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Myo-inositol (MI) has known to exert anti-diabetic, anti-oxidative and anti-inflammatory properties. The present study examined the effects of MI supplementation on the expression of some inflammatory genes, serum high-sensitivity C-reactive protein (hs-CRP), WBC-derived inflammatory biomarkers, body composition and liver function in obese patients with non-alcoholic fatty liver disease (NAFLD). Forty-eight obese patients with NAFLD were randomly allocated into either MI (4 g/day) or placebo (maltodextrin 4 g/day) group along with dietary recommendations for 8 weeks. At the end of the study, reduction in fat mass and an increase in fat free mass were statistically greater in the MI group compared with placebo group. Moreover, MI supplementation resulted in a significant reduction in TNF-α mRNA expression, compared with placebo. Despite the decrease in systemic inflammation response index (SIRI) and monocytes to lymphocyte ratio (MLR) in the MI group, no differences were observed in other WBC-derived inflammatory markers as well as serum hs-CRP.