https://www.ncbi.nlm.nih.gov/pubmed/31444465 NAFLD
Eur J Clin Nutr. 2019 Aug 23. doi: 10.1038/s41430-019-0493-y. [Epub ahead of print]
Vitamin D deficiency: prevalence and association with liver disease severity in pediatric nonalcoholic fatty liver disease.
Yodoshi T1, Orkin S1, Arce-Clachar AC1,2, Bramlage K1, Liu C3, Fei L2,3, El-Khider F4, Dasarathy S4, Xanthakos SA1,2, Mouzaki M5,6.

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.