A systematic review and meta-analysis on the impact of oral vitamin E supplementation on apolipoproteins A1 and B100

Clin Nutr ESPEN. 2021 Dec:46:106-114. doi: 10.1016/j.clnesp.2021.09.013. Epub 2021 Sep 29.


Background and aim: Cardiovascular diseases (CVDs) are the number one cause of mortality worldwide. Apolipoprotein B (ApoB), apolipoprotein A1 (ApoA1), and ApoB/ApoA1 ratio are considered as predictors of CVD alongside with lipid profile. Evidence suggest that nutrients with antioxidant properties, especially vitamin E, are essential for a healthy cardiovascular system. The aim of present meta-analysis was to determine the effect alpha-tocopherol on ApoA1 and ApoB levels.

Methods: PubMed-Medline and SCOPUS databases and Google Scholar were searched up to July 2021. Random-effects model was employed to perform meta-analysis. In order to find heterogeneity sources, subgroup analysis was performed. Trim and fill analysis was performed in case of presence of publication bias. Quality assessment was performed using Cochrane Collaboration's tool.

Results: Seven eligible studies, involving 1284 individuals were included. Mean age of participants ranged between 25.4 and 59 years. There was no significant effect of vitamin E supplementation on Apo A1 (SMD = 0.22 IU/d; 95% CI: -0.38, 0.28; P = 0.481) and Apo B levels (SMD = -0.62 IU/d; 95% CI: -1.94, 0.70; P = 0.360).

Conclusion: No remarkable effect of vitamin E supplementation was observed on ApoA1 and ApoB levels in adults. Additional studies investigating the influence of vitamin E on apolipoproteins as primary outcome with larger sample size are suggested.

Keywords: Alpha-tocopherol; Apolipoproteins; Cardiovascular disease; Lipids; Meta-analysis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Antioxidants
  • Apolipoprotein A-I*
  • Apolipoproteins
  • Dietary Supplements
  • Humans
  • Middle Aged
  • Vitamin E*


  • Antioxidants
  • Apolipoprotein A-I
  • Apolipoproteins
  • Vitamin E