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Review Article
Year: 2019 I Volume: 1 I Issue: 2 I Pages: 1- 7

Effects of Acetylsalicylic Acid on Non-Alcoholic Fatty Liver Disease – Systematic Review

Abdulrahman Ismaiel1,2*, Nahlah Al Srouji3

1 Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

2 2nd Department of Internal Medicine, Cluj-Napoca, Romania.

3 Leon Daniello Clinical Hospital of Pneumology, Cluj-Napoca, Romania

* Corresponding Author:

Abdulrahman Ismaiel, MD

Email address:

Source of support: None


Conflict of interest: None

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Background: Several studies have assessed the effects of acetylsalicylic acid (ASA), a widely used drug worldwide, in non-alcoholic fatty liver disease (NAFLD) patients. In this systematic review, we aim to evaluate the effect of ASA use on the prevalence of NAFLD, as well as hepatic steatosis and fibrosis in NAFLD patients. Methods: We performed a systematic search on PubMed and Embase electronic databases with predefined keywords searching for observational and experimental studies published from inception and till 19 July 2019. The diagnosis of NAFLD was based on histology, imaging or surrogate markers. Eligible articles based on inclusion and exclusion criteria were extracted and included in the qualitative assessment using the National Heart, Lung, and Blood Institute (NHLBI) quality assessment tools. Results: A total of seven observational studies (5 cross-sectional and 2 cohort) were included involving 18,209 subjects. Three studies evaluated the prevalence of NAFLD in subjects receiving ASA, out of which two studies demonstrated a lower prevalence rate in subjects using ASA for at least ≥ 15 times per month. On the other hand, only one study demonstrated no prevalence decrease in NAFLD with the use of ASA. Moreover, hepatic steatosis and fibrosis was evaluated in four studies with histological confirmation of NAFLD. Two of these studies reported a reduced severity of hepatic steatosis with ASA use. On the other hand, a study demonstrated that a less severe hepatic steatosis but not histological improvement was associated with ASA use. Furthermore, another study reported that ASA use in type 2 diabetic patients wasn’t associated with protective effects against advanced hepatic fibrosis. Statistical pooling of included studies wasn’t performed due to heterogeneity of the study designs. Conclusions: Although most studies demonstrated potential protective effects of ASA use in hepatic steatosis and fibrosis, as well as a reduced prevalence of NAFLD, results from the current literature remain inconsistent with the quality of most studies being rated as fair or poor. Therefore, clear conclusions and recommendations can’t be drawn from the current studies in the literature evaluating this association. Further experimental studies are required to confirm the potential protective effects associated with ASA use on NAFLD.


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