The Effects of Combined Vitamin E and C for Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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#adult #alanine-transaminase #antioxidants #aspartate-aminotransferases #child

The Effects of Combined Vitamin E and C for Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Poonyam et al., 2022 | Asian Pac J Cancer Prev | Meta Analysis

Citation

Poonyam Piyakorn, Kritsanaviparkporn Chawan, ... Soodcharoen Asawin. The Effects of Combined Vitamin E and C for Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD): A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Asian Pac J Cancer Prev. 2022-Sep-01;23(9):2891-2899. doi:10.31557/APJCP.2022.23.9.2891

Abstract

OBJECTIVE: Antioxidant therapy is a promising treatment option for non-alcoholic fatty liver disease (NAFLD) after failure of lifestyle modification. We aimed to explore the efficacy of combined vitamin E and C therapy compared to no treatment for NAFLD. METHODS: A literature search was performed in Ovid Embase, Ovid Medline, PubMed, Cochrane Library, Scopus, and Web of Science from inception to 28th April 2020. A systematic review and meta-analysis were conducted on randomized controlled trials that assessed vitamin E and C co-treatment in NAFLD. Quality of evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Assessed outcomes were changes in imaging findings, histological features, and serum transaminases. Subgroup analyses that compared adult versus children were further explored. RESULTS: Four studies (n=260) satisfied our eligibility criteria. Vitamin co-treatment  did not improve ultrasonographic liver brightness, histological parameters of hepatocyte injury (steatosis, lobular inflammation, and ballooning), fibrosis grading (standardized mean difference [SMD ]: 0.02, 95% CI: -0.40 to 0.45, I2=13%), serum aspartate transaminase (mean difference [MD]: -0.05, 95% CI: -2.59 to 2.50, I2=0%), and serum alanine transaminase (MD: 2.82, 95% CI: -2.11 to 7.76, I2=57%). Subgroup stratifications illustrated similar findings. CONCLUSION: Vitamin co-treatment may have limited efficacy in NAFLD. However, we have little confidence in our effect estimates due to bias and other major constraints.

Key Findings

Four studies (n=260) satisfied our eligibility criteria. Vitamin co-treatment  did not improve ultrasonographic liver brightness, histological parameters of hepatocyte injury (steatosis, lobular inflammation, and ballooning), fibrosis grading (standardized mean difference [SMD ]: 0.02, 95% CI: -0.40 to 0.45, I2=13%), serum aspartate transaminase (mean difference [MD]: -0.05, 95% CI: -2.59 to 2.50, I2=0%), and serum alanine transaminase (MD: 2.82, 95% CI: -2.11 to 7.76, I2=57%). Subgroup stratifi

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 260
Age Range See abstract
Condition inflammation

MeSH Terms

  • Adult
  • Alanine Transaminase
  • Antioxidants
  • Aspartate Aminotransferases
  • Child
  • Humans
  • Liver
  • Non-alcoholic Fatty Liver Disease
  • Randomized Controlled Trials as Topic
  • Vitamin E
  • Vitamins

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-e-liver

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09