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Non-Alcoholic Fatty Liver Disease (NAFLD) treated by Vitamin D (20,000 IU weekly after loading dose) – RCT June 2016

Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP).

J Gastrointestin Liver Dis. 2016 Jun;25(2):175-81. doi: 10.15403/jgld.2014.1121.252.cap.
Papapostoli I1, Lammert F1, Stokes CS2.
1Department of Medicine II, Saarland University Medical Center, Homburg, Germany.
2Department of Medicine II, Saarland University Medical Center, Homburg, Germany. caroline.stokes at uks.eu.

VitaminDWiki Summary

20,000 IU vitamin D daily for a week
20,000 IU vitamin D weekly for 6 months
Far better results would be expected if had done 1 or more of the following:

  1. Had used a type of vitamin D compatible with poorly functioning liver
  2. Had used a larger daily loading dose - e.g. 50,000 IU
  3. Had used daily loading dose for a longer time period e.g. 2 weeks
  4. Had used a larger weekly maintenance dose - e.g. 50,000 IU
  5. Had used dose sizes proportional to weight (obese need 2.5 X more)

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Note poor vitamin D response in first month, and Controlled Attenuation Parameter actually increased for a fraction of the people
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INTRODUCTION:
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries. A meta-analysis has confirmed decreased serum 25-hydroxyvitamin D levels in NAFLD patients. This intervention study investigates whether vitamin D correction ameliorates hepatic steatosis.
METHODS:
We prospectively recruited 40 patients from an outpatient liver clinic with vitamin D deficiency (serum 25-hydroxyvitamin D < 20 ng/ml). Controlled attenuation parameter (CAP) during transient elastography quantified hepatic steatosis. Patients with significant liver fat accumulation were included, which was defined by a CAP value >/= 280 dB/m. Patients received 20,000 IU vitamin D/week for six months, while vitamin D status, liver function tests (LFTs), CAP and body composition were monitored.
RESULTS:
The cohort comprised 47.5% women (age 54.9 +/- 12.1 years; BMI 29.5 +/- 3.0 kg/m2). Mean serum vitamin D level was 11.8 +/- 4.8 ng/ml. CAP decreased significantly from baseline (330 +/- 32 vs. 307 +/- 41 dB/m) during supplementation (P = 0.007). A mean CAP reduction relative to baseline was demonstrated at four weeks and three and six months: -5.3 +/- 13.8%; -6.0 +/- 14.6% and -6.4 +/- 13.0%, respectively. During these time points, restoration of serum vitamin D levels was observed (34.6 +/- 12.9, 36.3 +/- 10.2, 34.8 +/- 9.8 ng/ml; P < 0.0001). Liver function tests and body composition remained unchanged.
CONCLUSIONS:
Hepatic steatosis, as assessed by CAP, significantly improves after only 4 weeks of vitamin D correction. Hepatic steatosis is a dynamic process, that can be monitored in the short-term using such non-invasive methods.
PMID: 27308648

Attached files

ID Name Comment Uploaded Size Downloads
9052 Vitamin D Supplementation and Non-Alcoholic Fatty Liver Disease - Present and Future.pdf admin 29 Dec, 2017 209.40 Kb 744
7869 NAFLD Vitamin D.jpg admin 20 Mar, 2017 64.60 Kb 4694
7868 NAFLD Symptoms.jpg admin 20 Mar, 2017 32.14 Kb 2165
7867 NAFLD Obese.jpg admin 20 Mar, 2017 31.30 Kb 1792
6880 NAFLD CAP.jpg admin 13 Jul, 2016 28.43 Kb 2369
6879 NAFLD 2016.jpg admin 13 Jul, 2016 35.21 Kb 2159
6878 NAFLD RCT 2016.pdf admin 12 Jul, 2016 204.96 Kb 761