Preventing Metabolic-Associated Fatty Liver Disease with Fermented Cordyceps Preparation: an Electronic Medical Record based study

Xiaozhou Zhou^1,2Zijian Tian³Shaoyun Li⁴Ruifeng Jing²Ziqing Liu²Peng Wu⁵Jian Shao²Jie Bai^2,6Rong Huang⁷Ying Pan⁸Kaixin Zhou^2*

• ¹College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
• ²Guangzhou National Laboratory, Guangzhou, Guangdong, China
• ³National Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences (CAS), Beijing, Beijing Municipality, China
• ⁴Fifth People's Hospital of Chongqing, Chongqing, China
• ⁵College of Pharmacy and Tianjin Key Laboratory of Mo-lecular Drug Research, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China
• ⁶College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China
• ⁷Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
• ⁸Department of General Practice, Kunshan Hospital Affiliated to Jiangsu University, Kunshan,Jiangsu Province, China

Background: Metabolic-associated fatty liver disease (MAFLD) is a prevalent chronic liver condition with significant health implications. Fermented Cordyceps Preparation (FCP) has shown promise in managing metabolic disorders, prompting interest in its potential for MAFLD prevention.There is, however, a lack of large-scale clinical evidence regarding its preventive efficacy and longterm safety.Aim：We aimed to assess the preventive efficacy and safety of FCP, as regards combatting MAFLD.Methods: Propensity score matching was used to select 343 FCP users and 1372 non-users with metabolic syndrome, (MS) as recorded in EMR. These two groups were followed for 750 days, to track the incidence of MAFLD. The Kaplan Meier method was used to calculate the cumulative risk of MAFLD events in each subgroup. A Multiple linear regression model was used to compare the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), as between the two groups.Results: Compared with non-users, FCP users were associated with a 26% decreased risk of MAFLD (hazard ratio 0.74, 95% confidence interval 0.56 to 0.97). During the follow-up, the changes in both ALT and AST, were insignificantly different between the two groups.Conclusions: These findings highlight the potential of FCP in MAFLD prevention and offer insight into its safety profile, suggesting avenues for further clinical validation and drug repurposing efforts.