Effect of Complementary Therapy with Hydro-Ethanolic Extract of Aerial Parts of Portulaca oleracea on Clinical and Paraclinical Findings in Patients with Non-alcoholic Fatty Liver Disease: A Randomized Clinical Trial Protocol

Background: Non-alcoholic fatty liver disease (NAFLD) is a serious public health issue. Even though various natural and synthetic therapies are in the advanced stages of development, there is no authorized therapy for NAFLD. The use of anti-oxidant and anti-inflammatory compounds is one of these natural treatments. Portulaca oleracea aerial parts' extracts haveshownvarious pharmacological properties, including antioxidant, anti-inflammatory, and liver protection due to alkaloid compounds, flavonoids, terpenoids, sterols, omega-3 unsaturated fatty acids, and many vitamins and minerals. Objectives: We intend to examine the effectiveness of Portulaca oleracea extract in improving the symptoms caused by NAFLD. Methods: A randomized, double-blinded, controlled, parallel clinical trial is designed to study the effects of P. oleracea supplementation on the clinical and paraclinical findings in patients with NAFLD. An intervention group will get 700 mg of P. oleracea supplementation for eight weeks, while a control group will receive a placebo. Throughout the intervention, the clinical and nutritional status will be assessed three times. At the 0, 30, and 60th days of the intervention, anthropometric evaluation, blood pressure, and gastrointestinal problems will be monitored. Transient elastography will be done at the start and end of the research to assess the liver state. In addition, an International Physical Activity Questionnaire (IPAQ) and a 3-day food record will be collected, as well as biochemical variables, such as CBC-diff (complete blood count with differential count), lipid profiles, FBS, Fasting Blood Sugar; serum insulin, hepatic-related parameters, namely enzymes [ALP (alkaline phosphatase), AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transferase)], total and direct bilirubin, and inflammatory [hs-CRP (C-reactive protein), ESR (erythrocyte sedimentation rate) and IL-6 (interleukin-6)] and oxidative stress markers [SOD (super oxide dismutase), GSH-Px (glutathione peroxidase) and MDA (malondialdehyde)]. Discussion: This is the first randomized clinical trial (RCT) protocol specifically created for patients with NAFLD to evaluate the impact of P. oleracea supplementation. We intend to demonstrate that the suggested procedure is a novel and effective approach to decreasing NAFLD's laboratory and clinical symptoms. We also expect that supplementation with 700 mg of P. oleracea for 60 days will improve liver steatosis and clinical and nutritional status and reduce NAFLD patients' inflammation and oxidative stress.