Pistacia atlantica can improve oxidative status in patients with metabolic dysfunction-associated fatty liver disease

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a problem worldwide. Oxidative stress is important factor in beginning and progress of MAFLD. This study is the first clinical trial with the aim of determining the effect of Pistacia atlantica Sub. Kurdica gum on oxidative status in patients with metabolic dysfunction-associated fatty liver disease. In this double-blind randomized clinical trial 50 patients with metabolic dysfunction-associated fatty liver disease were randomized into two groups: those given syrup containing Pistacia atlantica sub. Kurdica gum (Group A), those on placebo (Group B). Over a two-month period, Group A given syrup containing 500 mg of P. atlantica sub. Kurdica gum per each tablespoon and Group B given syrup without P. atlantica sub. Kurdica gum. Anthropometric measures, serum oxidative markers and physical activity were evaluated at the beginning and end of the intervention. We observed a significant decrease in fatty liver grade in group A (P = 0.03). In the end of intervention had not been show significant change in serum total antioxidant capacity (TOS) in group A (P = 0.91) and group B (0.70). Serum total oxidant status (TAC) had been show increase in group A and decrease in group B but this changes not significant as within group (P = 0.36, P = 0.53, respectively) and between group (P = 0.66). The mean of Malondialdehid (MDA) had significant decrease from baseline in group A (P = 0.002) and had non-significant increase in group B (P = 0.65). The between-group comparison of changes of MDA had been show a significant difference (P = 0.025). As well as, after adjusting for baseline characteristics (Age, Gender, Physical activity, BMI), there were not significant differences between A and B groups in the changes comparison of TOS and TAC except for MDA (p < 0.032). Weight had significant decrease in group A (P = 0 < 001). Pistacia atlantica sub. Kurdica gum can improve some oxidative status indices, particularly lipid peroxidation and subsequently MAFLD in patient with metabolic dysfunction-associated fatty liver disease, but further studies with larger samples, longer duration and dose-response assessment will be needed.Trial registration: IRCT20231219060466N1, 2024-01-05 (https//irct.behdasht.gov.ir/).