Serum vitamin D is associated with ultrasound-defined hepatic fibrosis
Clin Res Hepatol Gastroenterol . 2023 Oct 19:102228. doi: 10.1016/j.clinre.2023.102228
Rong Jiang 1, Yichao Zhou 2, Lei Han 3, Zhen Hong 4
Background: Evidences from population-based investigations on the exact relationship between vitamin D and the severity of liver fibrosis remain debated and conflicting. Here, we aim to explore the relationship between serum vitamin D and ultrasound-defined advanced hepatic fibrosis in the US participants with nonalcoholic fatty liver disease (NAFLD).
Methods: In the retrospective study, individuals with intact information on interesting variables from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) were included. NAFLD was diagnosed on the basis of controlling attenuation parameter (CAP) value≥274 dB/m without causes of other chronic hepatic diseases. We identified advanced fibrosis grades (F2) by liver stiffness measurement (LSM) score of ≥8.2 kPa in NAFLD patients. The impact of elevated serum vitamin D on the prevalence of hepatic fibrosis was assessed by multivariate logistic regression models on the basis of the NHANES recommended weights.
Results: The study involved 1624 subjects with NAFLD in total, and 305 (18.28%, weighted %) of whom were diagnosed with advanced hepatic fibrosis according to the definition based on parameters obtained from vibration controlled transient elastography (VCTE).
In the multivariate logistic regression analysis, serum vitamin D presented a negative relationship to hepatic fibrosis with lower odds in patients with hepatic steatosis after being adjusted for potential confounding factors
- (fully adjusted: OR=0.47, 95% CI: 0.24-0.90, p=0.034).
Our subgroup analysis revealed that the inverse relationship was still existed in
- males (fully adjusted: OR=0.34, 95% CI: 0.17-0.70, p=0.014),
- non-obese subjects (fully adjusted: OR=0.20, 95% CI: 0.04-0.89, p=0.042) and
- participants below 60 years (fully adjusted: OR=0.43, 95% CI: 0.21-0.90, p=0.033),
whereas in models adjusted for the potential confounding factors, no statistically significant correlation was noted in females, obese subjects or subjects with age≥60 years.
Conclusions: This large population-based investigation indicated that elevated serum vitamin D reduced the onset of advanced fibrosis diagnosed by ultrasound in males, non-obese subjects and younger participants with NAFLD.