A 6-month randomized clinical trial published in Hepatology depicted that in patients with non-alcoholic fatty liver disease (NAFLD), Nicotinamide riboside and pterostilbene (NRPT) at the recommended dose is safe, and its use is associated with effective reduction in the markers of hepatic inflammation. Ryan W. Dellinger et al. aimed to assess the efficacy of daily NRPT supplementation in patients with NAFLD.

In this double-blind, placebo-controlled study, 111 people with NAFLD were selected. A placebo, a recommended daily dosage of NRPT (NRPT 1X), and a double dosage of NRPT (NRPT 2X) made up the study's three arms. The primary outcome was the within-individual alteration in hepatic fat fraction (HFF) from baseline comparing each intervention group to placebo at six months. Blood tests for hepatic function and inflammation, including alanine transaminase (ALT), gamma-glutamyl transferase (GGT), aspartate transaminase (AST), and alkaline phosphatase (ALP) were the secondary outcomes.

NRPT seemed well-tolerated and safe. No appreciable difference was noted in HFF when compared to the placebo. A time-dependent reduction in the levels of liver enzymes like GGT and ALT was found in the NRPT 1X group, and this reduction was significant compared to the placebo, among the prespecified secondary outcomes.

Additionally, compared to the placebo group, the NRPT 1X group showed a significant reduction in the circulating levels of the hazardous lipid ceramide 14:0, and this reduction was linked to a reduction in ALT among members of this group. In the NRPT 2X group, there was no evidence of a dose-dependent effect on ALT, GGT, or ceramide 14:0. Hence, the combination of synergistic natural compounds nicotinamide riboside and pterostilbene is safe, well-tolerated and beneficial for NAFLD treatment.