Effect of Nutraceutical Supplementation and Mediterranean Hypocaloric Diet on Calculated Steatosis Indices and Inflammation: Clinical and In Vitro Evidences

: This study evaluated the effect of a nutraceutical supplementation (NS) and Mediterranean hypocaloric diet (MHD) on hepatic steatosis indices (HSIs), γ-glutamyl transferase (γGT), and lipid profile in adults with hyperlipidemia and nonalcoholic fatty liver disease (NAFLD). In vitro study on HepG2 cells explored potential molecular mechanisms. A retrospective study was conducted on 45 overweight/obese subjects (19 M) prescribed MHD with/without NS. Anthropometric data, biochemical parameters, HSIs, and γGT were collected at baseline and after 3 months. In vitro, cells were pretreated with single and mixed NS components and then with tumor necrosis factor α (TNFα) or fatty acids (FAs). Antioxidant and antiinflammatory activities were evaluated by fluorescence assays and quantitative polymerase chain reaction or enzyme-linked immunosorbent assay; antiapoptotic effects by Western blot. After 3 months, all subjects improved anthropometric and biochemical parameters but only the combined MHD and NS treatment significantly reduced insulin resistance, HSIs, low-density lipoprotein cholesterol, and γGT. In vitro, treatment with mixed NS components decreased TNFα-/FAs-induced reactive oxygen species. Combined treatment also modulated the inflammatory response by lowering interleukin-6 and interleukin-1β, increasing interleukin-10 and pro-caspase 8 expression. These findings suggest that NS, due to its antiinflammatory properties, represents a promising strategy for NAFLD management.