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Relation between vitamin D status and nonalcoholic fatty liver disease in children
Suchitra K Hourigan1, Stephanie Abrams, Katherine Yates
1*Johns Hopkins School of Medicine, Baltimore, MD †Pediatric Specialists of Virginia, Fairfax, VA ‡Baylor College of Medicine, Houston, TX §Johns Hopkins Bloomberg School of Public Health, Baltimore, MD ||Mayo Clinic, Rochester, MN ¶Seattle Children's #Seattle Medical Center, Seattle, WA.
Insights
Pediatric nonalcoholic fatty liver disease (NAFLD) shows high rates of vitamin D deficiency. However, low vitamin D levels in children with NAFLD did not correlate with disease severity, unlike in adults.
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Nutritional Science
- Metabolic Disorders
Background:
- Vitamin D deficiency is prevalent in adults with nonalcoholic fatty liver disease (NAFLD) and linked to disease severity.
- Pediatric NAFLD differs from adult NAFLD, with limited research on vitamin D's role in children.
- Understanding vitamin D's impact in pediatric NAFLD is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between vitamin D levels and NAFLD in children.
- To compare findings in pediatric NAFLD with existing data from adult NAFLD studies.
Main Methods:
- Utilized clinical and histological data from 102 children (ages 2-18) with biopsy-proven NAFLD.
- Measured serum 25(OH) vitamin D levels, categorizing them as deficient (≤20 ng/mL), insufficient (21-29 ng/mL), or sufficient (≥30 ng/mL).
- Analyzed demographics, anthropometrics, laboratory markers, and liver histology.
Main Results:
- A high prevalence of vitamin D deficiency or insufficiency was observed in 78% of the pediatric cohort.
- No significant association was found between vitamin D levels and the histological characteristics or severity of NAFLD.
- Children with vitamin D deficiency exhibited significantly higher triglyceride levels (P=0.004).
Conclusions:
- Despite a high prevalence of vitamin D deficiency/insufficiency in pediatric NAFLD, it did not correlate with disease severity on liver biopsies.
- This finding contrasts with adult NAFLD studies, suggesting distinct pathophysiological mechanisms or consequences in pediatric cases.
- Further research is needed to elucidate the specific role of vitamin D in pediatric NAFLD progression and management.
Objectives:
In adults, vitamin D deficiency is common in patients with nonalcoholic fatty liver disease (NAFLD) and has been associated with the severity of histology. There are known differences between adult and pediatric NAFLD, with little data regarding the relation between vitamin D and pediatric NAFLD. The aim of the present study was to examine the relation between vitamin D levels and NAFLD in children.
Methods:
Clinical and histological data were used from children ages 2 to 18 years with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network studies. 25(OH) vitamin D levels were measured from serum. Data examined included demographics, anthropometrics, laboratory markers, and liver histology. Data were analyzed using 3 categories of vitamin D level: deficient (≤ 20 ng/mL), insufficient (21-29 ng/mL), and sufficient (≥ 30 ng/mL).
Results:
A total of 102 children were studied. There was a high prevalence (80/102, 78%) of vitamin D deficiency or insufficiency; however, there were no significant associations between vitamin D level and the histological characteristics or severity of NAFLD. Significantly higher levels of triglycerides were found in those with vitamin D deficiency (P = 0.004), but there was no association with other features of the metabolic syndrome.
Conclusions:
There is a high prevalence of vitamin D deficiency and insufficiency in children with biopsy-proven NAFLD; however, no association was found between vitamin D deficiency and the severity of disease on biopsies. This differs from adult NAFLD studies in which vitamin D deficiency correlates with histological severity, suggesting differences in the risk factors for or consequences of pediatric NAFLD.
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