The beneficial effects of Chlorella vulgaris supplementation on health-related indices in patients with non-alcoholic fatty liver disease: a GRADE-assessed systematic review and meta-analysis.

2026-02-07
BMC cardiovascular disorders 26(1)
- Ali Jafari
- Helia Mardani
- Bahare Parsi Nezhad
- Azita Hekmatdoost

PubMed: 41652544
DOI: 10.1186/s12872-025-05433-w

Study Design

Type: Meta-Analysis
Sample size: n = 375
Population: patients with non-alcoholic fatty liver disease (NAFLD)
Methods: Systematic review and meta-analysis of seven trials; interventions ranged from 8 to 12 weeks
Duration: 8 to 12 weeks
Funding: Unclear

This systematic review and meta-analysis aimed to assess the impact of Chlorella vulgaris (C. vulgaris) consumption on cardiovascular disease risk factors in patients with non-alcoholic fatty liver disease (NAFLD). Relevant research was identified through electronic searches of databases up to September 19, 2025. Study quality was assessed using the Cochrane risk-of-bias tool (ROB 2). Seven trials, all conducted in Iran, with interventions ranging from 8 to 12 weeks and involving 375 participants, were included. C. vulgaris supplementation demonstrated significant reductions in weight (Weighted Mean Difference [WMD]= -1.62, 95% Confidence Interval -1.00), fasting blood sugar (FBS) (WMD= -6.25, 95% CI: -9.02, -3.47), high-sensitivity C-reactive protein (hs-CRP) (WMD= -1.02, 95% CI: -1.84, -0.19), low-density lipoprotein cholesterol (LDL-C) (WMD= -6.45, 95% CI: -12.25, -0.64), total cholesterol (TC) (WMD= -7.18, 95% CI: -10.84, -3.52), alkaline phosphatase (ALP) (WMD= -14.84, 95% CI: -27.81, -1.87), and aspartate aminotransferase (AST) (WMD= -4.99, 95% CI: -7.26, -2.71). This meta-analysis demonstrates that C. vulgaris supplementation significantly improves liver function, glycemic control, and lipid profiles in patients with NAFLD. However, all included studies were conducted in Iran, limiting the generalizability of these findings, and the certainty of evidence was rated as very low due to risk of bias, indicating that the results should be interpreted with caution.

Research Insights

Chlorella→Reduced Alkaline Phosphatase Level
C. vulgaris supplementation demonstrated significant reductions in ... alkaline phosphatase (ALP) (WMD= -14.84, 95% CI: -27.81, -1.87)
Effect
Beneficial
Effect size
Small
Dose
not specified
Chlorella→Reduced Aspartate Aminotransferase Level
C. vulgaris supplementation demonstrated significant reductions in ... aspartate aminotransferase (AST) (WMD= -4.99, 95% CI: -7.26, -2.71)
Effect
Beneficial
Effect size
Small
Dose
not specified
Chlorella→Reduced Blood Cholesterol
C. vulgaris supplementation demonstrated significant reductions in ... total cholesterol (TC) (WMD= -7.18, 95% CI: -10.84, -3.52)
Effect
Beneficial
Effect size
Small
Dose
not specified
Chlorella→Reduced Body Weight
C. vulgaris supplementation demonstrated significant reductions in weight (Weighted Mean Difference [WMD]= -1.62, 95% Confidence Interval [CI]: -2.24, -1.00)
Effect
Beneficial
Effect size
Small
Dose
not specified
Chlorella→Reduced C-Reactive Protein Levels
C. vulgaris supplementation demonstrated significant reductions in ... high-sensitivity C-reactive protein (hs-CRP) (WMD= -1.02, 95% CI: -1.84, -0.19)
Effect
Beneficial
Effect size
Small
Dose
not specified
Chlorella→Reduced Fasting Blood Glucose Levels
C. vulgaris supplementation demonstrated significant reductions in ... fasting blood sugar (FBS) (WMD= -6.25, 95% CI: -9.02, -3.47)
Effect
Beneficial
Effect size
Small
Dose
not specified
Chlorella→Reduced Low-Density Lipoprotein Level
C. vulgaris supplementation demonstrated significant reductions in ... low-density lipoprotein cholesterol (LDL-C) (WMD= -6.45, 95% CI: -12.25, -0.64)
Effect
Beneficial
Effect size
Small
Dose
not specified