The effect of N-acetylcysteine on metabolic dysfunction associated with fatty liver disease and polycystic ovary syndrome as metabolic disorders

Metabolic dysfunction associated with fatty liver disease "MAFLD" and polycystic ovary syndrome "PCOS" are common disorders often related to metabolic syndrome. Insulin resistance, obesity and oxidative stress are contributing to the pathogenesis of both MAFLD and PCOS. N-acetyl cysteine "NAC", is an antioxidant with anti-inflammatory, antiapoptotic and insulin sensitizing properties, arises as a possible therapeutic option for MAFLD and PCOS. The aim of this review is to evaluate the effect of NAC alone or in combination on the metabolic parameters associated with MAFLD and PCOS. Using pre-defined keywords, PubMed, Google Scholar and clinical trial.gov were systemically searched to identify related studies. A total of 10 studies related to MAFLD and 17 other studies related to PCOS were included. In conclusion, most of the included studies showed a promising impact of NAC in reducing elevated transaminases and degree of liver steatosis in MAFLD through reducing oxidative stress and insulin resistance. Regarding PCOS NAC was reported to have a positive effect on endometrial thickness, ovulation rate and pregnancy rate either alone or when combined with clomiphene citrate. Further clinical trials are needed to confirm these results.