Vitamin E improves serum inflammation markers, histology in MASLD
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Key takeaways:
- Vitamin E significantly reduced serum ALT and AST in patients with MASLD.
- It also significantly increased MASH resolution but did not reduce fibrosis.
Vitamin E improved serum markers of liver inflammation and histology in patients with metabolic dysfunction-associated steatotic liver disease, according to results from a systematic review and meta-analysis.
“The prevailing theory suggests that insulin resistance plays a central role in the development of hepatic steatosis and potentially steatohepatitis,” Nicholas Ming-Zher Chee, of the gastroenterology and hepatology unit at the University of Malaya, and colleagues wrote in the Journal of Gastroenterology and Hepatology. “Apart from that, studies also suggest that the presence of oxidative stress is necessary to trigger the inflammatory aspect of steatohepatitis.”
They continued: “Hence, to address oxidative stress and decreased levels of antioxidant enzymes, multiple clinical trials have been conducted to explore the potential hepatoprotective benefits of vitamin E in the management of MASLD.”
Chee and colleagues conducted a literature search and identified eight randomized controlled trials comparing the effects of vitamin E vs. placebo in patients with MASLD. The studies included 1,008 participants (mean age, 36-59.1 years; 11.4%-65.8% women), of whom 255 on vitamin E, at dosages ranging from 400 IU to 800 IU, and 253 on placebo were included in analyses.
The researchers evaluated treatment response via serum alanine aminotransferase and aspartate aminotransferase, as well as fibrosis and resolution of metabolic dysfunction-associated steatohepatitis, among other outcomes.
According to meta-analysis, vitamin E significantly reduced serum ALT (standardized mean difference [SMD] = –0.82; 95% CI, –1.13 to –0.51) and AST (SMD = –0.68; 95% CI, –0.94 to –0.41), as well as steatosis (mean difference [MD] = –0.6; 95% CI, –0.83 to –0.37), lobular inflammation and hepatocyte ballooning.
In subgroup analysis, vitamin E significantly reduced ALT in patients with MASLD but fell short of significance in patients with MASH, while reductions in AST reached significance in both patient populations.
Vitamin E also significantly increased MASH resolution (RR = 1.9; 95% CI, 1.2-3.02), but did not reduce fibrosis (MD = –0.23; 95% CI, –0.51 to 0.05).
“Vitamin E resulted in significant reduction in serum markers of liver inflammation, namely serum ALT and AST levels, in patients with MASLD and improvements in histological features, namely steatosis, lobular inflammation and hepatocyte ballooning and MASH resolution, in patients with MASH,” Chee and colleagues wrote. “However, further clinical trials are warranted, including the investigation of the optimum dosage, type of vitamin E and potential long-term complications associated with the medication.”
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