Metabolic dysfunction‐associated steatotic liver disease (MASLD), previously known as non‐alcoholic fatty liver disease (NAFLD), is recognized as the most prevalent liver disease globally, impacting nearly 30% of the population. While lifestyle and dietary changes aimed at weight loss remain the cornerstone of management, these interventions often face adherence challenges. Vitamin E has demonstrated potential antioxidant properties that may alleviate oxidative stress, a key contributor to the pathogenesis of MASLD. However, the clinical benefits of vitamin E for MASLD remain uncertain, necessitating a systematic evaluation of its effects.
Author Conclusions:
Given the very low certainty evidence, the effects of long‐term treatment (18 to 24 months) with vitamin E alone on all‐cause mortality, serious adverse events, quality of life, or non‐serious adverse events in people with NAFLD remain uncertain compared with placebo or no intervention. No data were available on liver-related mortality, liver-related morbidity, or the proportion of participants without a decrease in liver enzymes. Vitamin E likely leads to a slight reduction in ALT and AST levels when compared with placebo, but it is unclear whether this affects the clinical progression of NAFLD. Trials involving vitamin E combined with vitamin C did not report on key outcomes, such as all‐cause mortality, liver-related mortality, serious adverse events, liver-related morbidity, health-related quality of life, or non‐serious adverse events. Given the very low certainty evidence, the impact of vitamin E plus vitamin C on liver enzymes in people with NAFLD compared with placebo is unknown
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