O R I G I N A L A RTICLE Hepatitis Monthly 2010; 10(1): 12-16 N-Acetylcysteine Improves Liver Function in Patients with Non-Alcoholic Fatty Liver Disease Manouchehr Khoshbaten 1, Akbar Aliasgarzadeh 2, Koorosh Masnadi 1, Mohammad K Tarzamani 3, Sara Farhang 4*, Hosain Babaei 5, Javad Kiani 6, Maryam Zaare 6, Farzad Najapifoor 6 1 Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2 Department of Endocrinology, Tabriz University of Medical Sciences, Tabriz, Iran 3 Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran 4 Liver and Gastrointestinal Diseases Research Center, Imam Reza Hospital, Tabriz, Iran 5 Department of Pharmacology, Tabriz University of Medical Sciences, Tabriz, Iran 6 Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Background and Aims: Non-alcoholic fatty liver change is a common disease of the liver in which oxidative stress plays a basic role. Studies are largely focused on protecting the liver by means of anti-oxidative material. The aim of this study is to evaluate the role of N- acetylcysteine in the process of liver injury. Methods: Thirty patients with non-alcoholic fatty liver steatosis were randomly selected to receive either N-acetylcysteine or vitamin C. Liver function tests (alanine aminotransfrase, aspartate aminotransfrase and alkaline phosphatase) were measured as well as the grade of steatosis, the pattern of its echogenicity, the span of the liver and the spleen and the portal vein diameter before the intervention. Patients were followed up using the same method of evaluation repeated in the first, second and third months. Results: The mean age (SD) was 40.1(12.4) in patients receiving NAC and 46(10.4) years in patients receiving vitamin C (P = 0.137). NAC resulted in a significant decrease of serum alanine aminotransfrase after three months, compared to vitamin C. This effect was independent of the grade of steatosis in the initial diagnosis. NAC was able to significantly decrease the span of the spleen. Conclusions: N-acetylcysteine can improve liver function in patients with non-alcoholic fatty liver disease. Better results may be achievable in a longer follow up. Keywords: Non-alcoholic Fatty Liver Disease, N-acetylcysteine, Therapy Introduction Nis very common and affects up to 24 % of on-alcoholic fatty liver disease (NAFLD) 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 (2). Studies focus on anti-oxidative material in order to find protection against liver injury. Vitamins C * Correspondence: Sara Farhang, M.D. Liver and Gastrointestinal Diseases Research Center, Imam Reza Hospital, Golbad St., Tabriz, East Azerbaijan, Iran. Tel/Fax: +98 411 336 7499 E-mail: dsfarhang@gmail.com Received: 26 Jul 2009 Accepted: 13 Jan 2010 Hepat Mon 2010; 10 (1): 12-16 Revised: 8 Dec 2009