Role of betaine in liver disease-worth revisiting or has the die been cast?

World J Gastroenterol. 2020 Oct 14;26(38):5745-5748. doi: 10.3748/wjg.v26.i38.5745.


Nonalcoholic steatohepatitis (NASH) is an important indication for liver transplantation in many Western countries due to the epidemic of obesity and insulin resistance. Unfortunately, no medication is approved for NASH and risk factor modification is often advised. Over the last decade, several clinical trials on NASH have been conducted with several ongoing and the future looks promising. Although betaine (trimethyl glycine) was evaluated for NASH, results were mixed in the clinical trials in large part due to the quality of the studies. It seems reasonable to re-evaluate betaine in clinical trials for NASH and alcoholic liver disease due to its low cost, tolerability and mechanism of action.

Keywords: Betaine; Cirrhosis; Insulin resistance; Nonalcoholic steatohepatitis; Obesity; S-adenosyl homocysteine; S-adenosyl methionine.

Publication types

  • Review

MeSH terms

  • Betaine / therapeutic use
  • Humans
  • Insulin Resistance*
  • Liver / pathology
  • Liver Cirrhosis / pathology
  • Liver Transplantation*
  • Non-alcoholic Fatty Liver Disease* / drug therapy
  • Non-alcoholic Fatty Liver Disease* / pathology
  • Obesity / pathology


  • Betaine