The Impact of Vitamin D in Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Patients with Morbid Obesity
Authors Borges-Canha M, Neves JS, Mendonça F, Silva MM, Costa C, Cabral PM, Guerreiro V, Lourenço R, Meira P, Salazar D, Ferreira MJ, Pedro J, Leite AR, von-Hafe M, Vale C, Viana S, Sande A, Belo S, Lau E, Freitas P, Carvalho D
Received 12 October 2020
Accepted for publication 21 January 2021
Published 3 February 2021 Volume 2021:14 Pages 487—495
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Konstantinos Tziomalos
Marta Borges-Canha,1,2 João Sérgio Neves,1,2 Fernando Mendonça,1 Maria Manuel Silva,1 Cláudia Costa,3 Pedro M Cabral,4 Vanessa Guerreiro,1 Rita Lourenço,5 Patrícia Meira,5 Daniela Salazar,1 Maria João Ferreira,1 Jorge Pedro,1 Ana Rita Leite,2 Madalena von-Hafe,2 Catarina Vale,2 Sara Viana,1 Ana Sande,1 Sandra Belo,1 Eva Lau,1 Paula Freitas,1,6 Davide Carvalho1,6
1Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal; 2Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; 3Serviço de Endocrinologia do Instituto Português de Oncologia do Porto, Porto, Portugal; 4Serviço de Patologia Clínica do Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal; 5Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal; 6Investigação e Inovação Em Saúde (I3s), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
Correspondence: Marta Borges-Canha
Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
Purpose: We aimed to evaluate the association between vitamin D status and hepatic function parameters and scores: Fatty Liver Index (FLI, predictor of hepatic steatosis) and BARD (BMI, AST/ALT ratio and DM, predictor of hepatic fibrosis) in patients with morbid obesity.
Patients and Methods: Cross-sectional study including patients with morbid obesity followed in our centre between January 2010 and July 2018. Patients with missing vitamin D levels or hepatic profile parameters were excluded. We divided the population according to two cut-offs of vitamin D levels (12ng/mL and 20ng/mL).
Results: The included population (n=1124) had an average age of 43.3± 10.7 years and 84.3% were female. Seventy-point eight percent of the population had vitamin D levels lower than 20ng/mL and 34.8% lower than 12ng/dL. Patients with lower vitamin D levels (< 12ng/mL) had higher BMI, hip and waist circumferences and higher prevalence of hypertension. Higher FLI scores [OR= 0.77 (0.07), p< 0.01] and ALP levels [β= − 0.03 (− 0.06, − 0.01), p< 0.01] associated to lower vitamin D levels.
Conclusion: Vitamin D deficiency is associated with a higher risk of hepatic steatosis in individuals with morbid obesity. Correction of vitamin D deficiency may have a beneficial role in the management of NAFLD in patients with morbid obesity.
Keywords: vitamin D, fatty liver, NAFLD, obesity
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