Role of folate in nonalcoholic fatty liver disease

Victoria Sid, Yaw L Siow, Karmin O.

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of chronic liver conditions characterized by steatosis, inflammation, fibrosis, and liver damage. The global prevalence of NAFLD is increasing rapidly in proportion to the increasing incidence of obesity and type 2 diabetes. Because NAFLD is a multifaceted disorder with many underlying metabolic abnormalities, there is currently no pharmacological agent that is therapeutically approved for the treatment of this sickness. Folate is a water-soluble B vitamin that plays an essential role in the one-carbon transfer reactions involved in nucleic acid biosynthesis, methylation reactions, and sulfur-containing amino acid metabolism. The liver is the main organ responsible for the storage and metabolism of folates. Low serum folate levels have been observed in patients with obesity and diabetes. A low level of endogenous folates in rodents has been reported to disrupt folate-dependent carbon metabolism and may be associated with the 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.