01/10/2025
Ginkgo (Ginkgo biloba) is widely recognised for its clinical applications in conditions such as cognitive decline, dementia, peripheral arterial disease, tinnitus and anxiety, yet its potential hepatic actions are rarely emphasised in Western herbal practice. There are two early small clinical trials showing some benefit in patients with chronic viral hepatitis. A recent study suggests that Ginkgo might also have value in MASLD.
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a growing global health concern linked to increased risks of cardiovascular disease, chronic kidney disease (CKD) and premature mortality. Since, Ginkgo biloba has shown potential therapeutic benefits in conditions characterised by metabolic dysfunction, an observational study was initiated to evaluate the potential protective effects of Ginkgo on overall survival (OS) and incidence of cardiovascular and renal outcomes in MASLD patients.
This cohort study included 402,476 participants from the UK Biobank, categorised into MASLD and “No steatotic liver disease (SLD)” cohorts. Ginkgo users and non-users were compared using inverse probability of treatment weighting to balance baseline characteristics. Clinical outcomes were assessed using Cox proportional hazards models, with subgroup analyses.
Ginkgo use was associated with significantly improved OS [hazard ratio (HR) = 0.79, p = 0.034) and reduced risks of cardiovascular events (HR = 0.82, 95 % CI: 0.66-1.00, p = 0.012) and CKD (HR = 0.73, 95 % CI: 0.56-0.96, p = 0.012) in the MASLD cohort, while no significant benefits were observed in the “No SLD” cohort. Subgroup analyses indicated enhanced benefits in older adults, males, individuals with BMI ≥ 25 kg/m² and diabetic patients. The beneficial effects were pronounced in patients with advanced fibrosis.
This study is limited by its non-randomised design, potential lifestyle and selection biases, lack of liver-specific endpoints and unmeasured confounding, making its findings hypothesis-generating rather than conclusive. What is needed next is a prospective randomised, controlled trial in MASLD using a defined, high-quality Ginkgo extract at an appropriate dose.
For more information see: https://pubmed.ncbi.nlm.nih.gov/40435579/