TNF and fatty liver disease: NAC or metformin individually improved most of these biochemical and histological parameters related to hepatic steatosis such as lobular inflammation, fibrosis accompanied with elevated serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutamyl transferase, cholesterol, triglycerides, LDL, VLDL, leptin, TNF-α, and TGF-β1. These improvements were more pronounced in the combination treatment.