Vitamin D Effect on Ultrasonography and Laboratory Indices and Biochemical Indicators in the Blood: an Interventional Study on 12 to 18-Year-Old Children with Fatty Liver

Abstract

Purpose The rising prevalence of childhood obesity in the past decades has caused non-alcoholic fatty liver disease (NAFLD) to become the most common cause of pediatric chronic liver disease worldwide. This study was aimed at determining the effect of vitamin D (Vit D) on ultrasonography and laboratory indices of NAFLD and some blood biochemical indicators in children. Methods In this interventional study liver ultrasonography was performed in 200 children with overweight and obesity. A 108 had fatty liver among which 101 were randomly divided into two groups of study (n=51) and control (n=50). The study group was treated with Vit D, 50000 U once a week whereas the control group received placebo with the same dose and package, both for 12 weeks. At the end of the intervention lab tests and ultrasound study was performed once again to evaluate the response to treatment. Results It was found out that Vit D supplementation improved the fatty liver grade in the study group. The mean changes in hemoglobin (Hb), uric acid, highdensity lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, albumin and alanine aminotransferase (ALT) was significantly higher in the study group compared to controls ( p <0.05). After the intervention and means adjustment, a significant difference was obtained in HDL-C, insulin, LDL-C and homeostasis model assessment of insulin resistance (HOMA-IR) between the two groups. Conclusion Vit D supplementation in addition to improving the fatty liver grade in ultrasonography and increasing the blood Vit D level, increases the HDL and Hb level besides decreasing uric acid, LDL, HOMA-IR, insulin and ALT levels.

Metabolic dysfunction-associated fatty liver disease in obese youth with insulin resistance and type 2 diabetes

“…However, there was no significant effect on the hepatocyte ballooning or hepatic fibrosis. Similar results have been recently reported by Namakin et al [80] using vitamin D, 50 000 U once a week compared to placebo group. In addition, similar effects were documented in a previous study by della Corte et al [81] who have evaluated the effect of daily DHA (500 mg) plus vitamin D (800 IU) treatment, in obese children with biopsy-proven NAFLD and vitamin D deficiency.…”

Optimal vitamin D supplement dosage for improving insulin resistance in children and adolescents with overweight/obesity: a systematic review and network meta-analysis

“…We categorized dosage strategy into low (< 1000 IU/day, LDS), medium (1000–2000 IU/day, MDS), high (2000–4000 IU/day, HDS), and extremely high (> 4000 IU/day, EHDS). Based on the classification of dosage strategy, eight studies [ 34 , 35 , 37 , 38 , 40 , 44 , 45 , 47 ] compared EHDS with control, one study [ 46 ] compared LDS with EHDS, one study [ 43 ] compared LDS, EHDS and control, three studies [ 33 , 41 , 42 ] compared HDS, MDS and LDS, and two studies [ 36 , 39 ] compared MDS with control. Other baseline characteristics of all included studies are summarized in Table 1 .…”

“…4. Five studies [ 39 , 40 , 44 , 45 , 47 ] were judged as “some concerns” because detailed information about random sequence generation was unavailable. All studies were judged as “low risk” in domains 2 and 5.…”

Dietary and Nutritional Interventions in Nonalcoholic Fatty Liver Disease in Pediatrics

“…In an RCT in which 109 children with NAFLD confirmed by biopsy participated and were given 2000 IU/day of vitamin D or a placebo for six months, the treated group reduced hepatic steatosis, lobular inflammation, AST, and ALT levels and improved lipid profile and IR [66]. Another study, where children with fatty liver detected by liver ultrasound were randomly assigned to receive a vitamin D supplement (50,000 U/week), found an improvement in the degree of fatty liver by ultrasonography and an increase in blood vitamin D levels, in addition to a significant increase in HDL and a significant decrease in LDL, insulin, HOMA-IR, and ALT [67]. This latest study suggests that vitamin D could be used as an adjunctive treatment for NAFLD in children.…”