Efficacy of Vitamin E on Lipid Profile in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review and Meta-Analysis.

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with dyslipidemia and overweight. Vitamin E has been suggested to improve lipid metabolism, but clinical evidence in MASLD remains inconsistent. This meta-analysis evaluates the effects of vitamin E on serum lipid profiles and body mass index (BMI) in adults with MASLD. A literature search was conducted across databases through January 2026 to identify eligible randomized controlled trials (RCTs). Outcomes included triglycerides (TG), total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDL-C & HDL-C), and BMI. Pooled effect estimates were calculated as weighted mean difference (WMD) with 95% confidence intervals (CIs) using a random-effects model. The pooled analysis of 12 RCTs showed that vitamin E in patients with MASLD significantly reduced TG (-12.74 mg/dL, 95% CI: [-22.78, -2.70], p = 0.013), whereas no significant change was observed in TC (-2.11 mg/dL, 95% CI: [-4.89, 0.67], p = 0.137) and LDL-C (-5.32 mg/dL, 95% CI: [-11.15, 0.51], p = 0.074), HDL-C levels (0.23 mg/dL, 95% CI: [-0.48, 0.94], p = 0.527), and BMI (0.36 kg/m², 95% CI: [-0.86, 1.58], p = 0.563). Subgroup analyses revealed that TG was significantly reduced in low-dose, more prolonged supplementation and in overweight patients. For TC, LDL-C, and HDL-C, only a slight, significant improvement was observed in patients with obesity. Vitamin E in patients with MASLD selectively modulates lipid metabolism, predominantly reducing TG levels. Modest improvements in TC, LDL-C, and HDL-C were observed primarily in patients with obesity. These findings support the potential role of vitamin E as an adjunctive therapy for MASLD-associated dyslipidemia.