosis grading system and the hepatorenal index (HRI), which quantifies hepatic echogenicity relative to the renal cortex.
Lower steatosis grade and HRI values indicate improvement in hepatic fat accumulation.
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At baseline and at the end of intervention (3 months)
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Liver function
Aikaikkuna: At baseline and after the end of intervention (3 months)
|
Change from baseline to the end of each treatment period in liver metabolic function assessed by the ¹³C-methacetin breath test.
Functional parameters included cumulative percent dose recovery (cPDR), reflecting hepatic microsomal metabolic capacity, and delta over baseline (DOB), reflecting hepatic substrate extraction and metabolism.
Higher cPDR and normalization of abnormal cPDR or DOB values indicate improved liver function.
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At baseline and after the end of intervention (3 months)
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Change in Liver Enzyme Levels
Aikaikkuna: At baseline and after the intervention (3 months)
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To evaluate the change in liver enzyme levels from baseline to the end of the treatment period.
Liver function will be assessed by measuring serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT).
Results will be reported as mean change from baseline and compared between treatment groups.
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At baseline and after the intervention (3 months)
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Yhteistyökumppanit ja tutkijat
Sponsori
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Portincasa P, Khalil M, Mahdi L, Perniola V, Idone V, Graziani A, Baffy G, Di Ciaula A. Metabolic Dysfunction-Associated Steatotic Liver Disease: From Pathogenesis to Current Therapeutic Options. Int J Mol Sci. 2024 May 22;25(11):5640. doi: 10.3390/ijms25115640.
- Abdallah H, Khalil M, Awada E, Lanza E, Di Ciaula A, Portincasa P. Metabolic dysfunction-associated steatotic liver disease (MASLD). Assessing metabolic dysfunction, cardiovascular risk factors, and lifestyle habits. Eur J Intern Med. 2025 Aug;138:101-111. doi: 10.1016/j.ejim.2025.05.018. Epub 2025 May 27.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
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Muut tutkimustunnusnumerot
- GLUT-FORTE2025
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