Role of aspirin in metabolic associated fatty liver disease

Yongqi LI; Yanqiu LI; Lina SUN; Chaoran WANG; Ying FENG; Liang WANG; Xianbo WANG

doi:10.12449/JCH260122

Volume 42 Issue 1

Jan. 2026

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Article Navigation > Journal of Clinical Hepatology > 2026 > 42(1): 178-182

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Role of aspirin in metabolic associated fatty liver disease

DOI: 10.12449/JCH260122

1.
Center of Integrative Medicine，Beijing Ditan Hospital，Capital Medical University，Beijing 100015，China
2.
Department of Traditional Chinese Medicine，Beijing Shijitan Hospital，Capital Medical University，Beijing 100038，China

Research funding:

National Natural Science Foundation of China (82474419);

National Administration of Traditional Chinese Medicine High Level Key Discipline Construction Project of Traditional Chinese Medicine (zyyzdxk-2023005);

Capital’s Funds for Health Improvement and Research (2024-1-2173)

More Information

Corresponding author: WANG Xianbo， wangxianbo638@163.com （ORCID： 0000-0002-3593-5741）
Received Date: 2025-05-28
Accepted Date: 2025-06-13
Published Date: 2026-01-25

Abstract

Abstract

Metabolic associated fatty liver disease （MAFLD） is the main type of chronic liver disease in the world， with an increasingly higher incidence rate and a younger age of onset. At present， the treatment of MAFLD mainly depends on lifestyle intervention and comorbidity management， and there is still a lack of effective drugs for MAFLD itself. As a classic nonsteroidal anti-inflammatory drug of the salicylic acid family， aspirin can intervene in the pathological process of MAFLD by regulating lipid metabolism， relieving insulin resistance， reducing liver inflammation and oxidative stress response， exerting an anti-liver fibrosis effect， and inhibiting hepatocellular carcinoma， and therefore， it has the value of preventing disease onset， delaying disease progression， and reversing disease condition. This article systematically reviews the mechanism of action and safety of aspirin in the treatment of MAFLD， in order to provide more drug treatment options for MAFLD patients.
- Metabolic Associated Fatty Liver Disease,
- Aspirin,
- Drug Therapy

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References(36)

References

[1]	European Association for the Study of the Liver(EASL), European Association for the Study of Diabetes(EASD), European Association for the Study of Obesity(EASO). EASL-EASD-EASO clinical practice guidelines on the management of metabolic dysfunction-associated steatotic liver disease(MASLD)[J]. Obes Facts, 2024, 17( 4): 374- 444. DOI: 10.1159/000539371.
[2]	YOUNOSSI Z, ANSTEE QM, MARIETTI M, et al. Global burden of NAFLD and NASH: Trends, predictions, risk factors and prevention[J]. Nat Rev Gastroenterol Hepatol, 2018, 15( 1): 11- 20. DOI: 10.1038/nrgastro.2017.109.
[3]	POUWELS S, SAKRAN N, GRAHAM Y, et al. Non-alcoholic fatty liver disease(NAFLD): A review of pathophysiology, clinical management and effects of weight loss[J]. BMC Endocr Disord, 2022, 22( 1): 63. DOI: 10.1186/s12902-022-00980-1.
[4]	ELSHAER A, LIZAOLA-MAYO BC. Evaluating the role of aspirin in liver disease: Efficacy, safety, potential benefits and risks[J]. Life, 2024, 14( 12): 1701. DOI: 10.3390/life14121701.
[5]	SHEN H, SHAHZAD G, JAWAIRIA M, et al. Association between aspirin use and the prevalence of nonalcoholic fatty liver disease: A cross-sectional study from the Third National Health and Nutrition Examination Survey[J]. Aliment Pharmacol Ther, 2014, 40( 9): 1066- 1073. DOI: 10.1111/apt.12944.
[6]	SIMON TG, WILECHANSKY RM, STOYANOVA S, et al. Aspirin for metabolic dysfunction-associated steatotic liver disease without cirrhosis: A randomized clinical trial[J]. JAMA, 2024, 331( 11): 920- 929. DOI: 10.1001/jama.2024.1215.
[7]	KARIN M, KIM JY. MASH as an emerging cause of hepatocellular carcinoma: Current knowledge and future perspectives[J]. Mol Oncol, 2025, 19( 2): 275- 294. DOI: 10.1002/1878-0261.13685.
[8]	RONG L, ZOU JY, RAN W, et al. Advancements in the treatment of non-alcoholic fatty liver disease(NAFLD)[J]. Front Endocrinol, 2022, 13: 1087260. DOI: 10.3389/fendo.2022.1087260.
[9]	HARRISON SA, BEDOSSA P, GUY CD, et al. A phase 3, randomized, controlled trial of resmetirom in NASH with liver fibrosis[J]. N Engl J Med, 2024, 390( 6): 497- 509. DOI: 10.1056/NEJMoa2309000.
[10]	HE ZX, PENG Y, DUAN WT, et al. Aspirin regulates hepatocellular lipid metabolism by activating AMPK signaling pathway[J]. J Toxicol Sci, 2015, 40( 1): 127- 136. DOI: 10.2131/jts.40.127.
[11]	STEINBERG GR, CARLING D. AMP-activated protein kinase: The current landscape for drug development[J]. Nat Rev Drug Discov, 2019, 18( 7): 527- 551. DOI: 10.1038/s41573-019-0019-2.
[12]	LI Y, XU SQ, MIHAYLOVA MM, et al. AMPK phosphorylates and inhibits SREBP activity to attenuate hepatic steatosis and atherosclerosis in diet-induced insulin-resistant mice[J]. Cell Metab, 2011, 13( 4): 376- 388. DOI: 10.1016/j.cmet.2011.03.009.
[13]	SHIMANO H, SATO R. SREBP-regulated lipid metabolism: Convergent physiology: Divergent pathophysiology[J]. Nat Rev Endocrinol, 2017, 13( 12): 710- 730. DOI: 10.1038/nrendo.2017.91.
[14]	LI AQ, ZHAO PR, ZHAO YQ, et al. Mechanism of action of sterol regulatory element-binding proteins in nonalcoholic fatty liver disease and related therapeutic targets[J]. J Clin Hepatol, 2024, 40( 7): 1459- 1465. DOI: 10.12449/JCH240726. 李安琪, 赵佩然, 赵玉强, 等. 固醇调节元件结合蛋白(SREBP)在非酒精性脂肪性肝病中的作用机制及治疗靶点[J]. 临床肝胆病杂志, 2024, 40( 7): 1459- 1465. DOI: 10.12449/JCH240726.
[15]	ROY S, BHOWMIK DR, BEGUM R, et al. Aspirin attenuates the expression of adhesion molecules, risk of obesity, and adipose tissue inflammation in high-fat diet-induced obese mice[J]. Prostaglandins Other Lipid Mediat, 2022, 162: 106664. DOI: 10.1016/j.prostagl-andins.2022.106664.
[16]	KAMANI L, SIDDIQUI M, RAHAT A. Frequency of insulin resistance among non-diabetic patients with non-alcoholic fatty liver disease using HOMA-IR: An experience of a tertiary care hospital in Karachi, Pakistan[J]. BMC Gastroenterol, 2025, 25( 1): 259. DOI: 10.1186/s12876-025-03790-6.
[17]	YAO ZY, GONG Y, CHEN WB, et al. Upregulation of WDR6 drives hepatic de novo lipogenesis in insulin resistance in mice[J]. Nat Metab, 2023, 5( 10): 1706- 1725. DOI: 10.1038/s42255-023-00896-7.
[18]	LIU FM, WANG Q, QIAN YZ, et al. Research progress of Adenosine 5′-monophosphate-activated protein kinase in the regulation of glycolipid metabolism[J]. Chin J Biotechnol, 2019, 35( 6): 1021- 1028. DOI: 10.13345/j.cjb.180529. 刘凡铭, 王琪, 钱昱臻, 等. 腺苷酸活化蛋白激酶在糖脂代谢调控中的研究进展[J]. 生物工程学报, 2019, 35( 6): 1021- 1028. DOI: 10.13345/j.cjb.180529.
[19]	RUMORE MM, KIM KS. Potential role of salicylates in type 2 diabetes[J]. Ann Pharmacother, 2010, 44( 7-8): 1207- 1221. DOI: 10.1345/aph.1M483.
[20]	REHMAN K, AKASH MSH, LIAQAT A, et al. Role of interleukin-6 in development of insulin resistance and type 2 diabetes mellitus[J]. Crit Rev Eukaryot Gene Expr, 2017, 27( 3): 229- 236. DOI: 10.1615/CritRevEukaryotGeneExpr.2017019712.
[21]	KAJANI S, CURLEY S, O’REILLY ME, et al. Sodium salicylate rewires hepatic metabolic pathways in obesity and attenuates IL-1β secretion from adipose tissue: The implications for obesity-impaired reverse cholesterol transport[J]. Mol Metab, 2022, 56: 101425. DOI: 10.1016/j.molmet.2021.101425.
[22]	ALEGBELEYE BJ, AKPOVESO OP, MOHAMMED RK, et al. Pharmacology, pharmaceutics and clinical use of aspirin: A narrative review[J]. J Drug Delivery Ther, 2020, 10( 5-s): 236- 253. DOI: 10.22270/jDDT.v10i5-s.4351.
[23]	LIU T, ZHANG LY, JOO D, et al. NF-κB signaling in inflammation[J]. Signal Transduct Target Ther, 2017, 2: 17023. DOI: 10.1038/sigtrans.2017.23.
[24]	BALTAZAR MT, DINIS-OLIVEIRA RJ, DUARTE JA, et al. Antioxidant properties and associated mechanisms of salicylates[J]. Curr Med Chem, 2011, 18( 21): 3252- 3264. DOI: 10.2174/092986711796391552.
[25]	SIMON TG, HENSON J, OSGANIAN S, et al. Daily aspirin use associated with reduced risk for fibrosis progression in patients with nonalcoholic fatty liver disease[J]. Clin Gastroenterol Hepatol, 2019, 17( 13): 2776- 2784. DOI: 10.1016/j.cgh.2019.04.061.
[26]	LI L, YU JX, ZHOU ZW. Association between platelet indices and non-alcoholic fatty liver disease: A systematic review and meta-analysis[J]. Rev Esp Enferm Dig, 2024, 116( 5): 264- 273. DOI: 10.17235/reed.2022.9142/2022.
[27]	JIANG QR, MAO RC, WU JW, et al. Platelet activation during chronic hepatitis B infection exacerbates liver inflammation and promotes fibrosis[J]. J Med Virol, 2020, 92( 12): 3319- 3326. DOI: 10.1002/jmv.25641.
[28]	TAN DJH, NG CH, LIN SY, et al. Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma: A systematic review and meta-analysis[J]. Lancet Oncol, 2022, 23( 4): 521- 530. DOI: 10.1016/S1470-2045(22)00078-X.
[29]	LANGE NF, RADU P, DUFOUR JF. Prevention of NAFLD-associated HCC: Role of lifestyle and chemoprevention[J]. J Hepatol, 2021, 75( 5): 1217- 1227. DOI: 10.1016/j.jhep.2021.07.025.
[30]	RICCIOTTI E, WANGENSTEEN KJ, FITZGERALD GA. Aspirin in hepatocellular carcinoma[J]. Cancer Res, 2021, 81( 14): 3751- 3761. DOI: 10.1158/0008-5472.CAN-21-0758.
[31]	WANG YF, FENG JY, ZHAO LN, et al. Aspirin triggers ferroptosis in hepatocellular carcinoma cells through restricting NF-κB p65-activated SLC7A11 transcription[J]. Acta Pharmacol Sin, 2023, 44( 8): 1712- 1724. DOI: 10.1038/s41401-023-01062-1.
[32]	DAI XY, YAN J, FU XH, et al. Aspirin inhibits cancer metastasis and angiogenesis via targeting heparanase[J]. Clin Cancer Res, 2017, 23( 20): 6267- 6278. DOI: 10.1158/1078-0432.CCR-17-0242.
[33]	YANG J, YAMASHITA-KANEMARU Y, MORRIS BI, et al. Aspirin prevents metastasis by limiting platelet TXA(2) suppression of T cell immunity[J]. Nature, 2025, 640( 8060): 1052- 1061. DOI: 10.1038/s41586-025-08626-7.
[34]	YAN LJ, YAO SY, LI HC, et al. Efficacy and safety of aspirin for prevention of hepatocellular carcinoma: An updated meta-analysis[J]. J Clin Transl Hepatol, 2022, 10( 5): 835- 846. DOI: 10.14218/JCTH.2021.00257.
[35]	LEE TY, HSU YC, HO HJ, et al. Daily aspirin associated with a reduced risk of hepatocellular carcinoma in patients with non-alcoholic fatty liver disease: A population-based cohort study[J]. EClinicalMedicine, 2023, 61: 102065. DOI: 10.1016/j.eclinm.2023.102065.
[36]	SOSTRES C, LANAS A. Gastrointestinal effects of aspirin[J]. Nat Rev Gastroenterol Hepatol, 2011, 8( 7): 385- 394. DOI: 10.1038/nrgastro.2011.97.

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Role of aspirin in metabolic associated fatty liver disease

DOI: 10.12449/JCH260122

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Role of aspirin in metabolic associated fatty liver disease

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