Hypovitaminosis D is associated with increased whole body fat mass and greater severity of non‐alcoholic fatty liver disease. (1st October 2013)

• Record Type: Journal Article
• Authors: Dasarathy, Jaividhya; Periyalwar, Pranav; Allampati, Sanath; Bhinder, Vikram; Hawkins, Carol; Brandt, Patricia; Khiyami, Amer; McCullough, Arthur J.; Dasarathy, Srinivasan
• Is Part Of: Liver international. Volume 34:Number 6(2014:Aug.)
• Page Start: e118
• Page End: e127
• Publication Date: 2013-10-01
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.12312
• Languages: English
• ISSNs: 1478-3223

Abstract

<abstract abstract-type="main" id="liv12312-abs-0001"> <title>Abstract</title> <sec id="liv12312-sec-0001" sec-type="section"> <title>Background & Aims</title> <p>Hypovitaminosis D is common in obesity and insulin‐resistant states. Increased fat mass in patients with non‐alcoholic fatty liver disease (NAFLD) may contribute to hypovitaminosis D. To determine the relation among plasma vitamin D concentration, severity of disease and body composition in NAFLD.</p> </sec> <sec id="liv12312-sec-0002" sec-type="section"> <title>Methods</title> <p>Plasma vitamin D concentration was quantified in 148 consecutive biopsy‐proven patients with NAFLD (non‐alcoholic steatohepatitis – NASH:<italic> n</italic> = 81; and hepatic steatosis: <italic>n</italic> = 67) and healthy controls (<italic>n</italic> = 39). NAFLD was scored using the NASH CRN criteria. Body composition was quantified by bioelectrical impedance analysis and abdominal CT image analysis.</p> </sec> <sec id="liv12312-sec-0003" sec-type="section"> <title>Results</title> <p>Plasma vitamin D concentration was significantly lower in NAFLD (21.2 ± 10.4 ng/ml) compared with healthy controls (35.7 ± 6.0 ng/ml). Higher NAFLD activity scores were associated with lower plasma concentration of vitamin D (<italic>r</italic><sup>2</sup> = 0.29; <italic>P</italic> < 0.001). Subgroup analysis among patients with NAFLD showed that patients with NASH had significantly lower (<italic>P</italic> < 0.01) vitamin D levels than those with steatosis alone (18.1 ± 8.4 vs. 25.0 ± 11.3 ng/ml). Low concentrations of vitamin D were associated with greater severity of steatosis, hepatocyte ballooning and fibrosis (<italic>P</italic> < 0.05).On multivariate regression analysis, only severity of hepatocyte ballooning was independently associated (<italic>P</italic> = 0.02) with low vitamin D concentrations. Plasma vitamin D (<italic>P</italic> = 0.004) and insulin concentrations (<italic>P</italic> = 0.03) were independent predictors of the NAFLD activity score on biopsy. Patients with NAFLD had higher fat mass that correlated with low vitamin D (<italic>r</italic><sup>2</sup> = 0.26; <italic>P</italic> = 0.008).</p> </sec> <sec id="liv12312-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Low plasma vitamin D concentration is an independent predictor of the severity of NAFLD. Further prospective studies demonstrating the impact of vitamin D replacement in NAFLD patients are required.</p> </sec> </abstract>