Vitamin E supplementation may benefit patients with NAFLD

Evidence from an umbrella meta-analysis of randomized controlled trials (RCTs) revealed that the administration of vitamin E reduces aspartate aminotransferase (AST), alanine aminotransferase (ALT), fibrosis and steatosis levels in patients with NAFLD. Research showed a significant reduction in fibrosis scores when vitamin E dose exceeds 500 IU/day and treatment duration surpasses 20 months.

NAFLD is defined as the accumulation of excessive fat in the liver, as shown by imaging or by histology, in the setting of no significant alcohol consumption and the absence of any secondary cause. The condition is estimated to be the most common cause of end‐stage liver disease in the coming years.

Vitamin E is the major lipid-soluble chain-breaking antioxidant in the human body. Molecules of the vitamin E family exert anti-inflammatory and anti-atherogenic activities in addition to their anti-oxidative properties. Although NAFLD pathogenesis and its progression to fibrosis need clarification, it is suggested that oxidative stress plays a crucial role in producing the lethal hepatocyte injury linked with NALFD.

The impact of vitamin E supplementation on liver biomarkers in patients with NAFLD remains controversial. Therefore, Mingyue Wang, Nantong University, Nantong, China, and colleagues present a meta-analysis of RCTs to clarify the effects of vitamin E administration on AST, ALT, GGT, steatosis levels and fibrosis score in people with NAFLD diagnosis. The umbrella meta-analysis included a total of 6 meta-analyses.

The authors reported the following findings:

• By pooling ES based on the random-effects model, vitamin E supplementation significantly decreased ALT (ES = −6.47 U/L), AST (ES = −5.35 U/L), fibrosis score (ES = −0.24 U/L), and steatosis levels (ES = −0.66) but had no effect on GGT values in NAFLD patients.
• In the subgroup analyses, we detected that fibrosis scores notably decreased when vitamin E dosage was >500 IU/day (ES = −0.25) and when the treatment duration was >20 months (ES = −0.26).

"We discovered that supplementation with vitamin E significantly reduced aspartate aminotransferase, alanine aminotransferase, fibrosis score, and steatosis levels but had no effect on GGT values in patients with non-alcoholic fatty liver disease," the researchers wrote.

The researchers found a significant reduction in fibrosis scores when vitamin E dose exceeds 500 IU/day and treatment duration surpasses 20 months.

Reference:

Wang, M., Prabahar, K., Găman, A., & Zhang, J. Vitamin E supplementation in the treatment on non-alcoholic fatty liver disease (NAFLD): Evidence from an umbrella meta-analysis on randomized controlled trials. Journal of Digestive Diseases. https://doi.org/10.1111/1751-2980.13210