Clinical effect of vitamin E in treatment of nonalcoholic fatty liver disease in children: A Meta-analysis

Objective To investigate the clinical effect of vitamin E in the treatment of nonalcoholic fatty liver disease( NAFLD) in children. Methods PubMed,Web of Science,The Cochran Library,Embase,OVID/NEJM,CNKI,and Wanfang Data were searched for the articles on vitamin E in the treatment of NAFLD in children published up to December 2019. The data of 8 parameters were analyzed,i. e.,body mass index( BMI),liver enzymes [alanine aminotransferase( ALT) and aspartate aminotransferase( AST) ],blood lipid levels [triglyceride( TG),total cholesterol( TC),low-density lipoprotein( LDL),and high-density lipoprotein( HDL) ],and remission rate of hepatic steatosis. RevMan 5. 3 was used to perform a Meta-analysis. Continuous variables were analyzed by standardized mean difference( SMD) and 95% confidence interval( CI),and the changes after intervention were analyzed; categorical variables were analyzed by risk difference( RD) and 95% CI. A fixed effects model was used for homogeneous data,and a random effects model was used for heterogeneous data. Funnel plots were used to evaluate publication bias. Results A total of 599 articles were retrieved,among which 9 were included in the Meta-analysis,with 607 subjects in total. Vitamin E significantly improved the level of ALT( SMD =-0. 27,95% CI:-0. 48 to-0. 06,P = 0. 01),but it did not improve the levels of BMI( SMD =-0. 09,95% CI:-0. 28 to 0. 10,P = 0. 34),AST( SMD =-0. 20,95% CI:-0. 42 to 0. 02,P = 0. 07),TG( SMD =-0. 19,95% CI:-0. 51 to 0. 12,P = 0. 22),TCHO( SMD =-0. 11,95% CI:-0. 31 to 0. 08,P = 0. 24),HDL( SMD =-0. 02,95% CI:-0. 27 to 0. 23,P = 0. 88),LDL( SMD =-0. 04,95% CI:-0. 27 to0. 19,P = 0. 72),and the remission rate of hepatic steatosis( RD = 0. 06,95% CI:-0. 05 to 0. 17,P = 0. 29). Conclusion Vitamin E can significantly improve the level of ALT in children with NAFLD and can be considered as an adjuvant drug for clinical treatment.