Hypovitaminosis D is associated with increased whole body fat mass and greater severity of non‐alcoholic fatty liver disease

Dasarathy, Jaividhya; Periyalwar, Pranav; Allampati, Sanath; Bhinder, Vikram; Hawkins, Carol; Brandt, Patricia; Khiyami, Amer; McCullough, Arthur J.; Dasarathy, Srinivasan

doi:10.1111/liv.12312

Cited by 102 publications

(106 citation statements)

References 59 publications

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“…25 No 2: 175-181 peroxisome proliferator-activated receptor gamma (PPAR-γ) [12,13]. Although not all [14,15], many observational studies report associations between vitamin D deficiency and hepatic steatosis [12,16], the aggregate effect of which has been illustrated in a meta-analysis [17] confirming the presence of decreased serum 25-hydroxyvitamin D concentrations in such patients. Specifically, they were 26% more likely than healthy controls to be vitamin D deficient.…”

Section: Introductionmentioning

confidence: 74%

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Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP)

Papapostoli

Lammert

Stokes

2016

JGLD

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Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries. A meta-analysis has confirmed decreased serum 25-hydroxyvitamin D levels in NAFLD patients. This intervention study investigates whether vitamin D correction ameliorates hepatic steatosis. Methods: We prospectively recruited 40 patients from an outpatient liver clinic with vitamin D deficiency (serum 25-hydroxyvitamin D < 20 ng/ml). Controlled attenuation parameter (CAP) during transient elastography quantified hepatic steatosis. Patients with significant liver fat accumulation were included, which was defined by a CAP value ≥ 280 dB/m. Patients received 20,000 IU vitamin D/week for six months, while vitamin D status, liver function tests (LFTs), CAP and body composition were monitored. Results: The cohort comprised 47.5% women (age 54.9 ± 12.1 years; BMI 29.5 ± 3.0 kg/m2). Mean serum vitamin D level was 11.8 ± 4.8 ng/ml. CAP decreased significantly from baseline (330 ± 32 vs. 307 ± 41 dB/m) during supplementation (P = 0.007). A mean CAP reduction relative to baseline was demonstrated at four weeks and three and six months: -5.3 ± 13.8%; -6.0 ± 14.6% and -6.4 ± 13.0%, respectively. During these time points, restoration of serum vitamin D levels was observed (34.6 ± 12.9, 36.3 ± 10.2, 34.8 ± 9.8 ng/ml; P < 0.0001). Liver function tests and body composition remained unchanged. Conclusions: Hepatic steatosis, as assessed by CAP, significantly improves after only 4 weeks of vitamin D correction. Hepatic steatosis is a dynamic process, that can be monitored in the short-term using such non-invasive methods. Abbreviations: ALT: alanine aminotransferase; ANOVA: analysis of variance; AP: alkaline phosphatase; AST: aspartate aminotransferase; CAP: controlled attenuation parameter; CRP: C-reactive protein; FFA: free fatty acids; γ-GT: gamma-glutamyl transpeptidase; ITT: intention-to-treat; LFT: liver function test; LSM: liver stiffness measurement; NAFLD: non-alcoholic fatty liver disease; PPAR-γ: peroxisome proliferator-activated receptor gamma; PP: per protocol; PTH: parathyroid hormone; VDR: vitamin D receptor

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Section: Introductionmentioning

confidence: 74%

“…Some studies have also inversely correlated serum 25-hydroxyvitamin D concentrations with elevated body fat, which is often seen in patients with comorbid hepatic steatosis [16,20]. Indeed adipose tissue has been reported to sequester vitamin D and reduce its bioavailbility, thus exacerbating suboptimum vitamin D status [21].…”

Section: Introductionmentioning

confidence: 99%

Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP)

Papapostoli

Lammert

Stokes

2016

JGLD

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“…Indeed, when the studies are grouped for general comparison according to NAFLD diagnosis method or study population, some consistency is found. For example, the two studies using biopsy-based NAFLD diagnosis (from Italy and the USA) found a significantly lower serum vitamin D level in NAFLD patients and demonstrated a close association of vitamin D levels with both fibrosis and hepatocyte ballooning [8,18] . Furthermore, in two studies using B-mode ultrasound NAFLD diagnosis (again from Italy and the USA), serum vitamin D was also found to be an independent predictor of NAFLD [19,20] .…”

Section: Discussionmentioning

confidence: 99%

Serum vitamin D is associated with non-alcoholic fatty liver disease in Chinese males with normal weight and liver enzymes

Hao

Luo

et al. 2014

Acta Pharmacol Sin

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Aim: Considering the characterization of vitamin D deficiency as a risk factor of ectopic fat deposition, the association of serum 25-hydroxy vitamin D 3 [25(OH)D 3 ] levels with non-alcoholic fatty liver disease (NAFLD) was evaluated in Chinese men with normal body mass index (BMI) and enzyme markers of liver function. Methods: A total of 514 participants (22 to 79 years old) with normal BMI and liver enzymes were identified for analysis. Abdominal ultrasound was performed to diagnose NAFLD, and the fatty liver index (FLI) was calculated to quantify liver steatosis. Serum 25(OH)D 3 levels were determined by an electrochemiluminescence immunoassay. Results: Among the entire study population, the mean levels of serum 25(OH)D 3 were 15.32±5.77 ng/mL. However, when serum 25(OH)D 3 levels were compared between non-NAFLD subjects (n=438) and NAFLD subjects (n=76), the latter showed significantly lower levels (15.65±5.89 ng/mL vs 13.46±4.65 ng/mL, P=0.002). In addition, serum 25(OH)D 3 levels were found to be significantly correlated with FLI after adjustment for age and BMI (r=-0.108, P=0.014). Logistic regression showed that serum 25(OH)D 3 levels were independently correlated with NAFLD (OR: 0.937, 95% CI: 0.884-0.993, P=0.028). Furthermore, stepwise regression analysis revealed that serum 25(OH)D 3 levels were inversely associated with FLI (β=-0.055, P=0.040). Conclusion:The present study demonstrated that serum 25(OH)D 3 levels were inversely associated with NAFLD, even in subjects with normal total body fat, suggesting a potential role of lower levels of vitamin D in the occurrence and development of NAFLD.

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“…One of the most discussed mechanisms is explained by low bioavailability of vitamin D when high content of body fat acts as a reservoir for lipid soluble vitamin D and increases its sequestration (Wortsman et al, 2000). Furthermore, the synthesis of 25-OH D may be decreased in obese subjects because of hepatic steatosis (Targher et al, 2007;Dasarathy et al, 2014). In addition, low sun exposure and limited cutaneous vitamin D synthesis in obese patients may also play a role (Florez et al, 2007).…”

Section: Hypovitaminosis D and Body Composition Indicesmentioning

confidence: 99%

High Prevalence of Hypovitaminosis D in Postmenopausal Women with Type 2 Diabetes Mellitus

et al. 2016

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Abstract:The link between vitamin D and type 2 diabetes mellitus (T2DM) is intensively studied. This study aims to define the serum concentration of 25-hydroxyvitamin D (25-OH D) and to investigate the relationship between 25-OH D status, glycated hemoglobin (HbA1c) and body composition in postmenopausal women with T2DM and in non-diabetic controls. In this crosssectional study, 75 women with T2DM and 32 control subjects were selected. Serum 25-OH D, intact parathyroid hormone (PTH), calcium, fasting glucose and HbA1c, were measured. The mean 25-OH D level was 21.4 ± 11.4 ng/ml (range 4.1-50.7 ng/ml) in diabetic women and 30.3 ± 9.4 ng/ml (range 10.8-54.2 ng/ml) in control group (p<0.001). The prevalence of hypovitaminosis D (< 30 ng/ml) was higher in vitamin D 3 non-supplemented T2DM women (89% vs. 63% controls); the difference diminished in vitamin D 3 (500-1000 IU per day) supplemented subgroups (45% diabetics vs. 42% controls). In T2DM women, 25-OH D levels were not associated to HbA1c, duration of diabetes, fasting glucose and PTH levels, however, 25-OH D levels negatively associated with body mass index (p=0.011), total body fat mass (p=0.005) and total body lean mass (p=0.004). 6)Prague Medical Report / Vol. 117 (2016) No. 1, p. 5-17 of hypovitaminosis D is higher in non-supplemented postmenopausal women with T2DM than in non-diabetic controls (89% vs. 63%). Obesity is a risk factor for vitamin D insufficiency in T2DM postmenopausal women. Further studies evaluating relationships between fat, muscle, bone and vitamin D metabolism in T2DM patients are warranted.

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Hypovitaminosis D is associated with increased whole body fat mass and greater severity of non‐alcoholic fatty liver disease

Cited by 102 publications

References 59 publications

Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP)

Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP)

Serum vitamin D is associated with non-alcoholic fatty liver disease in Chinese males with normal weight and liver enzymes

High Prevalence of Hypovitaminosis D in Postmenopausal Women with Type 2 Diabetes Mellitus

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