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Background <p>Alpha-lipoic acid (ALA) has attracted interest as a potential adjunctive therapy for non-alcoholic fatty liver disease (NAFLD) because of its antioxidant, metabolic, and anti-inflammatory properties. This systematic review evaluated the available in vitro, animal, and human evidence on the effects of ALA in NAFLD.</p> Methods <p>We searched Web of Science, Embase, ScienceDirect, PubMed, Scopus, and Cochrane from inception to December 2025 for studies evaluating ALA in NAFLD. Eligible studies included in vitro, animal, and human investigations. Data were extracted on study characteristics, outcomes, and mechanistic findings, and risk of bias was assessed using design-specific tools.</p> Results <p>Twenty-seven studies met the inclusion criteria: 6 in vitro, 15 animal, and 6 human studies. Preclinical studies consistently showed that ALA modulated pathways related to mitochondrial function, oxidative stress, inflammation, lipid handling, and glucose metabolism. In human studies, the effects of ALA were heterogeneous but generally suggested modest improvements in liver enzymes, steatosis-related outcomes, and selected metabolic markers. However, the clinical evidence was limited by small sample sizes, short follow-up, and variable study quality.</p> Conclusion <p>The current evidence suggests that ALA may be a biologically active and mechanistically plausible adjunct in NAFLD, but the available human data are insufficient to establish it as an effective disease-modifying therapy. Larger, well-designed randomized controlled trials with standardized NAFLD endpoints are needed to determine its true clinical value.</p>

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Effects of alpha-lipoic acid in non-alcoholic fatty liver disease (NAFLD): a systematic review of literature

  • 期刊论文

  • 发表日期：

    2026年6月26日

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  • Tamara Nazar Saeed,
  • Ali Fawzi Al-Hussainy,
  • Gaurav Sanghvi,
  • R. Roopashree,
  • Aditya Kashyap,
  • D. Alex Anand,
  • Rajashree Panigrahi,
  • Zafar Aminov,
  • Sada Ghalib Taher,
  • Mariem Alwan,
  • Mahmood Jawad,
  • Hiba Mushtaq

摘要

Background

Alpha-lipoic acid (ALA) has attracted interest as a potential adjunctive therapy for non-alcoholic fatty liver disease (NAFLD) because of its antioxidant, metabolic, and anti-inflammatory properties. This systematic review evaluated the available in vitro, animal, and human evidence on the effects of ALA in NAFLD.

Methods

We searched Web of Science, Embase, ScienceDirect, PubMed, Scopus, and Cochrane from inception to December 2025 for studies evaluating ALA in NAFLD. Eligible studies included in vitro, animal, and human investigations. Data were extracted on study characteristics, outcomes, and mechanistic findings, and risk of bias was assessed using design-specific tools.

Results

Twenty-seven studies met the inclusion criteria: 6 in vitro, 15 animal, and 6 human studies. Preclinical studies consistently showed that ALA modulated pathways related to mitochondrial function, oxidative stress, inflammation, lipid handling, and glucose metabolism. In human studies, the effects of ALA were heterogeneous but generally suggested modest improvements in liver enzymes, steatosis-related outcomes, and selected metabolic markers. However, the clinical evidence was limited by small sample sizes, short follow-up, and variable study quality.

Conclusion

The current evidence suggests that ALA may be a biologically active and mechanistically plausible adjunct in NAFLD, but the available human data are insufficient to establish it as an effective disease-modifying therapy. Larger, well-designed randomized controlled trials with standardized NAFLD endpoints are needed to determine its true clinical value.