Pattern of Serum Vitamin D in Individuals with non-Alcoholic Fatty Liver and its Relation to Metabolic Dysfunction

Background and study aim: Vitamin D has extensive anti-fibrotic, anti-inflammatory, and insulin-sensitizing ‎properties, in addition to involvement in immune-metabolic pathways within the ‎gut-adipose tissue-liver axis. This study aims to assess the association between ‎vitamin D deficiency, metabolic dysfunction and NAFLD which is still ‎controversial‎‎‎‎‎‎. Patients and Methods: Cross sectional study that included 170 subjects; 85 cases with fatty liver and 85 ‎healthy controls.  After measurement of BMI, both studied groups were subjected ‎to the following laboratory investigations: vitamin D, liver enzymes, random ‎blood glucose, HbA1C, cholesterol, TG, LDL, HDL and uric acid‎.‎ Results: Vitamin D deficiency was associated with many metabolic dysfunction ‎parameters. Regarding NAFLD: in univariate analysis, vitamin D deficiency, male ‎sex, overweight and obesity, hypercholesterolemia, hyper-glycaemia, and elevated ‎liver enzymes were the risk factors. Meanwhile multivariate analysis showed that ‎the risk factors included male sex, overweight and obesity. Sensitivity and ‎specificity of vit D deficiency, at a cutoff value of ≤18.5 mg/mL, were 68.24% ‎and 52.92%, respectively. Sensitivity and specificity of hypertriglyceridemia, with ‎a cutoff value of >113 mg/dL, were 77.65% and 48.24%, respectively.  At cutoff ‎value of >5.2%, sensitivity and specificity of HBA1C were 69.41% and 56.47%, ‎respectively‎‎. Conclusion: Vitamin D deficiency is associated with high prevalence of metabolic changes. ‎Thus, early detection and treatment of such deficiency can improve fatty liver ‎disease and its associated metabolic changes, hence, preventing progression into ‎liver cirrhosis‎‎‎‎‎‎‎‎‎.