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Serum vitamin D is associated with ultrasound-defined hepatic fibrosis - 03/12/23

Doi : 10.1016/j.clinre.2023.102228 
Rong Jiang a, , Yichao Zhou b, 1, Lei Han c, , Zhen Hong a,
a Jiangsu Health Vocational College, Nanjing, Jiangsu 210000, China 
b Department of Occupation Disease Prevention and Cure, Changzhou Wujin District Center for Disease Control and Prevention, Changzhou, Jiangsu 213100, China 
c Department of Occupation Disease Prevention and Cure, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210000, China 

Corresponding authors.

Highlights

This large population-based investigation indicated that elevated serum vitamin D reduced the onset of advanced fibrosis in subjects with NAFLD.
Higher serum vitamin D levels were prone to be at lower prevalence of advanced liver fibrosis, especially among males, non-obese and younger participants with NAFLD.
This association offered a new perspective into the prevention and control of advanced fibrosis in NAFLD.

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Abstract

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 20172018 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.

Le texte complet de cet article est disponible en PDF.

Keywords : Vitamin D, NAFLD, Hepatic fibrosis, Population-based investigation


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Vol 47 - N° 10

Article 102228- décembre 2023 Retour au numéro
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