维生素D链接到严重NAFLD

StephenW

Vitamin D linked to severe NAFLD
October 24, 2016

  

LAS VEGAS — Vitamin D levels are inversely associated with nonalcoholic fatty liver disease severity, per data presented in a liver plenary session at ACG 2016.

“It is still controversial whether vitamin D level defers by severity of NAFLD,” Hyun-seok Kim, MD, MPH, resident at Rutgers New Jersey Medical School, said during his presentation. “Furthermore. … vitamin D level as a prognostic factor in the NAFLD patient is unknown. Our objective was to investigate the association between vitamin D level severity of NAFLD and its relationship to mortality using nationally representative data.”

Kim and colleagues conducted a population-based study by evaluating data of 14,797 adults extracted from the Third National Health and Nutrition Examination Survey. Of these, 10,960 had available data, such as liver ultrasound and vitamin D levels, between 1988 and 1994 and subsequent follow-up mortality data through December 2011. These patients were included in the final analysis where researchers used NAFLD fibrosis score to determine severity of hepatic fibrosis in those with NAFLD; Diasorin 25-OH-D assay to measure vitamin D levels; and the ANOVA (F-test) to evaluate association between vitamin D level and degree of NAFLD.

Overall, 35% of patients had NAFLD; liver ultrasound found 1,491 of these had mild, 1,707 people had moderate and 817 had severe steatosis. There were 2,354 patients who had low NAFLD fibrosis score, implying no significant fibrosis, per Kim, 1,379 presented with intermediate NAFLD fibrosis score and 282 had high NAFLD fibrosis score.

Per Kim’s presentation, vitamin D levels classified as normal were 25.1 ± 0.3 ng/mL, mild were 24.6 ± 0.4 ng/mL, moderate were 23.7 ± 0.3 ng/mL and severe were 23.5 ± 0.6 ng/mL (P < .001). In addition, vitamin D levels for low NAFLD fibrosis score was 24.7 ± 0.4 ng/mL, intermediate was 23.4 ± 0.4 ng/mL and high was 21.8 ± 0.5 ng/mL (P < .001).

“Vitamin D level was inversely related to the degree of steatosis and liver fibrosis among NAFLD patients based on the liver ultrasound findings,” Kim said.

After a median follow-up of 19 years, vitamin D deficiency less than 20 ng/mL was significantly associated with diabetes-related mortality (HR = 3; 95% CI, 1.5-6) and Alzheimer’s disease-related mortality (HR = 4.8; 95% CI, 1.5-15.5). However, this vitamin D level was not associated with all-cause mortality in people with NAFLD, after adjustment for age, sex, race, BMI, and evidence of diabetes.

Kim concluded: “Prospective or clinical trials are needed to confirm our findings and investigate whether treating vitamin D deficiency would be helpful in preventing or slowing the progression of NAFLD.” – by Melinda Stevens

Reference:

Kim H-s, et al. Abstract #47. Presented at: American College of Gastroenterology Annual Scientific Meeting; Oct. 14-19, 2016; Las Vegas, NV.

Disclosure: The researchers report no relevant financial disclosures.

StephenW

维生素D链接到严重NAFLD
2016年10月24日

  

LAS VEGAS - 维生素D水平与非酒精性脂肪肝疾病严重程度负相关，每个数据在ACG 2016的肝脏全会上提供。

Rutgers新泽西医学院的居民Hyun-Seok Kim，MD，MPH在他的演讲中说：“维生素D水平是否依据NAFLD的严重程度仍然存在争议。 “此外。 ...维生素D水平作为NAFLD患者的预后因素是未知的。我们的目标是调查维生素D水平NAFLD严重程度与其与死亡率的关系之间的关联，使用全国代表性的数据。

Kim和同事通过评估从第三次国家健康和营养调查中提取的14,797名成年人的数据进行了基于人群的研究。其中，10,960个有可用的数据，如肝超声和维生素D水平，1988年至1994年和随后的随访死亡率数据到2011年12月。这些患者被纳入最终分析，研究人员使用NAFLD纤维化评分确定严重性肝纤维化;测定维生素D水平的Diasorin 25-OH-D测定;和ANOVA（F检验）来评估维生素D水平与NAFLD程度之间的关联。

总体而言，35％的患者有NAFLD;肝超声发现其中1,491例轻度，1,707例中度，817例有严重脂肪变性。有2354名患者具有低NAFLD纤维化评分，意味着没有显着的纤维化，每Kim，1,379呈现中间NAFLD纤维化评分，282具有高NAFLD纤维化评分。

根据Per Kim的报告，分类为正常的维生素D水平为25.1±0.3ng / mL，轻度为24.6±0.4ng / mL，中度为23.7±0.3ng / mL，重度为23.5±0.6ng / mL（P < 。此外，低NAFLD纤维化评分的维生素D水平为24.7±0.4ng / mL，中间为23.4±0.4ng / mL，高为21.8±0.5ng / mL（P <0.001）。

基于肝脏超声检查，维生素D水平与NAFLD患者的脂肪变性和肝纤维化程度负相关，“Kim说。

在中位随访19年后，维生素D缺乏小于20 ng / mL与糖尿病相关死亡率（HR = 3; 95％CI，1.5-6）和阿尔茨海默病相关死亡率（HR = 4.8 ; 95％CI，1.5-15.5）。然而，在调整年龄，性别，种族，BMI和糖尿病证据后，这种维生素D水平与NAFLD患者的全因死亡率无关。

Kim总结说：“需要进行前瞻性或临床试验以证实我们的发现，并研究治疗维生素D缺乏是否有助于预防或减缓NAFLD的进展。” - Melinda Stevens

参考：

Kim H-s，et al。摘要＃47。介绍：美国消化内科学会年度科学会议; 2016年10月14日 - 拉斯维加斯，内华达州。

披露：研究人员报告无相关财务披露。