Non-alcoholic fatty liver disease (
NAFLD) generally has a relatively favorable
clinical course; however, non-
alcoholic steatohepatitis (NASH) was much more frequently progresses to
cirrhosis and
hepatocellular carcinoma. We performed a systematic review and meta-analysis of clinical trials to examine the effects of
vitamin E supplementation in improving liver histology in NASH. We performed a comprehensive search of the PubMed, Embase and Cochrane databases through October 2014. Weighted mean differences (WMDs) and their respective 95% confidence intervals (CIs) were calculated to assess the efficacy of
vitamin E in improving liver histological scores by using fixed effects or random effects. Standard methods were performed to explore statistical heterogeneity and publication bias. Compared with controls,
vitamin E supplementation significantly improved all histological parameters, including steatosis (WMD = -0.62, 95% CI: -0.95, -0.77, P = 0.0002), hepatocyte ballooning (WMD = -0.30, 95% CI: -0.56, -0.04, P = 0.03), lobular
inflammation (WMD = -0.39, 95% CI: -0.67, -0.11, P = 0.007) and
fibrosis (WMD = -0.39, 95% CI: -0.72, -0.06, P = 0.02). Our analysis also indicated the absence of publication bias between NASH and
Vitamin E intake. This meta-analysis indicates that
vitamin E supplementation had a significant and positive effect in the improvement of steatosis, ballooning degeneration, lobular
inflammation and
fibrosis in patients with NASH.