Factors influencing severity and various clinical indexes in herb-induced liver injury: an updated bibliometric analysis and meta-analysis

Nguyen, Hoang An, Le, Ngoc Vy, Le, Nhat Thong, Do, Thi Thu Hien, Dao, Ngoc Bac, Nguyen, Thu Nga, Duong, Doan Minh Trung, Tran, Doan Hong Ngoc, Huynh, Thuc Quyen, Nguyen, Ha Linh, Luong, Minh Hoang, Le, Minh Thong, Huynh, Chan Khon, Nguyen, Thi Thu Hoai, Vu, Huyen Thanh, Tran, Phillip, Nguyen, Phuong-Hien and Thao, Nguyen Phuong 2025. Factors influencing severity and various clinical indexes in herb-induced liver injury: an updated bibliometric analysis and meta-analysis. Journal of Ethnopharmacology , 120864. 10.1016/j.jep.2025.120864

Full text not available from this repository.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE The global rise in herbal medicine utilizes as an alternative treatment has corresponded with a rise in herb-induced liver injury (HILI). Although numerous systematic reviews existed, their generalizability is limited, and factors associated with HILI remain unclear. AIM OF THE STUDY To comprehensively summarize HILI cases reported in English language literature and to investigate the association between potential factors related to HM use and the severity of liver injury. MATERIALS AND METHODS A total of 643 patients from 382 studies were included. Global HILI cases rose markedly between 2002 and 2011. Weight management was the most common reason for HM use. Single-herb product users were more likely to develop mild injury compared with mixed-product users. Supplementary product use was associated with higher chances for having cholestasis. Females (64.9%) were generally older at onset and had longer herb use durations, while males showed higher Gamma-Glutamyl Transferase (GGT) levels. Older patients tended to have less severe injury, though with elevated GGT and prolonged herb use. Race significantly influenced International Normalized Ratio, total bilirubin, and overall severity. CONCLUSION This study highlights sex, age, race, usage patterns, liver function markers (GGT, INR, TBL), and HM type (herbal preparations and constituents) as key factors in HILI diagnosis and management. Further studies are warranted to confirm these associations.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Optometry and Vision Sciences
Additional Information:	License information from Publisher: LICENSE 1: Title: This article is under embargo with an end date yet to be finalised.
Publisher:	Elsevier
ISSN:	0378-8741
Date of Acceptance:	5 November 2025
Last Modified:	13 Nov 2025 11:45
URI:	https://orca.cardiff.ac.uk/id/eprint/182392

Actions (repository staff only)

Edit Item