Clinical efficacy of Silybum marianum seed extract in treatment of type 2 diabetes mellitus and non-alcoholic fatty liver disease: a narrative review

Background: Several clinical studies have been undertaken to investigate the potential therapeutic effects of Silybum marianum (S. marianum) seed extract (silymarin) in Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). Objective: We performed the present narrative review to evaluate the efficacy of silymarin supplement for treatment of T2DM and NAFLD. Methods: Electronic databases PubMed, Science Direct, Scopus, Google and Google Scholar were surveyed for the English and non-English human clinical trial papers published concerning the effects of silymarin on T2DM and NAFLD from January 2010 to April 2018. Results: Sixteen articles regarding silymarin effects on T2DM and NAFLD in clinical studies have been included in this review. The anti-diabetic effect of silymarin was reported in four clinical trials in single formula and in one trial in combination with nettle and boswellia gum resin. The efficacy of silymarin or silybin has been reported in the treatment of NAFLD in eleven clinical trials as single formula or in combination with phosphatidylcholine, simvastatin and vitamin E. Conclusion: Silymarin appears to be effective as an adjuvant with the standard therapy in the treatment of T2DM and NAFLD.