Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent metabolic disorder characterized by excessive hepatic fat accumulation. Intermittent fasting (IF) has emerged as a potential therapeutic strategy with the ability to induce weight loss, improve insulin sensitivity and reduce hepatic steatosis. We aim to compare the efficacy of different IF regimens for MASLD management. A systematic review and network meta-analysis of randomized controlled trials investigating different IF regimens for MASLD. PubMed, EMBASE, WOS, SCOPUS and Cochrane Central Register of Controlled Trials were searched until 10 April 2023. Analysis was performed using R software with the meta and netmeta packages. Mean difference (MD) was used to pool continuous outcomes with 95% confidence intervals (CIs). Our meta-analysis was registered in PROSPERO (CRD42023418467). Our meta-analysis included eight randomized controlled trials with a total of 635 participants. The 5 : 2 diet significantly improved liver stiffness (MD, -0.32; 95% CI, -0.55 to -0.09; P < 0.01). Time-restricted feeding significantly improved liver steatosis (controlled attenuation parameter score) (MD, -39.83; 95% CI, -64.78 to -14.87; P < 0.01). No significant changes were observed in asparate aminotransferase, gamma-glutamyl transpeptidase, low-density lipoproteins cholesterol, total cholesterol, triglyceride levels, basal metabolic index, blood pressure, Homeostatic Model Assessment of Insulin Resistance, fasting blood sugar, lean body mass or waist circumference across all IF regimens. However, alternate-day fasting showed positive results in anthropometric measures, including significant improvements in lean body mass, waist circumference, fat mass and weight reduction (P < 0.05). IF regimens showed various positive effects on clinical outcomes in MASLD patients; however, these effects were not consistent. Therefore, a patient-tailored IF regimen should be considered.

中文翻译：

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代谢功能障碍相关脂肪肝病的间歇性禁食方案：随机对照试验的系统评价和网络荟萃分析。

代谢功能障碍相关的脂肪肝病（MASLD）是一种常见的代谢性疾病，其特征是肝脏脂肪过度积累。间歇性禁食（IF）已成为一种潜在的治疗策略，能够减轻体重、提高胰岛素敏感性并减少肝脏脂肪变性。我们的目的是比较不同 IF 方案对 MASLD 管理的疗效。对研究 MASLD 不同 IF 方案的随机对照试验进行系统回顾和网络荟萃分析。PubMed、EMBASE、WOS、SCOPUS 和 Cochrane 对照试验中央注册库的检索截止日期为 2023 年 4 月 10 日。使用带有 meta 和 netmeta 软件包的 R 软件进行分析。平均差 (MD) 用于汇集具有 95% 置信区间 (CI) 的连续结果。我们的荟萃分析已在 PROSPERO 中注册 (CRD42023418467)。我们的荟萃分析包括 8 项随机对照试验，共有 635 名参与者。5:2 饮食显着改善肝脏硬度（MD，-0.32；95% CI，-0.55 至 -0.09；P < 0.01）。限时喂养显着改善肝脏脂肪变性（受控衰减参数评分）（MD，-39.83；95% CI，-64.78至-14.87；P < 0.01）。天门冬氨酸转氨酶、γ-谷氨酰转肽酶、低密度脂蛋白胆固醇、总胆固醇、甘油三酯水平、基础代谢指数、血压、胰岛素抵抗稳态模型评估、空腹血糖、去脂体重或腰围未观察到显着变化涵盖所有 IF 方案。然而，隔日禁食在人体测量方面显示出积极的结果，包括去脂体重、腰围、脂肪量和体重减轻的显着改善（P < 0.05）。IF 方案对 MASLD 患者的临床结果显示出多种积极影响；然而，这些效果并不一致。因此，应考虑针对患者量身定制的 IF 方案。