{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:01:49Z","timestamp":1791849709315,"version":"4.3.4"},"reference-count":38,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"name":"Higher Education Commission, Government of Pakistan Islamabad"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Complementary Therapies in Medicine"],"published-print":{"date-parts":[[2020,8]]},"DOI":"10.1016\/j.ctim.2020.102494","type":"journal-article","created":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T12:24:40Z","timestamp":1592915080000},"page":"102494","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":39,"special_numbering":"C","title":["Delta-tocotrienol supplementation improves biochemical markers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease: A randomized, placebo-controlled trial"],"prefix":"10.1016","volume":"52","author":[{"given":"Muhammad Amjad","family":"Pervez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilshad Ahmed","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atiq Ur Rehman","family":"Slehria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aamir","family":"Ijaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ctim.2020.102494_bib0005","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1053\/j.gastro.2012.04.001","article-title":"The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology","volume":"142","author":"Chalasani","year":"2012","journal-title":"Gastroenterology"},{"key":"10.1016\/j.ctim.2020.102494_bib0010","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1007\/s40273-015-0316-5","article-title":"Economic and quality-of-life implications of non-alcoholic fatty liver disease","volume":"33","author":"Younossi","year":"2015","journal-title":"Pharmacoeconomics"},{"key":"10.1016\/j.ctim.2020.102494_bib0015","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence and outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"key":"10.1016\/j.ctim.2020.102494_bib0020","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.metabol.2015.12.012","article-title":"The multiple-hit pathogenesis of nonalcoholic fatty liver disease (NAFLD)","volume":"65","author":"Buzzetti","year":"2016","journal-title":"Metabolism"},{"key":"10.1016\/j.ctim.2020.102494_bib0025","doi-asserted-by":"crossref","first-page":"3966","DOI":"10.3390\/ijms19123966","article-title":"miRNA signature in NAFLD: A turning point for a non-invasive diagnosis","volume":"19","author":"Dongiovanni","year":"2018","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.ctim.2020.102494_bib0030","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.3748\/wjg.v25.i11.1307","article-title":"Non-invasive evaluation of nonalcoholic fatty liver disease: Current evidence and practice","volume":"25","author":"Zhou","year":"2019","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.ctim.2020.102494_bib0035","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/978-3-319-41334-1_5","article-title":"Tocotrienol and its role in chronic diseases","volume":"928","author":"Chin","year":"2016","journal-title":"Adv Exp Med Biol"},{"key":"10.1016\/j.ctim.2020.102494_bib0040","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s12263-011-0227-9","article-title":"Multifaceted role of tocotrienols in cardioprotection supports their structure: Function relation","volume":"7","author":"Vasanthi","year":"2012","journal-title":"Genes Nutr"},{"key":"10.1016\/j.ctim.2020.102494_bib0045","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11010-005-9020-7","article-title":"Comparative antioxidant activity of tocotrienols and the novel chromanyl-polyisoprenyl molecule feaox-6 in isolated membranes and intact cells","volume":"287","author":"Palozza","year":"2006","journal-title":"Mol Cell Biochem"},{"key":"10.1016\/j.ctim.2020.102494_bib0050","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s00394-015-1064-1","article-title":"Anti-inflammatory gamma- and delta tocotrienols improve cardiovascular, liver and metabolic function in diet-induced obese rats","volume":"56","author":"Wong","year":"2017","journal-title":"Eur J Nutr"},{"key":"10.1016\/j.ctim.2020.102494_bib0055","doi-asserted-by":"crossref","first-page":"11377","DOI":"10.1038\/s41598-018-29063-9","article-title":"Annatto-extracted tocotrienols improve glucose homeostasis and bone properties in high-fat diet-induced type 2 diabetic mice by decreasing the inflammatory response","volume":"8","author":"Shen","year":"2018","journal-title":"Sci Rep"},{"key":"10.1016\/j.ctim.2020.102494_bib0060","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jnutbio.2017.07.003","article-title":"Effects of delta-tocotrienol on obesity-related adipocyte hypertrophy, inflammation and hepatic steatosis in high-fat-fed mice","volume":"48","author":"Allen","year":"2017","journal-title":"J Nutr Biochem"},{"key":"10.1016\/j.ctim.2020.102494_bib0065","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.5551\/jat.4911","article-title":"Gamma delta tocotrienols reduce hepatic triglyceride synthesis and VLDL secretion","volume":"17","author":"Zaiden","year":"2010","journal-title":"J Atheroscler Thromb"},{"key":"10.1016\/j.ctim.2020.102494_bib0070","doi-asserted-by":"crossref","DOI":"10.1155\/2012\/960742","article-title":"Effects of tocotrienol and lovastatin combination on osteoblast and osteoclast activity in estrogen-deficient osteoporosis","volume":"2012","author":"Abdul-Majeed","year":"2012","journal-title":"Evid Based Complement Alternat Med"},{"key":"10.1016\/j.ctim.2020.102494_bib0075","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1096\/fj.07-9574LSF","article-title":"Dose translation from animal to human studies revisited","volume":"22","author":"Reagan-Shaw","year":"2008","journal-title":"FASEB J"},{"key":"10.1016\/j.ctim.2020.102494_bib0080","doi-asserted-by":"crossref","first-page":"434","DOI":"10.4172\/2155-9880.1000434","article-title":"Evaluation of pharmacokinetics, and bioavailability of higher doses of tocotrienols in healthy fed humans","volume":"7","author":"Qureshi","year":"2016","journal-title":"J Clin Exp Cardiolog"},{"key":"10.1016\/j.ctim.2020.102494_bib0085","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s00280-016-3048-0","article-title":"Pharmacokinetics and safety of vitamin E \u03b4-tocotrienol after single and multiple doses in healthy subjects with measurement of vitamin E metabolites","volume":"78","author":"Mahipal","year":"2016","journal-title":"Cancer Chemother Pharmacol"},{"key":"10.1016\/j.ctim.2020.102494_bib0090","doi-asserted-by":"crossref","first-page":"57","DOI":"10.3748\/wjg.v19.i1.57","article-title":"Comparison of fatty liver index with non-invasive methods for steatosis detection and quantification","volume":"19","author":"Zelber-Sagi","year":"2013","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.ctim.2020.102494_bib0095","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1177\/1756283X16638830","article-title":"Lifestyle changes for the treatment of nonalcoholic fatty liver disease: A review of observational studies and intervention trials","volume":"9","author":"Zelber-Sagi","year":"2016","journal-title":"Ther Adv Gastroenterol"},{"key":"10.1016\/j.ctim.2020.102494_bib0100","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1038\/nprot.2008.73","article-title":"Analyzing real-time PCR data by the comparative CT method","volume":"3","author":"Schmittgen","year":"2008","journal-title":"Nat Protoc"},{"key":"10.1016\/j.ctim.2020.102494_bib0105","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1136\/bmj.292.6512.13","article-title":"Ultrasound scanning in the detection of hepatic fibrosis and steatosis","volume":"292","author":"Saverymuttu","year":"1986","journal-title":"Br Med J"},{"key":"10.1016\/j.ctim.2020.102494_bib0110","unstructured":"The Medical Algorithms (n.d.). Fatty Liver Index (FLI) of Bedogni et al. for Predicting Hepatic Steatosis [Software]. Available at: http:\/\/www.medicalalgorithms.com\/fatty-liver-index-fli-of-bedogni-et-al-for-predicting-hepatic-steatosis. Accessed March 15, 2019."},{"key":"10.1016\/j.ctim.2020.102494_bib0115","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/1745-6215-15-264","article-title":"Sample size requirements to estimate key design parameters from external pilot randomised controlled trials: A simulation study","volume":"15","author":"Teare","year":"2014","journal-title":"Trials"},{"key":"10.1016\/j.ctim.2020.102494_bib0120","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1177\/0962280215588241","article-title":"Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable","volume":"25","author":"Whitehead","year":"2016","journal-title":"Stat Methods Med Res"},{"key":"10.1016\/j.ctim.2020.102494_bib0125","doi-asserted-by":"crossref","first-page":"170","DOI":"10.5152\/tjg.2018.17297","article-title":"Effects of delta-tocotrienol supplementation on liver enzymes, inflammation, oxidative stress and hepatic steatosis in patients with nonalcoholic fatty liver disease","volume":"29","author":"Pervez","year":"2018","journal-title":"Turk J Gastroenterol"},{"key":"10.1016\/j.ctim.2020.102494_bib0130","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1038\/ijo.2014.124","article-title":"Gamma-tocotrienol attenuates high fat diet-induced obesity and insulin resistance by inhibiting adipose inflammation and M1 macrophage recruitment","volume":"39","author":"Zhao","year":"2015","journal-title":"Int J Obes"},{"key":"10.1016\/j.ctim.2020.102494_bib0135","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.3390\/nu4101527","article-title":"Tocotrienols reverse cardiovascular, metabolic and liver changes in high carbohydrate, high fat diet-fed rats","volume":"4","author":"Wong","year":"2012","journal-title":"Nutrients"},{"key":"10.1016\/j.ctim.2020.102494_bib0140","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s11745-012-3659-0","article-title":"Tocotrienol attenuates triglyceride accumulation in hepg2 cells and f344 rats","volume":"47","author":"Burdeos","year":"2012","journal-title":"Lipids"},{"key":"10.1016\/j.ctim.2020.102494_bib0145","doi-asserted-by":"crossref","first-page":"923","DOI":"10.3390\/molecules24050923","article-title":"The role of tocotrienol in protecting against metabolic diseases","volume":"24","author":"Pang","year":"2019","journal-title":"Molecules"},{"key":"10.1016\/j.ctim.2020.102494_bib0150","doi-asserted-by":"crossref","first-page":"344","DOI":"10.3390\/molecules21030344","article-title":"Regulation of obesity and metabolic complications by Gamma and Delta tocotrienols","volume":"21","author":"Zhao","year":"2016","journal-title":"Molecules"},{"key":"10.1016\/j.ctim.2020.102494_bib0155","first-page":"259","article-title":"The adipokines in the pathogenesis and treatment of nonalcoholic fatty liver disease","volume":"20","author":"Boutari","year":"2016","journal-title":"Hippokratia"},{"key":"10.1016\/j.ctim.2020.102494_bib0160","doi-asserted-by":"crossref","first-page":"905","DOI":"10.3892\/mmr.2012.770","article-title":"\u03b3-Tocotrienol attenuates TNF-\u03b1-induced changes in secretion and gene expression of MCP-1, IL-6 and adiponectin in 3T3-L1 adipocytes","volume":"5","author":"Matsunaga","year":"2012","journal-title":"Mol Med Rep"},{"key":"10.1016\/j.ctim.2020.102494_bib0165","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/1475-2891-12-166","article-title":"Tocotrienols for normalization of hepatic echogenic response in nonalcoholic fatty liver: A randomised placebo-controlled clinical trial","volume":"12","author":"Magosso","year":"2013","journal-title":"Nutr J"},{"key":"10.1016\/j.ctim.2020.102494_bib0170","doi-asserted-by":"crossref","first-page":"706","DOI":"10.3109\/09637486.2013.775228","article-title":"Does grape seed oil improve inflammation and insulin resistance in overweight or obese women?","volume":"64","author":"Irandoost","year":"2013","journal-title":"Int J Food Sci Nutr"},{"key":"10.1016\/j.ctim.2020.102494_bib0175","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1002\/mnfr.200900119","article-title":"Vitamin E tocotrienols improve insulin sensitivity through activating peroxisome proliferator-activated receptors","volume":"54","author":"Fang","year":"2010","journal-title":"Mol Nutr Food Res"},{"key":"10.1016\/j.ctim.2020.102494_bib0180","first-page":"231","article-title":"Potential of mixed tocotrienol supplementation to reduce cholesterol and cytokines level in adults with metabolic syndrome","volume":"22","author":"Heng","year":"2015","journal-title":"Mal J Nutr"},{"key":"10.1016\/j.ctim.2020.102494_bib0185","first-page":"617","article-title":"The effects of tocotrienols added to canola oil on microalbuminuria, inflammation, and nitrosative stress in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled trial","volume":"5","author":"Haghighat","year":"2014","journal-title":"Int J Prev Med"},{"key":"10.1016\/j.ctim.2020.102494_bib0190","doi-asserted-by":"crossref","first-page":"540","DOI":"10.4103\/1735-1995.165945","article-title":"Effect of Tocotrienols enriched canola oil on glycemic control and oxidative status in patients with type 2 diabetes mellitus: A randomized double-blind placebo-controlled clinical trial","volume":"20","author":"Vafa","year":"2015","journal-title":"J Res Med Sci"}],"container-title":["Complementary Therapies in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0965229920300777?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0965229920300777?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T17:16:08Z","timestamp":1760807768000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0965229920300777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":38,"alternative-id":["S0965229920300777"],"URL":"https:\/\/doi.org\/10.1016\/j.ctim.2020.102494","relation":{},"ISSN":["0965-2299"],"issn-type":[{"value":"0965-2299","type":"print"}],"subject":[],"published":{"date-parts":[[2020,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Delta-tocotrienol supplementation improves biochemical markers of hepatocellular injury and steatosis in patients with nonalcoholic fatty liver disease: A randomized, placebo-controlled trial","name":"articletitle","label":"Article Title"},{"value":"Complementary Therapies in Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ctim.2020.102494","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"102494"}}