The Efficacy of Silymarin in Decreasing Transaminase Activities in Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Clinical Trial

N fatty liver disease (NAFLD) is considered as the most common cause of chronic liver diseases worldwide. One type of progressive NAFLD is known as non-alcoholic steatohepatitis (NASH) which can lead to cirrhosis, hepatocellular carcinoma (HCC), liver dysfunction and ultimately to death (1, 2). From the histological point of view, the characteristic of NAFLD is accumulation of macrovesicular lipids. There are two histological types of NAFLD including isolated fatty liver and fatty liver together with evidence of inflammation (NASH). Histology of the liver in NAFLD is indistinguishable from alcoholic hepatitis and includes balloon degeneration, hepatocyte necrosis, and fibrosis. Currently, there is no consensus for staging and grading of NAFLD. It has been shown that there is no relationship between the disease grade and serum level of alanine aminotransferase (ALT) (3). Incidence of NAFLD is not accurately determined based on the published reports. NAFLD is the most common disorder relating to liver in developed