The increasing burden of
nonalcoholic fatty liver disease (
NAFLD) requires innovative management strategies, but an effective pharmacological agent has yet to be found. Apart from
weight loss and lifestyle adjustments, one isomer of the
vitamin E family-
alpha-tocopherol-is currently recommended for nondiabetic
steatohepatitis patients. Another member of the
vitamin E family,
tocotrienol (T3), has anti-inflammatory and
antioxidant properties that reach beyond those of
alpha-tocopherol, making it a potential agent for use in
NAFLD management. This systematic review aimed to provide an overview of the effects of T3 supplementation on
NAFLD from both clinical and preclinical perspectives. A literature search was performed in October 2022 using PubMed, Scopus and Web of Science. Original research articles reporting
NAFLD outcomes were included in this review. The search located 12 articles (8 animal studies and 4 human studies). The literature reports state that T3 isomers or natural mixtures (derived from palm or
annatto) improved
NAFLD outcomes (liver histology, ultrasound or liver profile). However, the improvement depended on the severity of
NAFLD, study period and type of intervention (isomers/mixture of different compositions). Mechanistically, T3 improved lipid metabolism and prevented
liver steatosis, and reduced mitochondrial and endoplasmic reticulum stress,
inflammation and ultimately
liver fibrosis. In summary, T3 could be a potential agent for use in managing
NAFLD, pending more comprehensive preclinical and human studies.