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Effects of vitamin E administration on serum lipid profile in diabetic patients: a grade-assessed systematic review and dose-response meta-analysis of RCTs.

  • 2025-07-18
  • Diabetology & metabolic syndrome 17(1)
    • Mehdi Karimi
    • Mohammad Amin Karimi
    • Farzad Fayedeh
    • Fatemeh Ziyafati Kafi
    • Kimia Kazemi
    • Sharareh Jahangiri
    • Omid Asbaghi

Study Design

Type
Review
Population
individuals with diabetes
Methods
meta-analysis of 28 RCTs; pooled effect sizes using weighted mean differences with 95% CIs, random-effects model

Background

Diabetes is often associated with dyslipidemia, increasing the risk of cardiovascular complications. Studies have shown that Vitamin E, as a potent antioxidant, may improve serum lipid profile by reducing oxidative stress and inflammation. However, findings on its effects on diabetic patients remain inconsistent. To address this gap, this meta-analysis aims to evaluate the impact of vitamin E on serum lipid parameters in individuals with diabetes.

Methods

A search was conducted on databases from inception to June 2025 to identify relevant randomized controlled trials (RCTs). Pooled effect sizes were estimated using weighted mean differences (WMDs) with 95% confidence intervals (CIs), applying a random-effects model. All statistical analyses were performed using STATA (V. 11.2).

Results

The pooled analysis of 28 RCTs found that overall vitamin E administration in diabetic patients significantly reduced total cholesterol (TC) (WMD: - 5.20 mg/dL, 95% CI: [- 7.60, - 2.80], p < 0.001) and low-density lipoprotein cholesterol (LDL-C) (WMD: - 4.21 mg/dL, 95% CI: [- 7.32, - 1.09], p = 0.008). While no significant change was observed in triglyceride (TG) (WMD: - 6.19 mg/dL, 95% CI: [- 13.13, 0.75], p = 0.081) and high-density lipoprotein cholesterol (HDL-C) serum levels (WMD: 0.57 mg/dL, 95%CI: [- 0.11, 1.24], p = 0.99). Subgroup analysis showed that vitamin E reduced TG with longer durations, lowered TC and LDL-C in participants with high baseline levels, higher doses, or longer interventions, and increased HDL-C only in studies lasting over 8 weeks. Linear regression analysis found no significant associations between vitamin E dose or duration and serum lipids. In contrast, non-linear dose-response analysis showed a significant inverse relationship between vitamin E dose and TC levels.

Conclusion

Vitamin E administration may improve lipid profiles in diabetic patients, with significant reductions in TC and LDL-C, while effects on TG and HDL-C were not statistically significant but showed potential clinical relevance. Subgroup analysis highlighted greater benefits with higher doses (> 400 IU/day) and longer intervention durations (> 8 weeks), particularly in individuals with elevated baseline lipid levels. Further large-scale studies are needed to confirm these findings and establish optimal dosing strategies for clinical application.

Research Insights

  • Vitamin E→Increased High-Density Lipoprotein Cholesterol

    no significant change was observed in ... high-density lipoprotein cholesterol (HDL-C) serum levels (WMD: 0.57 mg/dL, 95%CI: [-0.11, 1.24], p = 0.99)

    Effect
    Neutral
    Effect size
    Small
  • Vitamin E→Reduced LDL Cholesterol

    significantly reduced ... low-density lipoprotein cholesterol (LDL-C) (WMD: -4.21 mg/dL, 95% CI: [-7.32, -1.09], p = 0.008)

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin E→Reduced Total Cholesterol

    overall vitamin E administration in diabetic patients significantly reduced total cholesterol (TC) (WMD: -5.20 mg/dL, 95% CI: [-7.60, -2.80], p < 0.001)

    Effect
    Beneficial
    Effect size
    Small
  • Vitamin E→Reduced Triglyceride Levels

    no significant change was observed in triglyceride (TG) (WMD: -6.19 mg/dL, 95% CI: [-13.13, 0.75], p = 0.081)

    Effect
    Neutral
    Effect size
    Small
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