J Korean Med Sci.  2017 Jan;32(1):95-101. 10.3346/jkms.2017.32.1.95.

Is Vitamin D an Independent Risk Factor of Nonalcoholic Fatty Liver Disease?: a Cross-Sectional Study of the Healthy Population

Affiliations
  • 1Department of Family Medicine, Seoul National University Hospital, Seoul, Korea. hyuktae@gmail.com
  • 2Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
  • 3Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Family Medicine, Seoul National University Health Service Center, Seoul, Korea.
  • 5Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea.
  • 6Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.

Abstract

The association between vitamin D levels and nonalcoholic fatty liver disease (NAFLD) has been recognized. However, few studies showed independent associations between vitamin D deficiency and NAFLD after a sex-related adjustment for metabolic factors. We aimed to study whether vitamin D deficiency is an independent risk factor of NAFLD even after controlling for metabolic syndrome and visceral fat in both sexes. In this cross-sectional study, 7,514 Korean adults (5,278 men, 2,236 women) participated in a health check-up program. They underwent blood tests, abdominal computed tomography (CT) of the visceral fat area, and ultrasonography for NAFLD screening. Multiple logistic regression analysis was used to investigate the association of vitamin D deficiency with NAFLD according to the sex differences. Vitamin D deficiency is associated with NAFLD. The adjusted odds ratio (aOR) for NAFLD increased sequentially with decreasing vitamin D level, even after adjusting for metabolic syndrome and visceral fat. The subjects in the vitamin D sufficiency group (20-30 ng/mL) had an aOR for NAFLD of 1.18 (95% CI, 1.00-1.39), whereas the deficiency group (< 20 ng/mL) had an aOR of 1.29 (95% CI, 1.10-1.52). However, we have detected a significant sex-related interaction when analyzing the results. A significant relationship between vitamin D deficiency and NAFLD was found in men (aOR, 1.33; 95% CI, 1.11-1.60) but not in women.

Keyword

Vitamin D; Non-Alcoholic Fatty Liver Disease; Metabolic Syndrome X; Intra-Abdominal Fat; Sex

MeSH Terms

Adult
Cross-Sectional Studies
Female
Hematologic Tests
Humans
Intra-Abdominal Fat
Logistic Models
Male
Mass Screening
Metabolic Syndrome X
Non-alcoholic Fatty Liver Disease*
Odds Ratio
Risk Factors*
Sex Characteristics
Ultrasonography
Vitamin D Deficiency
Vitamin D*
Vitamins*
Vitamin D
Vitamins

Figure

  • Fig. 1 Study population. 25(OH)D3 = 25-hydroxyvitamin D3, HPDPC = Health Promotion/Disease Prevention Center, HCSGC = Healthcare System Gangnam Center.

  • Fig. 2 aOR of NAFLD according to 25(OH)D3. Logistic regression aOR (95% CI) of NAFLD according to the serum 25(OH)D3 level compared with the sufficient (≥ 30 ng/mL) reference group by sex (light gray bar: insufficient [20–30 ng/mL]; dark gray bar: deficient [< 20 ng/mL]). The regression model is adjusted for age (continuous), BMI (continuous), month of measurement (January to December), smoking (nonsmoker/ex-smoker/current smoker), physical activity (inactive/minimal activity/health-enhancing physical activity), health check-up center (HPDPC/HCSGC), metabolic syndrome (present/absent), and visceral fat (continuous). aOR = adjusted odds ratio, NAFLD = nonalcoholic fatty liver disease, 25(OH)D3 = 25-hydroxyvitamin D3, CI = confidence interval, BMI = body mass index, HPDPC = Health Promotion Disease Prevention Center, HCSGC = Healthcare System Gangnam Center.


Cited by  1 articles

Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population
Young Hoon Cho, Ju Whi Kim, Jung Ok Shim, Hye Ran Yang, Ju Young Chang, Jin Soo Moon, Jae Sung Ko
Pediatr Gastroenterol Hepatol Nutr. 2019;22(3):233-241.    doi: 10.5223/pghn.2019.22.3.233.


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