Non-alcoholic fatty liver disease (NAFLD) is very common and affects up to 24 % of the general population in various countries (1). An increased level of fatty acids within the hepatocytes causing oxidative stress, is believed to be responsible for the progression from steatosis to steatohepatitis and cirrhosis. The elevated serum levels of liver enzymes may be the only laboratory clues during this progress.
Studies focus on anti-oxidative material in order to find protection against liver injury. Vitamins C and E have been found to have both protective and therapeutic effects on NAFLD in an animal model (3, 4). This effect has been linked to the anti-oxidative function of these two vitamins. Nevertheless no medication has been definitively established for NAFLD and research has tried different free-radical scavengers and antioxidant agents. N-acetylcysteine (NAC) is frequently utilized where intracellular oxidant-antioxidant balance is concerned. NAC has a protective effect against liver injury in rats (5-8). One study has reported improvement of liver histopathology and reduction of oxidative stress by NAC in non-alcoholic fatty steatosis (NASH) in a rat model (9). A recent study has reported a significant decrease in liver steatosis and fibrosis in patients with NASH receiving Metformin and NAC (10). In this study, the significance of treatment with NAC in patients with NAFLD and with elevated liver enzymes has been investigated.
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