Association between Vitamin D Levels and Nonalcoholic Fatty Liver Disease: Potential Confounding Variables

Pacifico, Lucia; Osborn, John; Bonci, Enea; Pierimarchi, Pasquale; Chiesa, Claudio

doi:10.2174/1389557518666181025153712

Cited by 34 publications

(24 citation statements)

References 212 publications

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“…The recent systematic review of Pacifico and colleagues [23] included 45 studies exploring the association between vitamin D status and NAFLD/NASH. Of them, 29 studies reported an inverse association between vitamin D status and NAFLD, while 16 studies did not support this association.…”

Section: Discussionmentioning

confidence: 99%

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The association between vitamin D status and non-alcoholic fatty liver disease in adults: a hospital-based study

Gad

Elmedames

Abdelhai

et al. 2020

Egypt Liver Journal

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Background: The association between vitamin D levels and non-alcoholic fatty liver disease (NAFLD) has been increasingly determined in recent researches. The aim of this study was to determine the association between vitamin D levels, measured as serum 25-hydroxy vitamin D (25(OH)D) and NAFLD. Serum 25(OH)D was prospectively determined in 80 patients. Of them, 40 subjects had NAFLD, whereas 40 subjects served as healthy control. Vitamin D deficiency was defined as serum 25(OH)D level < 20 ng/ml. Receiver operating characteristic (ROC) and regression analysis methods were used in our analysis. Results: About 70% of patients with NAFLD had vitamin D deficiency, but only 35% in the control group had. The mean serum 25 (OH)D was significantly lower in patients with NAFLD than the healthy control group (16.13 ± 10.23 versus 27.35 ± 10.58 ng/mL; P < 0.001). ROC curve analysis revealed that serum 25(OH)D level of less than 11.2 ng/ml increases the risk of NAFLD with 45% sensitivity and 97.5% specificity (Serum 25(OH)D level ≤ 18.1 ng/ml in males and ≤ 9.4 ng/ml in females increase the risk of NAFLD). Multivariate regression analysis showed that vitamin D deficiency, high age, and high BMI were associated with a significant high risk of NAFLD. Conclusion: NAFLD patients have low serum vitamin D concentrations, suggesting that vitamin D may have a role in the development of NAFLD. Future studies are recommended to determine the important therapeutic implications of vitamin D for the prophylaxis or the treatment of NAFLD.

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Section: Discussionmentioning

confidence: 99%

“…Mean serum 25 (OH)D of 16.13 ± 10.23 ng/mL in the NAFLD group was significantly lower than in the normal control group (27.35 ± 10.58 ng/mL). The results of systematic review [23] showed that the median level of vitamin D in the control group is 27.7 ± 8.75 ng/mL, while the mean level in the NAFLD group is 25.7 ± 8.74.…”

Section: Discussionmentioning

confidence: 99%

The association between vitamin D status and non-alcoholic fatty liver disease in adults: a hospital-based study

Gad

Elmedames

Abdelhai

et al. 2020

Egypt Liver Journal

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“…A recently published systematic review including 45 cross-sectional studies, revealed that 29 studies (64.4%) reported an inverse relationship between vitamin D levels and NAFLD, whereas 16 studies (35.6%) were unable to demonstrate a correlation between these two (22). The optimal threshold for vitamin D in chronic liver disease has reported 10 to 32 ng/mL in (22), which is equal to 24 -80 nmol/L.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Serum Vitamin D Level and Nonalcoholic Fatty Liver Disease

et al. 2019

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Background: Nonalcoholic fatty liver disease (NAFLD) is a condition, in which triglyceride accumulates in hepatic cells without a history of alcohol consumption and is strongly associated with insulin resistance, obesity, diabetes mellitus, hypertension and dyslipidemia. The potential role of vitamin D in the pathogenesis of NAFLD has been reported. Objectives: The aim of this study was to determine the optimal vitamin D levels for prevention of NAFLD. Methods: In a cross-sectional study, 2,160 cases who referred to a university-affiliated health center were randomly selected and their demographic information, anthropometric and metabolic indices and also vitamin D levels were collected. Fatty liver was assessed by fatty liver index (FLI) and confirmed by FibroScan using controlled attenuation parameter (CAP). Based on the NAFLD score, the subjects were divided into two groups and the vitamin D cutoff point was calculated by ROC curve. Results: Based on the results, 745 patients (34.5%) had different degrees of fatty liver. Significant differences in the stiffness of liver tissue were observed between vitamin D categories (285.10 ± 30.56 for severe, 251.82 ± 42.63 for moderate and 201.02 ± 36.08for mild deficiency). According to the multivariate analysis, age, fasting insulin and vitamin D levels were found as the most significant factors in NAFLD pathogenesis. Vitamin D cutoff point was obtained 18 nmol/L in women and 21 nmol/L in men. Conclusions: The results indicated a significant association between vitamin D level and NAFLD score. Accordingly, increasing the public awareness to maintain a proper level of vitamin D may be a preventative strategy against NAFLD.

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“…A systematic review of Pacifico and colleagues 17 included 45 studies exploring the association between vitamin D status and NAFLD/NASH. Of them, 29 studies reported an inverse association between vitamin D status and NAFLD, while 16 studies did not support this association.…”

Section: Methodsmentioning

confidence: 99%

Relationship between Nonalcoholic Fatty Liver Disease and Vitamin D in Nepal

Sah

Shrestha

et al. 2021

Nep. Mediciti Med. J.

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Background and Aims: Vitamin D deficiency has been frequently reported in many causes of chronic liver disease and has been associated with the development and evolution of non-alcoholic fatty liver disease (NAFLD).The study was done to explore associations between serum vitamin D concentrations among obesity, diabetes mellitus, hypothyroidism, and metabolic syndrome and its effects on liver fibrosis by ultra-sonogram and 2 d shear wave elastography in patients with non-alcoholic fatty liver disease (NAFLD). Methods: A hospital based prospective observational study was conducted from May 2019 for twelve months period in Gastroenterology Unit, NAMS, Nepal. Seventy patients with known fatty liver identiﬁed by Ultrasonogram criteria were enrolled. All patients were evaluated by different ﬁbrosis scores (NAFLD Fibrosis, FIB4, APRI, AST/ALT ratio) and 2d shear wave score. Patients were evaluated for Vitamin D level and its effects on obesity, diabetes mellitus, thyroid related disease, dyslipidemias and NAFLD. Results: Among 70 patients, 39 (55.7%) were male and 31 (44.3%) were female with mean age of 44.3 years. Most of the patients were overweight with mean BMI of 28.2 kg/m2; among them 51 (72.9%) were more than 25.kg/m2. About 41.4% had diabetes mellitus, 77.1% had hypertension, 30% had hypothyroidism and 25.9% had metabolic syndrome. Majority of patients on ultrasound grading were mild with 64.28%; 25.72% were moderate and only 10 % were in severe groups. A study of 2 d shear wave elastography showed mean fibrosis of 7.07 kpa for mild grade, 8.22 kpa for moderate grade and 18.16 kpa for severe grade. The mean value of vitamin D was 22.61iu/ml for mild grade, 24.89 iu/ml for moderate grade and 17.4 iu/ml for severe grade. Conclusion: The results of this study showed high prevalence of serum 25(OH) vitamin D inadequacy in individuals with obesity, diabetes mellitus, hypothyroidism and metabolic syndrome which worsens as the stage of liver disease progresses.

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Association between Vitamin D Levels and Nonalcoholic Fatty Liver Disease: Potential Confounding Variables

Cited by 34 publications

References 212 publications

The association between vitamin D status and non-alcoholic fatty liver disease in adults: a hospital-based study

The association between vitamin D status and non-alcoholic fatty liver disease in adults: a hospital-based study

The Association Between Serum Vitamin D Level and Nonalcoholic Fatty Liver Disease

Relationship between Nonalcoholic Fatty Liver Disease and Vitamin D in Nepal

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