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Vitamin D deficiency: prevalence and association with liver disease severity in pediatric nonalcoholic fatty liver disease
Journal article   Peer reviewed

Vitamin D deficiency: prevalence and association with liver disease severity in pediatric nonalcoholic fatty liver disease

Toshifumi Yodoshi, Sarah Orkin, Ana Catalina Arce-Clachar, Kristin Bramlage, Chunyan Liu, Lin Fei, Faris El-Khider, Srinivasan Dasarathy, Stavra A. Xanthakos and Marialena Mouzaki
European journal of clinical nutrition, Vol.74(3), pp.427-435
03/01/2020
DOI: 10.1038/s41430-019-0493-y
PMID: 31444465

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Abstract

Background/Objectives To determine associations between serum 25-hydroxyvitamin D (25(OH)-D) concentrations and histologic nonalcoholic fatty liver disease (NAFLD) severity. Subjects/Methods Clinical, laboratory, and histology data were collected retrospectively in a pediatric cohort with biopsy-confirmed NAFLD. Serum 25(OH)-D concentrations were used to define vitamin D deficiency (<= 20 ng/ml), insufficiency (21-30 ng/ml), and sufficiency (>= 31 ng/ml). Results In all, 234 patients (78% non-Hispanic, median age 14 years) were included. The majority (n = 193) were either vitamin D insufficient (50%) or deficient (32%). Eighty-four patients (36%) reported taking vitamin D supplements at the time of biopsy; serum 25(OH)-D concentrations were not higher in those supplemented. There were no differences in the demographic, clinical, and laboratory characteristics of the three vitamin D status groups. Severity of steatosis, ballooning, lobular/portal inflammation, and NAFLD activity score were also not different between the groups. The proportion of patients with significant fibrosis (stage >= 2) was higher in those with insufficiency (29%) compared to those who were sufficient (17%) or deficient (15%, p = 0.04). After controlling for important covariates selected from age, body mass index, ethnicity, vitamin D supplementation, and season, the insufficient group had increased odds of a higher fibrosis score compared to the sufficient group (adjusted OR, 2.04; 95%CI, 1.02-4.08). Conclusions Vitamin D deficiency and insufficiency are common in children with NAFLD, but not consistently related with histologic disease severity. Prospective longitudinal studies are needed to determine optimal dosing strategies to achieve sufficiency and to determine whether adequate supplementation has an impact on histology.
 Life Sciences & Biomedicine Nutrition & Dietetics Science & Technology

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