Glucose homeostasis, insulin resistance and inflammatory biomarkers in patients with non-alcoholic fatty liver disease: Beneficial effects of supplementation with microalgae Chlorella vulgaris: A double-blind placebo-controlled randomized clinical trial

Clin Nutr. 2017 Aug;36(4):1001-1006. doi: 10.1016/j.clnu.2016.07.004. Epub 2016 Jul 19.


Background: Chlorella vulgaris (C. vulgaris) is reported to improve dyslipidemia and hypertension; however, its effect on inflammatory biomarkers and insulin resistance has not been noticed thus far. Non-alcoholic fatty liver disease (NAFLD) as a hepatic symptom of metabolic syndrome is strongly associated with insulin resistance and inflammation.

Aim of the study: In the current interventional trial, we aimed to study the effects of C. vulgaris supplementation on glucose homeostasis, insulin resistance and inflammatory biomarkers in patients with NAFLD.

Methods: Seventy NAFLD patients confirmed by ultra-sonographic findings were randomly assigned into intervention group (four 300 mg tablets of C. vulgaris) or placebo group (four 300 mg tablets of placebos) for 8 weeks. Anthropometric measurements, liver enzymes, fasting serum glucose (FSG), insulin, high sensitive C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-α) were assessed and homeostatic model assessment (HOMA) score for insulin resistance was estimated before and after the intervention.

Results: Anthropometric measurements decreased significantly in both group (p < 0.001). However, mean reduction in weight was significantly higher in C. vulgaris - treated group compared to placebo group. Serum concentrations of liver enzymes, FSG and hs-CRP also significantly decreased and serum insulin concentration and HOMA score increased significantly only in C. vulgaris-treated group (P < 0.001, P < 0.006 and P < 0.025, respectively). Mean change in serum glucose and TNF-α levels were significant between the groups even after adjusting for the serum insulin and baseline values of variables (P = 0.014, P = 0.005, P = 0.014, respectively); between-group differences were not significant for the other variables by the end of study.

Conclusion: To our finding, C. vulgaris supplementation could be considered as an adjunctive therapy to decrease weight and improve glycemic status and reducing hs-CRP as well as improving liver function in patients with NAFLD.

Irct number: 201202233320N7.

Keywords: Chlorella vulgaris; Inflammation; Insulin resistance; Non-alcoholic fatty liver disease.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antioxidants / adverse effects
  • Antioxidants / therapeutic use*
  • Biological Products / adverse effects
  • Biological Products / therapeutic use*
  • Biomarkers / blood
  • Chlorella vulgaris / chemistry*
  • Dietary Supplements* / adverse effects
  • Double-Blind Method
  • Female
  • Humans
  • Inflammation Mediators / blood
  • Insulin Resistance*
  • Intention to Treat Analysis
  • Iran
  • Lipotropic Agents / adverse effects
  • Lipotropic Agents / therapeutic use
  • Liver / diagnostic imaging
  • Liver / immunology
  • Liver / metabolism
  • Liver / physiopathology
  • Lost to Follow-Up
  • Male
  • Microalgae / chemistry*
  • Non-alcoholic Fatty Liver Disease / complications
  • Non-alcoholic Fatty Liver Disease / diet therapy*
  • Non-alcoholic Fatty Liver Disease / immunology
  • Non-alcoholic Fatty Liver Disease / metabolism
  • Patient Dropouts


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antioxidants
  • Biological Products
  • Biomarkers
  • Inflammation Mediators
  • Lipotropic Agents

Associated data

  • IRCT/201202233320N7