NAFLD weakly associated with low vitamin D – meta-analysis 2013

Meta-analysis: vitamin D and non-alcoholic fatty liver disease - 2013

AP T Alimentary Pharmacology and Therapeutics, 2013; 38: 246-254
M. Eliades eliadesm at yahoo.com, E. Spyrou , N. Agrawal , M. Lazo t't, F. L. Brancati ™, J. J. Potter 1", A. A. Koteish 1", J. M. Clark ™, E. Guallar 8 & R. Hernaez 1
Washington Hospital Center, Washington, DC, USA. tDepartment of Medicine, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
§ Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.

Background: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent condition. Emerging evidence suggests that vitamin D may play a role in the pathogenesis of NAFLD.

Aim: To review systematically the association between vitamin D levels, measured as serum 25-hydroxy vitamin D [25(OH)D], and NAFLD.

Methods: We used PubMed and EMBASE databases to identify all studies that assessed the association between vitamin D and NAFLD up until 22 April 2013, without language restrictions. We included studies that compared vitamin D levels between NAFLD cases and controls and also those that compared the odds of vitamin D deficiency by NAFLD status. Pooled standardised differences and odds ratios were calculated using an inverse variance method.

Results: Seventeen cross-sectional and case-control studies have evaluated the association between vitamin D and NAFLD.
NAFLD was diagnosed using biopsy (4 studies), ultrasound or CT (10 studies) and liver enzymes (3 studies).
Nine studies provided data for a quantitative meta-analysis.
Compared to controls, NAFLD patients had 0.36 ng/mL (95% CI: 0.32, 0.40 ng/mL) lower levels of 25(OH)D and were 1.26 times more likely to be vitamin D deficient (OR 1.26, 95% CI: 1.17, 1.35).

Conclusions: NAFLD patients have decreased serum 25(OH)D concentrations, suggesting that vitamin D may play a role in the development of NAFLD. The directionality of this association cannot be determined from cross-sectional studies.
Demonstration of a causal role of hypovitaminosis D in NAFLD development in future studies could have important therapeutic implications.

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Note by VitaminDWiki: The study found 0.36 ng/ml lower for NAFLD. This is a tiny amount.
0.4 ng is far less than the typical differences between vitamin D test accuracies and variabilities

See also VitaminDWiki

• Fatty liver disease (NAFLD) and the importance of vitamin D – Oct 2012
• Fatty liver disease (NAFLD), metabolic syndrome, and perhaps vitamin D – June 2013
• Non-alcoholic Fatty Liver Disease (4 in 10 seniors) and Vitamin D
• Strong association of non alcoholic fatty liver disease and low vitamin D
• Non-alcoholic fatty liver disease (NAFLD) reduced somewhat by 50,000 IU vitamin D every 2 weeks – RCT Sept 2014
• Non-alcoholic fatty liver disease associated with much lower vitamin D – Aug 2014
• Search for Fatty Liver in VitaminDWiki 140 items as of Jan 2016

NAFLD and NASH 1.26 higher risk of low vitamin D - meta-analysis 2015

Association between vitamin D and non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: results from a meta-analysis.
Int J Clin Exp Med. 2015 Oct 15;8(10):17221-34. eCollection 2015.
Wang X1, Li W2, Zhang Y1, Yang Y1, Qin G1.
1Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University Zhengzhou, China.
2Department of Oncology, The First Hospital of Yangquan City Yangquan, China.

The prevalence and impact of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) have continued to increase in recent years. Previous reports have shown that hypovitaminosis D is associated with the prevalence and severity of non-alcoholic fatty liver disease (NAFLD). The aim of this study was to systematically evaluate the association of vitamin D levels, as measured by serum 25-hydroxy vitamin D [25(OH)D], with NAFLD and NASH. We searched all of the publications that assessed the association between vitamin D and NAFLD/NASH in the PubMed and EMBASE databases up to November 2014. In total, twenty-nine articles met the eligibility criteria, including twenty-seven studies about NAFLD and four studies about NASH, which were identified and included in the meta-analysis.
Twenty-nine cross-sectional and case-control studies evaluated the association between vitamin D and NAFLD/NASH. Twenty-three studies provided data for a quantitative meta-analysis. Compared with the controls, the NAFLD patients had significantly lower levels of 25(OH)D (SMD-0.76; 95% CI-0.97 to-0.54) and were 1.26 times more likely to be vitamin D deficient (OR 1.26, 95% CI: 1.15 to 1.38). Compared with the controls, the NASH patients had significantly lower levels of 25(OH)D (SMD-1.30; 95% CI-2.37 to -0.23). Although the cross-sectional studies did not allow us to determine a causal nexus, our meta-analysis found lower serum 25(OH)D levels in NAFLD/NASH patients than in subjects without NAFLD/NASH, which suggests that hypovitaminosis D could play a role in the pathogenesis of NAFLD/NASH. Further studies are required to establish the causality between vitamin D status and NAFLD.

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