The effects of carnitine supplementation on clinical characteristics of patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials

•Carnitine supplementation could decrease aspartate aminotransferase, alanine aminotransferase, triglycerides levels and HOMA-IR in nonalcoholic fatty liver disease patients.•Carnitine supplementation could not significantly decrease gamma- glutamyl transferase, cholesterol, high-density lipoprotein-cholesterol , low-density lipoprotein-cholesterol levels, BMI and body weight in nonalcoholic fatty liver disease patients.•To confirm the effect of carnitine supplementation on nonalcoholic fatty liver disease patients, more well-established prospective studies need to be conducted in the future. The beneficial effects of carnitine supplementation on nonalcoholic fatty liver disease are unclear. We conducted a systematic review and meta-analysis to evaluate the effects of carnitine supplementation on liver function, lipid profile, body mass index, body weight, and homeostasis model assessment of insulin resistance in patients with nonalcoholic fatty liver disease. A comprehensive search of PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar databases were performed. Only randomized placebo-controlled human studies that examined the effects of carnitine supplementation on liver function, lipid profile, body mass index, body weight, and homeostasis model assessment of insulin resistance up to September 2019 were included. Fixed effects or random-effects models were applied to compute the pooled effect size. Heterogeneity assessments were performed using Cochran’s Q test and I-squared statistics. The quality of the studies was assessed using the Jaded scale. A total of 5 articles were selected, including 334 individuals (167 in control and 167 in intervention groups). The results demonstrated that carnitine supplementation significantly reduced homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: −0.91; 95 % CI: −1.11, −0.72; p