The Potential Use of Metabolic Cofactors in Treatment of NAFLD

Nutrients. 2019 Jul 12;11(7):1578. doi: 10.3390/nu11071578.


Non-alcoholic fatty liver disease (NAFLD) is caused by the imbalance between lipid deposition and lipid removal from the liver, and its global prevalence continues to increase dramatically. NAFLD encompasses a spectrum of pathological conditions including simple steatosis and non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis and liver cancer. Even though there is a multi-disciplinary effort for development of a treatment strategy for NAFLD, there is not an approved effective medication available. Single or combined metabolic cofactors can be supplemented to boost the metabolic processes altered in NAFLD. Here, we review the dosage and usage of metabolic cofactors including l-carnitine, Nicotinamide riboside (NR), l-serine, and N-acetyl-l-cysteine (NAC) in human clinical studies to improve the altered biological functions associated with different human diseases. We also discuss the potential use of these substances in treatment of NAFLD and other metabolic diseases including neurodegenerative and cardiovascular diseases of which pathogenesis is linked to mitochondrial dysfunction.

Keywords: N-acetyl-l-cysteine; NAFLD; l-carnitine; l-serine; metabolic cofactors; nicotinamide riboside.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / drug therapy
  • Coenzymes / therapeutic use*
  • Humans
  • Neurodegenerative Diseases / drug therapy
  • Non-alcoholic Fatty Liver Disease / drug therapy*


  • Coenzymes