Effect of vitamin E in non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomised controlled trials

Abstract

The efficacy of vitamin E among patients with non-alcoholic fatty liver disease (NAFLD) is unclear. The current qualitative and quantitative analyses aimed to ascertain the efficacy of vitamin E on clinical outcomes of patients with NAFLD. A systematic search of randomised controlled trials (RCTs) was performed using databases (PubMed, ProQuest, Scopus, EBSCOhost and Ovid) from inception to July 2018. Trials meeting the inclusion criteria were subjected to quality assessment using the Jadad Scoring. All trials meeting the prerequisites information for meta-analysis were subjected to quantitative synthesis of results. Nine RCTs (five in adults and four in children) were included. Four of the five RCTs on adults demonstrated significant improvements in alanine transaminase and other liver function surrogates in patients with NAFLD. On the other hand, only one of the four RCTs conducted on children showed significant improvements in liver functions with the use of vitamin E. Although quantitative synthesis of available data revealed insignificant differences between vitamin E and placebo, still the use of vitamin E improves the level of alanine transaminase and aspartate transaminase by −1.96 and −0.59, with heterogeneity of I2=67% and I2=0%, respectively. Adjuvant vitamin E therapy provides significant biochemical and histological improvements in adult patients with NAFLD, while paediatric patients showed insignificant efficacy compared with placebo. Lifestyle interventions along with vitamin E can provide much better results. Data, including the impact of vitamin E on hepatic histology, are still lacking. Moreover, the short duration of trials limits the conclusion on the safety and efficacy of proposed treatments.

Non-alcoholic fatty liver disease and childhood obesity

“…Adjuvant Vitamin E therapy has been shown to be efficacious in adults with NAFLD, however a similar significant effect has not been demonstrated on meta-analysis in paediatric patients [63]. Vitamin E therefore remains unlicensed for this indication in the United Kingdom, although may be considered for children with advanced liver fibrosis in tertiary care settings [64].…”

Vitamin E as an Adjuvant Treatment for Non-alcoholic Fatty Liver Disease in Adults: A Systematic Review of Randomized Controlled Trials

“…Despite the potential benefits of vitamin E for the treatment of NAFLD and the randomized controlled trials (RCTs) conducted to validate this fact, there is a lack of systematic reviews that could help conclude these studies. There has been some work where authors have looked at the effects of vitamin E among all population groups [11]. However, there exists a great deal of disproportionation between the prevalence of NAFLD among different age groups, with the disease becoming more prevalent in the aging population [12].…”

The effect of vitamin E supplementation on selected inflammatory biomarkers in adults: a systematic review and meta-analysis of randomized clinical trials

“…Inclusion criteria. We included eligible studies that met the following criteria: (1) randomized controlled clinical trials, (2) studies that conducted on adult subjects (≥ 18 years), (3) studies that administered vitamin E in different chemical forms including alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol, (4) RCTs with at least one week's duration of intervention, and (5) controlled trials that reported mean changes and their standard deviations (SDs) of inflammatory cytokines throughout the trial for both intervention and control groups or presented required information for calculation of those effect sizes. If > 1 article were published for one dataset, the more complete one was included.…”