Effect of nano-micelle curcumin on hepatic enzymes: A new treatment approach for non-alcoholic fatty liver disease (NAFLD)

Document Type : Original Research Article


1 Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Medical Genetics & Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Objective: Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive lipid accumulation in hepatocytes with no consumption of alcohol. Recently, curcumin is a natural polyphenol found in turmeric has been examined for the treatment of NAFLD. This study aimed to assess the efficacy of 160 mg/day nano-micelle curcumin on the amelioration of NAFLD by measuring liver enzymes.
Materials and Methods: Patients with NAFLD were randomly divided into curcumin (intervention group n=33) and placebo (n=33) groups and at the end of the study, the data of 56 participants who completed the 2-month intervention were analyzed. Laboratory tests and questionnaires were used to gather information. Both groups received recommendations for lifestyle modification, and were advised to other necessary advices. Patients in the curcumin group received 160 mg/day of nano-micelle curcumin in two divided doses for 60 days. The 2 groups were followed up for two months and clinical and laboratory indices were compared.
Results: Our data showed a significant decrease in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the curcumin group (p<0.01) as well as a significant difference between the groups before and after the intervention in curcumin group (p<0.05). Interestingly, a meaningful decrease in AST serum level was observed in the intervention group (p<0.01). 
Conclusion: Our study demonstrated that short-term supplementation with nano-micelle curcumin results in the reduction of AST and ALT and is beneficial for the treatment of NAFLD.


Almobarak A, Barakat S, Khalifa M,
Elhoweris M, Elhassan T , Ahmed M.
2014. Nonalcoholic fatty liver disease
(NAFLD) in a Sudanese population: What
is the prevalence and risk factors? Arab J
Gastroenterol, 15: 12-15.
Association, AD. 2009. All About
Diabetes. [http://www.diabetes.org/about
Ballestri S, Nascimbeni F, Baldelli E,
Marrazzo A, Romagnoli D, Targher G,
Lonardo A. 2017. Ultrasonographic fatty
liver indicator detects mild steatosis and
correlates with metabolic/histological
parameters in various liver diseases.
Metabolism, 72: 57-65.
Bateni Z, Rahimi HR, Hedayati M, Afsharian
S, Goudarzi R, Sohrab G. 2021. The
effects of nano-curcumin supplementation
on glycemic control, blood pressure, lipid
profile, and insulin resistance in patients
with the metabolic syndrome: A
randomized, double-blind clinical trial.
Phytother Res, 35: 3945-3953.
Björnsson ES. 2016. Hepatotoxicity by drugs:
The most common implicated agents. Int
J Mol Sci, 17: 224.
Chalasani N, Younossi Z, Lavine J, Diehl A,
Brunt E, Cusi K, Charlton M, Sanyal A.
2012. The diagnosis and management of
non-alcoholic fatty liver disease: Practice
guideline by the American Association
for the study of liver diseases, American
College of Gastroenterology, and the
American Gastroenterological
Association. Am J Gastroenterol, 107:
Chobanian AV, Bakris GL, Black HR,
Cushman WC, Green LA, Izzo JL, Jones
JrDW, Materson BJ, Oparil S, Wright JT,
Roccella EJ. 2003. Seventh report of the
Joint National Committee on prevention,
detection, evaluation, and treatment of
high blood pressure. Hypertension, 42:
Chuengsamarn S, Rattanamongkolgul S,
Phonrat B, Tungtrongchitr R,
Jirawatnotai S. 2014. Reduction of
atherogenic risk in patients with type 2
diabetes by curcuminoid extract: a
randomized controlled trial. J Nutr
Biochem , 25: 144-150.
Cicero AF, Colletti A, Bellentani S. 2018.
Nutraceutical approach to non-alcoholic
fatty liver disease (NAFLD): The
available clinical evidence. Nutrients, 10:
Cunningham RP, Moore MP, Moore AN,
Healy JC, Roberts MD, Rector RS,
Martin JS, 2018. Curcumin
supplementation mitigates NASH
development and progression in female
Wistar rats. Physiol Rep, 6: e13789.
Fazel Y, Koenig AB, Sayiner M, Goodman
ZD, Younossi ZM. 2016. Epidemiology
and natural history of non-alcoholic fatty
liver disease. Metabolism, 65: 1017-1025.
Festi D, Schiumerini R, Marzi L, Di Biase A,
Mandolesi D, Montrone L, Scaioli E,
Bonato E, Marchesini-Reggiani G,
Colecchia A. 2013. The diagnosis of nonalcoholic fatty liver disease--availability
and accuracy of non-invasive methods.
Aliment Pharmacol Ther, 37: 392-400.
Hatamipour M, Sahebkar A, Alavizadeh S,
Dorri M, Jaafari M. 2019. Novel
nanomicelle formulation to enhance
bioavailability and stability of
curcuminoids. Iran J Basic Med Sci, 22:
Hosseini S, Chamani J, Rahimi HR,
Azmoodeh N, Ghasemi F, Abadi PH.
2018. An in vitro study on curcumin
delivery by nano-micelles for esophageal
squamous cell carcinoma (KYSE-30).
Rep Biochem Mol Biol, 6: 137-143.
Inzaugarat M, De Matteo E, Baz P, Lucero D,
García C, Daruich J, Sorda J, Wald M,
Cherñavsky A. 2017. New evidence for
the therapeutic potential of curcumin to
treat nonalcoholic fatty liver disease in
humans. PLoS One, 12: e0172900.
Jalali M, Mahmoodi M, Mosallanezhad Z,
Jalali R, Imanieh M, Moosavian S. 2019.
The effects of curcumin supplementation
on liver function, metabolic profile and
body composition in patients with nonalcoholic fatty liver disease: A systematic
review and meta-analysis of randomized
Beheshti Namdar et al.
AJP, Vol. 13, No. 6, Nov-Dec 2023 624
controlled trials. Complement Ther Med,
48: 102283.
Jazayeri-Tehrani SA, Rezayat SM, Mansouri
S, Qorbani M, Alavian SM, DaneshiMaskooni M, Hosseinzadeh-Attar MJ.
2019. Nano-curcumin improves glucose
indices, lipids, inflammation, and
Nesfatin in overweight and obese patients
with non-alcoholic fatty liver disease
(NAFLD): a double-blind randomized
placebo-controlled clinical trial. Nutr
Metab (Lond), 16: 8.
Khodadoostan M, Shariatifar B, Motamedi N,
Abdolahi H. 2016. Comparison of liver
enzymes level and sonographic findings
value with liver biopsy findings in
nonalcoholic fatty liver disease patients.
Adv Biomed Res, 5: 40.
Kim N, Park J, Kim S, Kim Y, Kim D, Cho G,
Baik I, Lim H, Kim E, Na J. 2014. Nonalcoholic fatty liver disease, metabolic
syndrome and subclinical cardiovascular
changes in the general population. Heart,
100: 938-943.
Lam B, Younossi Z. 2010. Treatment options
for nonalcoholic fatty liver disease.
Therap Adv Gastroenterol, 3: 121-137.
Larasati YA, Yoneda-Kato N, Nakamae I,
Yokoyama T, Meiyanto E, Kato JY.
2018. Curcumin targets multiple enzymes
involved in the ROS metabolic pathway
to suppress tumor cell growth. Sci Rep, 8:
Lim S, Oh TJ, Koh KK. 2015. Mechanistic
link between nonalcoholic fatty liver
disease and cardiometabolic disorders. Int
J Cardiol, 201: 408-414.
Liu Z, Que S, Xu J, Peng T. 2014. Alanine
aminotransferase-old biomarker and new
concept: a review. Int J Med Sci, 11: 925-
Mahaling D, Basavaraj M, Bika A. 2013.
Comparison of lipid profile in different
grades of non-alcoholic fatty liver disease
diagnosed on ultrasound. Asian Pac J
Trop Biomed, 3: 907-912.
Mansour-Ghanaei F, Pourmasoumi M, Hadi A,
Joukar F. 2019. Efficacy of
curcumin/turmeric on liver enzymes in
patients with non-alcoholic fatty liver
disease: A systematic review of
randomized controlled trials. Integr Med
Res, 8: 57-61.
Mokgalaboni K, Ntamo Y, Ziqubu K,
Nyambuya TM, Nkambule BB,
Mazibuko-Mbeje SE, Gabuza KB,
Chellan N, Tiano L, Dludla PV. 2021.
Curcumin supplementation improves
biomarkers of oxidative stress and
inflammation in conditions of obesity,
type 2 diabetes and NAFLD: updating the
status of clinical evidence. Food Funct,
12: 12235-12249.
Panahi Y, Kianpour P, Mohtashami R, Jafari
R, Simental-Mendía L, Sahebkar A. 2016.
Curcumin lowers serum lipids and uric
acid in subjects with nonalcoholic fatty
liver disease: A randomized controlled
trial. J Cardiovasc, 68: 223-229.
Panahi Y, Kianpour P, Mohtashami R, Jafari
R, Simental-Mendía L, Sahebkar A. 2017.
Efficacy and safety of phytosomal
curcumin in non-alcoholic fatty liver
disease: A randomized controlled trial.
Drug Res (Stuttg), 67: 244-251.
Rahimi HR, Nedaeinia R, Nikdoust S. 2016.
Novel delivery system for natural
products: Nano-curcumin formulations.
Avicenna J Phytomed, 6: 383-398.
Rahimi HR, Jaafari MR, Mohammadpour AH,
Abnous K, Ghayour Mobarhan M,
Ramezanzadeh E, Mousavi F, Kazemi
Oskuee R. 2015. Curcumin: reintroduced
therapeutic agent from traditional
medicine for alcoholic liver disease. Asia
Pac J Med Toxicol, 4: 25-30.
Rahimi HR, Mohammadpour AH, Dastani M,
Jaafari MR, Abnous K, Ghayour
Mobarhan M, Kazemi Oskuee R. 2016.
The effect of nano-curcumin on HbA1c,
fasting blood glucose, and lipid profile in
diabetic subjects: a randomized clinical
trial. Avicenna J Phytomed, 6: 567-577.
Rahmani S, Asgary S, Askari G, Keshvari M,
Hatamipour M, Feizi A, Sahebkar A.
2016. Treatment of non-alcoholic fatty
liver disease with curcumin: A
randomized placebo-controlled trial.
Phytother Res, 30: 1540-1548.
Rinella ME. 2015. Nonalcoholic fatty liver
disease: a systematic review. JAMA, 313:
Rivera-Espinoza Y, Muriel P. 2009.
Pharmacological actions of curcumin in
liver diseases or damage. Liver, 29: 1457-
Schindhelm RK, Diamant M, Dekker JM,
Tushuizen ME, Teerlink T, Heine RJ.
2006. Alanine aminotransferase as a
marker of non-alcoholic fatty liver disease
Impact of nano-micelle curcumin on liver enzymes
AJP, Vol. 13, No. 6, Nov-Dec 2023 625
in relation to type 2 diabetes mellitus and
cardiovascular disease. Diabetes Metab
Res Rev, 22: 437-443.
Serfaty L, Lemoine M. 2008. Definition and
natural history of metabolic steatosis:
clinical aspects of NAFLD, NASH and
cirrhosis. Diabetes Metab, 34: 634-637.
Shahcheraghi S, Rahimi HR, Lotfi M,
Ayatollahi J. 2020. Can other herbal
drugs affect signaling pathways in
glioblastoma cells similar to curcumin?
Middle East J Cancer, 11: 120-124.
Slika L, Patra D. 2020. A short review on
chemical properties, stability and nanotechnological advances for curcumin
delivery. Expert Opin Drug Deliv, 17: 61-
Spooner M, Jump D. 2019. Omega-3 fatty
acids and nonalcoholic fatty liver disease
in adults and children: where do we
stand? Curr Opin Clin Nutr Metab Care,
22: 103-110.
Sutti S, Albano E. 2020. Adaptive immunity:
an emerging player in the progression of
NAFLD. Nat Rev Gastroenterol Hepatol,
17: 81-92.
Tiniakos D, Vos M, Brunt E. 2010.
Nonalcoholic fatty liver disease:
pathology and pathogenesis. Annu Rev
Pathol, 5: 145-171.
Um M, Hwang K, Ahn J, Ha T. 2013.
Curcumin attenuates diet-induced hepatic
steatosis by activating AMP-activated
protein kinase. Basic Clin Pharmacol
Toxicol, 113: 152-157.
Varì R, Scazzocchio B, Silenzi A, Giovannini
C, Masella R, Grosso G. 2021. Obesityassociated inflammation: Does curcumin
exert a beneficial role? Nutrients, 13:
Weiß J, Rau M, Geier A. 2014. Non-alcoholic
fatty liver disease: epidemiology, clinical
course, investigation, and treatment.
Dtsch Arztebl Int, 111: 447-452.
Yallapu MM, Jaggi M, Chauhan SC. 2012.
Curcumin nanoformulations: a future
nanomedicine for cancer. Drug Discov
Today, 17: 71-80.
Yki-Järvinen H. 2016. Diagnosis of
nonalcoholic fatty liver disease (NAFLD).
Diabetologia, 59: 1104-1111.