Role of folate in nonalcoholic fatty liver disease

Can J Physiol Pharmacol. 2017 Oct;95(10):1141-1148. doi: 10.1139/cjpp-2016-0681. Epub 2017 May 1.


Nonalcoholic fatty liver disease (NAFLD) is a spectrum of chronic liver conditions that are characterized by steatosis, inflammation, fibrosis, and liver injury. The global prevalence of NAFLD is rapidly increasing in proportion to the rising incidence of obesity and type 2 diabetes. Because NAFLD is a multifaceted disorder with many underlying metabolic abnormalities, currently, there is no pharmacological agent that is therapeutically approved for the treatment of this disease. Folate is a water-soluble B vitamin that plays an essential role in one-carbon transfer reactions involved in nucleic acid biosynthesis, methylation reactions, and sulfur-containing amino acid metabolism. The liver is the primary organ responsible for storage and metabolism of folates. Low serum folate levels have been observed in patients with obesity and diabetes. It has been reported that a low level of endogenous folates in rodents perturbs folate-dependent one-carbon metabolism, and may be associated with development of metabolic diseases such as NAFLD. This review highlights the biological role of folate in the progression of NAFLD and its associated metabolic complications including obesity and type 2 diabetes. Understanding the role of folate in metabolic disease may position this vitamin as a potential therapeutic for NAFLD.

Keywords: acide folique; folate; inflammation; nonalcoholic fatty liver disease; oxidative stress; steatosis; stress oxydatif; stéatose; surcharge en graisse du foie non alcoolique.

Publication types

  • Review

MeSH terms

  • Animals
  • Energy Metabolism
  • Folic Acid / metabolism*
  • Folic Acid / therapeutic use
  • Folic Acid Deficiency / drug therapy
  • Folic Acid Deficiency / metabolism*
  • Folic Acid Deficiency / pathology
  • Humans
  • Inflammation Mediators / metabolism
  • Liver / drug effects
  • Liver / metabolism*
  • Liver / pathology
  • Non-alcoholic Fatty Liver Disease / drug therapy
  • Non-alcoholic Fatty Liver Disease / metabolism*
  • Non-alcoholic Fatty Liver Disease / pathology
  • Oxidative Stress


  • Inflammation Mediators
  • Folic Acid