The effect of bergamot-derived polyphenolic fraction on LDL small dense particles and non-alcoholic fatty liver disease in patients with metabolic syndrome

The occurrence of Metabolic Syndrome (MS) represents an independent risk factor for developing cardiovascular disease states in patients suffering from type 2 diabetes mellitus. Moreover, both the size of LDL particles and liver dysfunction identified as non-alcoholic fatty liver disease (NAFLD) represent important biomarkers for the development of cardiometabolic risk in patients with MS. We studied the effect of bergamot polyphenolic fraction (BPF) in patients with MS and NAFLD. 107 patients were enrolled at the San Raffaele IRCCS (Rome). All of them showed ultrasonografic evidences of NAFLD and at least three out of five previous identified criteria for the diagnosis of MS. Patients were divided into two groups: one receiving placebo and the second receiving BPF 650 mg twice a day for 120 consecutive days. In the group receiving BPF 650 mg twice a day, a significant reduction of fasting plasma glucose, serum LDL cholesterol and triglycerides alongside with an increase of HDL cholesterol was found. This effect was accompanied by a significant reduction of both ultrasonographic and metabolic biomarkers of NAFLD as well as by a decrease of small dense LDL particles. Overall, our data show that bergamot-deriving polyphenolic fraction given in patients with MS and NAFLD, leads to concomitant amelioration of the lipemic and glycemic serum profiles and to substantial reduction of liver steatosis. This effect, alongside with a reduction of pro-atherogenic small dense LDL and enhancement of anti-atherogenic high dense HDL, shed new light on the potential use of bergamot-extract for reducing cardiometabolic risk in patients with MS.