Severe Vitamin D Deficiency Is Not Associated with Liver Damage in Morbidly Obese Patients

Anty, Rodolphe; Hastier, Audrey; Canivet, Clémence M.; Patouraux, Stéphanie; Schneck, Anne-Sophie; Ferrari, P.; Ben-Amor, Imed; Saint-Paul, M; Gugenheim, Jean; Gual, Philippe; Iannelli, Antonio; Tran, Albert

doi:10.1007/s11695-016-2070-y

Cited by 25 publications

(16 citation statements)

References 33 publications

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“…In addition, when we search through the previous studies, the data are rather limited for generalizability because most of the studies involved small number of patients [ 5 , 13 ] or a specific population that already has risk factors for NAFLD, e.g., diabetes or obesity [ 13 ]. Therefore, we attempted to elucidate the association between vitamin D insufficiency and NAFLD in a large number of nationally representative samples.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, regarding nonalcoholic fatty liver disease (NAFLD) among chronic liver diseases, previous studies have largely reported that vitamin D insufficiency was associated with the presence [ 6 , 7 , 8 , 9 ] or severity [ 10 , 11 ] of NAFLD. However, some other studies reported quite contradictory results [ 12 , 13 ], and one experimental study even argued that vitamin D insufficiency alleviated accumulation of liver fat [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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The Association between Vitamin D Insufficiency and Nonalcoholic Fatty Liver Disease: A Population-Based Study

Hwang

Rim

2017

Nutrients

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Previous studies have shown inconsistent results regarding the association between vitamin D insufficiency and nonalcoholic fatty liver disease (NAFLD). We attempted to demonstrate this relationship using population-based data. Vitamin D insufficiency was defined as a 25(OH)D level ≤20 ng/mL. Hepatic steatosis index was calculated to define NAFLD. Significant fibrosis was assessed using Body mass index, AST/ALT Ratio, Diabetes (BARD) score. Logistic regression analyses were performed to determine the relationship between vitamin D insufficiency and NAFLD. Among 1812 participants, 409 (22.6%) had NAFLD. Patients with nonalcoholic fatty liver disease were more likely to be male (56.7%), had higher body mass index (28.1 kg/m2), and had more metabolic syndrome (57.2%). The proportion of vitamin D insufficiency did not differ between NAFLD and non-NAFLD (77.5% vs. 77.4%). Logistic regression analyses showed that BMI, diabetes, and triglyceride level were significantly associated with NAFLD, whereas vitamin D insufficiency was not related. Subgroup analyses involving non-obese participants, male participants, and participants without metabolic syndrome showed similar results. The BARD score and the proportion of significant fibrosis by BARD score did not differ according to vitamin D status. Vitamin D insufficiency was not associated with the presence of NAFLD as assessed by validated noninvasive prediction models.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Association between Vitamin D Insufficiency and Nonalcoholic Fatty Liver Disease: A Population-Based Study

Hwang

Rim

2017

Nutrients

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“…12,[69][70][71] Although low vitamin D levels are significantly associated with NAFLD severity in both Asian and Western studies, the therapeutic role of vitamin D supplementation is unclear. 72 Likewise, the effect of hypothyroidism on NAFLD is unclear. 73,74 Non-obese NAFLD While NAFLD is strongly associated with obesity and metabolic syndrome, a proportion of NAFLD patients have relatively normal BMI.…”

Section: Othersmentioning

confidence: 99%

New trends on obesity and NAFLD in Asia

Fan

Kim

Wong

2017

Journal of Hepatology

905

749

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Traditionally, obesity and its related diseases have been considered a problem in Western countries. However, in the past two decades, urbanisation in many Asian countries has led to a sedentary lifestyle and overnutrition, setting the stage for the epidemic of obesity. This article reviews the epidemiological trend of obesity in Asia, with special emphasis on the emerging condition of non-alcoholic fatty liver disease (NAFLD). Currently, the population prevalence of NAFLD in Asia is around 25%, like many Western countries. While hepatocellular carcinoma and end-stage liver disease secondary to NAFLD remain uncommon, a rising trend has emerged. Around 8-19% of Asians with body mass indexes less than 25kg/m are also found to have NAFLD, a condition often described as "lean" or "non-obese" NAFLD. Although this condition is generally less severe than that in more obese patients, steatohepatitis and fibrotic disease are well recognized. Central adiposity, insulin resistance and weight gain are major risk factors, and genetic predisposition, such as the PNPLA3 polymorphism appears to be more important in the development of NAFLD in the non-obese population. Lifestyle modification remains the cornerstone of management for obesity and NAFLD, but few patients can achieve adequate weight reduction and even fewer can maintain the weight in the long run. While pharmacological agents have entered phase III development for steatohepatitis, Asian patients are under-represented in most drug trials. Future studies should define the optimal management of obesity and NAFLD in Asia.

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“…We also conducted a meta-regression to determine whether there was an association between serum vitamin D levels and METAVIR stage of liver fibrosis (F0-F4) in NAFLD. As shown in Table 4 , there are conflicting reports with three studies demonstrating significance ( P < 0.05)[ 26 , 27 , 32 ] and three finding no association ( P > 0.05)[ 28 - 30 ]. Our meta-regression did not find an association between vitamin D level and fibrosis stage across the studies.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D levels do not predict the stage of hepatic fibrosis in patients with non-alcoholic fatty liver disease: A PRISMA compliant systematic review and meta-analysis of pooled data

Saberi

Dadabhai

Nanavati

et al. 2018

WJH

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AIMTo investigate the relationship between 25-hydroxyvitamin D [25(OH)D] levels and fibrosis stage in patients with non-alcoholic fatty liver disease (NAFLD).METHODSTwo individual reviewers identified relevant studies using the PubMed, EMBASE, Cochrane, and Scopus databases. Inclusion criteria were as follows: (1) Studies that evaluated adults with NAFLD and serum or plasma 25(OH)D levels; and (2) assessed fibrosis stage using liver biopsy. A rigorous analysis yielded six articles as having sufficient data to employ in evaluating the association of serum vitamin D levels in patients with NAFLD based on their liver fibrosis stage by histopathological analysis. The lead investigators of each of the six studies were contacted and the data were collected. To meta-analyze vitamin D levels in F0-F2 vs F3-F4 fibrosis, a random-effects meta-analysis fit using restricted maximum likelihood was applied. To examine trends across each stage of fibrosis with respect to vitamin D levels, a meta-regression was performed. P < 0.05 was considered statistically significant.RESULTSA total of 937 subjects from six studies were included in the final analysis to evaluate the association of serum vitamin D levels in patients with NAFLD based on their liver fibrosis stage by histopathological analysis. The lead investigators of each of the six studies were contacted and the data were collected. First, the investigators performed a meta-analysis to compare serum vitamin D levels in patients with NAFLD with stage F0-F2 compared to F3-F4, which did not show significance [meta-estimate of the pooled mean difference = -0.86, P = 0.08 (-4.17, 2.46)]. A meta-regression evaluation of serum vitamin 25 (OH)D levels across the individual stages (F0-F4) of fibrosis did not show an association for the six included studies.CONCLUSIONLow vitamin D status is not associated with higher stages of liver fibrosis in patients with NAFLD.

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Severe Vitamin D Deficiency Is Not Associated with Liver Damage in Morbidly Obese Patients

Abstract: Low levels of 25-OH vitamin D were not independently associated with liver damage in morbidly obese patients with non-alcoholic fatty liver diseases (NAFLD).

Cited by 25 publications

References 33 publications

The Association between Vitamin D Insufficiency and Nonalcoholic Fatty Liver Disease: A Population-Based Study

The Association between Vitamin D Insufficiency and Nonalcoholic Fatty Liver Disease: A Population-Based Study

New trends on obesity and NAFLD in Asia

Vitamin D levels do not predict the stage of hepatic fibrosis in patients with non-alcoholic fatty liver disease: A PRISMA compliant systematic review and meta-analysis of pooled data

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