Vitamin D and nonalcoholic fatty liver disease in children: a randomized controlled clinical trial
Eur J Pediatr. 2021 Aug 30. doi: 10.1007/s00431-021-04243-4 Publisher wants $40 for the PDF
Doaa El Amrousy 1 2, Dina Abdelhai 3 4, Dina Shawky 5 4
Overview Liver and vitamin D contains the following summary
- Fact: A properly functioning liver is needed for the efficient activation of vitamin D in the body
- Fact: Liver diseases often result in lower levels of vitamin D
- Fact: Various pain relievers damage the liver function
- Fact: Lower levels of vitamin D result in osteoporosis and many other diseases
- Options with a poorly functioning liver appear to be:
- Increased vitamin D (example: 2X more vitamin D if Liver is 1/2 as efficient)
- Increase the response you get from vitamin D
- Increase sunshine / UVB,
- Get the response you get from the sun/UVB
- Consider supplementing with Iron - a patented Iron supplement appears to work very well
- Get prescription for active form of vitamin D (Calcitriol) which does not need the liver or kidney to get the benefits of vitamin D in the body
- Get Calcidiol which does not need the liver
- Use Topical Vitamin D - activation by the skin etc does not require the liver
Click on image for ways of getting vitamin D even if Liver is not functioning well
Items in both categories Liver and Infant-Child:
- Hepatitis normally rare in children: huge increase after lockdown (Adenovirus, low Vitamin D) - April 2022
- NAFLD somewhat treated in children with 2,000 IU Vitamin D daily – RCT Aug 2021
- Liver transplants in children more likely to be rejected if insufficient vitamin D – Aug 2021
- Very low Vitamin D levels after Liver transplant in children (need Calcitriol or topical) – May 2021
- NAFLD associated with low vitamin D (in children too) – meta-analysis Aug 2019
- Severe Non-Alcoholic fatty liver disease treated by Omega-3 – RCT April 2018
- NAFLD in children nicely treated by combination of Vitamin D and Omega-3 – RCT Dec 2016
- Infants who have iron deficiency anemia are 4X more likely to be vitamin D deficient – March 2013
2,000 IU may be a large enough dose for children
Previous studies indicate that better results might result
if a different form were used, along with Omega-3 to reduce inflammation
What is Known:
- Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease in pediatrics.
- Several studies reported a negative association between low serum vitamin D level and grades of NAFLD.
What is New:
- Vitamin D supplementation has significantly decreased hepatic steatosis and lobular inflammation and improved the grades of NAFLD in children, confirmed by liver biopsy, but no effect on hepatocyte ballooning or fibrosis was observed.
- Adjuvant vitamin D supplementation is recommended in children with NAFLD.
Vitamin D is reported to have anti-inflammatory and insulin-sensitizing effects, yet vitamin D effects on hepatic fat content in children with nonalcoholic fatty liver disease (NAFLD) are not studied sufficiently. We aimed to evaluate the role of vitamin D supplementation on the hepatic fat content and NAFLD progression in children. This randomized controlled clinical trial was performed on 109 children with biopsy-proven NAFLD; only 100 patients completed the study.
Patients were randomly assigned into two groups: the treatment group who received 2000 IU/day vitamin D for 6 months and the control group who received a placebo. Anthropometric measurements, vitamin D levels, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), serum triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), fasting blood glucose (FBG), fasting blood insulin level (FBI), homeostasis model assessment of insulin resistance (HOMA-IR), and serum calcium level were measured at the beginning and the end of the study.
Liver biopsy was taken before and at the end of the study for all included children. There was a significant improvement of the hepatic steatosis and lobular inflammation by liver biopsy in the treatment group after treatment. However, there was no significant effect on the hepatocyte ballooning or hepatic fibrosis. There were significant decrease of AST, ALT, TG, LDL, FBG, FBI, and HOMA-IR and significant increase of vitamin D levels and HDL in the treatment group compared to the placebo group (P < 0.05).
Conclusion: Vitamin D supplementation was found to be beneficial in the treatment of NAFLD in children
.Trial registration: www.pactr.org , PACTR201710002634203.
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