Effects of Quercetin on Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis aimed to evaluate the effects of quercetin (QE) on liver function, lipid profiles, kidney function, anthropometric measures, hematological markers, and inflammatory markers in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). PubMed, Cochrane Library, Web of Science, and Embase were searched to January 26, 2025, for randomized controlled trials (RCTs). Additional gray literature sources, trial registries, and preprint platforms were screened. Weighted mean differences (WMDs) with 95% confidence intervals were calculated. Heterogeneity was assessed using the I2 statistic, and meta-regression analyses explored the influence of quercetin dose, baseline BMI, and age. Seven RCTs (540 patients) were included. Quercetin significantly reduced liver enzymes (ALT, AST, GGT), direct bilirubin, and C-reactive protein. Lipid profiles improved with reductions in total cholesterol, LDL, and triglycerides, and an increase in HDL. No significant effects were observed on kidney function, BMI, body fat, hematological markers, or TNF-α. Meta-regressions suggested dosage, baseline BMI, and age may contribute to heterogeneity. According to GRADE, the certainty of evidence ranged from very low to moderate. QE shows preliminary evidence of improving liver function, lipid profiles, and inflammation in MASLD patients. However, given the small number of RCTs and the generally limited certainty of evidence, these findings should be interpreted with caution. Further large-scale, high-quality trials are warranted to confirm its therapeutic role. PROSPERO Registration Code: CRD42025639487.