Essential phospholipids for nonalcoholic fatty liver disease associated with metabolic syndrome: A systematic review and network meta-analysis

Table 1 Features of the studies included in this analysis

Ref.	Design	Patient type	Treatments	N	M/F	Age, yr, range (mean)	BMI, kg/m2	Duration
Yin et al[23], 2000	Randomized, OL	NAFLD + diabetes	PPC + ADs vs ADs	125	73/52	42–78 (59)	N/A	84 d
Poongothai et al[25], 2005	Prospective, OL	NAFLD + type 2 diabetes	PPC + ADs	22	11/11	(41)	28.2	6 mo
Arvind et al[26], 2006	Prospective, non-randomized, DB	NAFLD + diabetes or obesity	PPC vs ursodeoxycholic acid	40	NA	NA	NA	3 mo
Sun et al[21], 2008	Prospective, randomized, OL	NAFLD + type 2 diabetes	PPC + metformin vs metformin	74	40/34	28–60 (42)	NA	12 wk
Wu et al[22], 2009	Prospective, randomized, OL	NAFLD + type 2 diabetes	PPC + usual care vs usual care	100	64/36	(55)	NA	1 mo
Li et al[18], 2013	Prospective, randomized, OL	NAFLD + diabetes	PPC + metformin vs metformin	86	57/29	(51)	NA	6 wk
Sas et al[19], 2013	Prospective, randomized, OL	NASH + type 2 diabetes	PPC + metformin vs metformin	189	NA	NA	NA	6 mo
Dajani et al[24], 2015	Prospective, OL	NAFLD ± type 2 diabetes or hyperlipidemia	Essential phospholipid	324	176/148	21–69 (43.5)	29.3	72 wk
Shan et al[20], 2015	Prospective, randomized, OL	NASH + obesity	PPC vs Chinese medicine (Quzhi hepatoprotection recipe)	60	38/22	18-55 (41.3)	NA	8 wk
Li et al[17], 2017	Prospective, randomized, OL	NAFLD + diabetes	PPC + Chinese medicine (Shugan Huazhuo recipe) vs PPC	80	44/36	29-63 (48)	NA	3 mo

In Arvind et al 2006[26], half the patients in each group had T2D and half were obese. In Dajani et al[24], three patient groups were included: Non-alcoholic fatty liver disease only, non-alcoholic fatty liver disease with type 2 diabetes, and non-alcoholic fatty liver disease with hyperlipidemia. AD: Antidiabetic drugs; DB: Double-blind; NA: Not available; NAFLD: Non-alcoholic fatty liver disease; NASH: Non-alcoholic steatohepatitis; OL: Open-label; PPC: Polyene phosphatidylcholine.

Table 2 Summary of the authors’ assessment of the risk of bias for each item in the Cochrane quality assessment

Ref.	Selection bias (sequence generation)	Selection bias (allocation concealment)	Performance bias (blinding)	Detection bias	Attrition bias (incomplete outcomes data)	Reporting bias (selective outcome reporting)	Other bias
Yin et al[23], 2000	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Low risk	Low risk	Low risk
Poongothai et al[25], 2005	High risk	High risk	High risk	High risk	Low risk	Low risk	Low risk
Arvind et al[26], 2006	High risk	High risk	Unclear risk	Unclear risk	Low risk	Low risk	Low risk
Sun et al[21], 2008	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Low risk	Low risk	Low risk
Wu et al[22], 2009	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Low risk	Low risk	Low risk
Li et al[18], 2013	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Low risk	Low risk	Low risk
Sas et al[19], 2013	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Low risk
Dajani et al[24], 2015	High risk	High risk	High risk	High risk	Low risk	Unclear risk	Low risk
Shan et al[20], 2015	Unclear risk	Unclear risk	Unclear risk	Unclear risk	Low risk	Low risk	Low risk
Li et al[17], 2017	Low risk	Unclear risk	Unclear risk	Unclear risk	Low risk	Low risk	Low risk

The risk of bias was deemed unclear when the study did not specify the required information (e.g., a randomized study that does not specify the method of randomization or allocation concealment).