These studies demonstrated improvement in biochemical profiles , with a decline in or normalization of liver enzymes .
However , some concerns have been raised regarding the use of vitamin E in patients with NASH due to its adverse effects profile and lack of significant improvement in hepatic fibrosis .
There has been a growing interest in the role of vitamin E supplementation in the treatment and /or prevention of nonalcoholic fatty liver ( NAFLD ) .
Furthermore , histological assessment showed favorable outcomes in lobular inflammation and hepatic steatosis following treatment with vitamin E. Current guidelines regarding the use of vitamin E in the setting of NAFLD recommend that vitamin E-based treatment be restricted to biopsy-proven nondiabetic patients with NASH only .
Antioxidant supplements reduced oxidative stress and stabilized liver function tests but did not reduce inflammation in a randomized controlled trial in obese children and adolescents.
Oxidative stress and low- grade systemic inflammation may contribute to the pathogenesis of obesity-induced comorbidities , including nonalcoholic fatty liver disease . Increasing intake of dietary antioxidants might be beneficial , but there are few data in obese children . To examine the effect of antioxidant supplementation on biomarkers of oxidative stress , inflammation , and liver function , we r and omly assigned overweight or obese children and adolescents ( n = 44 ; mean ± SD age : 12.7 ± 1.5 y ) participating in a lifestyle modification program to a 4-mo intervention with daily antioxidants ( vitamin E , 400 IU ; vitamin C , 500 mg ; selenium , 50 μg ) or placebo . We measured anthropometrics , antioxidant status , oxidative stress ( F(2)-isoprostanes , F(2)-isoprostane metabolites ) , inflammation , liver enzymes , fasting insulin and glucose , and lipid profile at baseline and endpoint . There was a significant treatment effect of antioxidant supplementation on antioxidant status [ α-tocopherol , β = 23.2 ( 95 % CI : 18.0 , 28.4 ) ; ascorbic acid , β = 70.6 ( 95 % CI : 51.7 , 89.4 ) ; selenium , β = 0.07 ( 95 % CI : 0.01 , 0.12 ) ] and oxidative stress [ 8-iso-prostagl and in F2α , β = -0.11 ( 95 % CI : -0.19 , -0.02 ) ] but not on any of the inflammatory markers measured . There was a significant treatment effect on alanine aminotransferase [ β = -0.13 ( 95 % CI : -0.23 , -0.03 ) ] , a trend toward a significant effect on aspartate aminotransferase [ β = -0.04 ( 95 % CI : -0.09 , 0.01 ) ] , and no significant effect on γ-glutamyltransferase [ β = -0.03 ( 95 % CI : -0.11 , 0.06 ) ] . In  summary , antioxidant supplementation for 4 mo improved antioxidant-oxidant balance and modestly improved liver function tests ; however , it did not reduce markers of systemic inflammation despite significant baseline correlations between oxidative stress and inflammation . The study was registered at clinical trials.gov as NCT01316081
These studies demonstrated improvement in biochemical profiles , with a decline in or normalization of liver enzymes .
However , some concerns have been raised regarding the use of vitamin E in patients with NASH due to its adverse effects profile and lack of significant improvement in hepatic fibrosis .
There has been a growing interest in the role of vitamin E supplementation in the treatment and /or prevention of nonalcoholic fatty liver ( NAFLD ) .
Furthermore , histological assessment showed favorable outcomes in lobular inflammation and hepatic steatosis following treatment with vitamin E. Current guidelines regarding the use of vitamin E in the setting of NAFLD recommend that vitamin E-based treatment be restricted to biopsy-proven nondiabetic patients with NASH only .