Vol 9, No 5 (2020)
Research paper
Published online: 2020-09-17

open access

Page views 1065
Article views/downloads 608
Get Citation

Connect on Social Media

Connect on Social Media

Hepatic steatosis indices as predictors of vitamin D3 deficiency in patients with NAFLD associated with type 2 diabetes

Mahmoud Aludwan1, Nazarii Kobyliak1, Ludovico Abenavoli2, Liudmyla Kononenko1, Larysa Shuliarenko1, Dmytro Kyriienko13, Iuliia Komisarenko1
Clin Diabetol 2020;9(5):313-320.

Abstract

Background. Recently, vitamin D3 deficiency is considered one of the factors associated with the development of non-alcoholic fatty liver disease (NAFLD). The aim was to evaluate steatosis indices and metabolic parameters in NAFLD depending on vitamin D3 status. Methods. According to the recommendations of the European Society of Endocrinology, all patients were divided into 3 groups: group 1 — with an optimal level of vitamin D3 (30 ng/mL); group 2 — vitamin D3 insufficiency (21–29 ng/mL) and group 3 — vitamin D3 deficiency (< 20 ng/mL). Results. The study included 126 T2D patients with NAFLD diagnosed with ultrasound. The highest hepatic steatosis (HSI) and fatty liver (FLI) index values were diagnosed in vitamin D3 deficiency as compared to optimal group (HSI — 43.34 ± 6.59 vs. 39.67 ± 4.37; P = 0.032 and FLI — 79.21 ± 19.61 vs. 64.96 ± 17.72; P = 0.007). Triglyceride and glucose index (TyG) also were insignificantly elevated parallel to vitamin D3 status worsened (P = 0.175). In multivariate logistic regression analysis all steatosis indices were independent from transaminases activity, body mass index (BMI) and T2D duration associated with vitamin D3 deficiency. Conclusions. Hepatic steatosis indices (HSI, FLI and TyG) independently from anthropometric parameters and transaminase activity associated with D3 deficiency in NAFLD patients

Article available in PDF format

View PDF Download PDF file

References

  1. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002; 346(16): 1221–1231.
  2. Mykhalchyshyn G, Kobyliak N, Bodnar P. Diagnostic accuracy of acyl-ghrelin and it association with non-alcoholic fatty liver disease in type 2 diabetic patients. J Diabetes Metab Disord. 2015; 14: 44.
  3. Abenavoli L, Falalyeyeva T, Boccuto L, et al. Obeticholic Acid: A New Era in the Treatment of Nonalcoholic Fatty Liver Disease. Pharmaceuticals (Basel). 2018; 11(4).
  4. Adams LA, Lymp JF, St Sauver J, et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005; 129(1): 113–121.
  5. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011; 34(3): 274–285.
  6. Sumida Y, Yoneda M. Current and future pharmacological therapies for NAFLD/NASH. J Gastroenterol. 2018; 53(3): 362–376.
  7. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018; 67(1): 328–357.
  8. Younossi Z, Anstee QM, Marietti M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018; 15(1): 11–20.
  9. Kobyliak N, Falalyeyeva T, Boyko N, et al. Probiotics and nutraceuticals as a new frontier in obesity prevention and management. Diabetes Res Clin Pract. 2018; 141: 190–199.
  10. Kobyliak N, Falalyeyeva T, Mykhalchyshyn G, et al. Probiotic and omega-3 polyunsaturated fatty acids supplementation reduces insulin resistance, improves glycemia and obesity parameters in individuals with type 2 diabetes: A randomised controlled trial. Obesity Medicine. 2020; 19: 100248.
  11. Kobyliak N, Virchenko O, Falalyeyeva T, et al. Cerium dioxide nanoparticles possess anti-inflammatory properties in the conditions of the obesity-associated NAFLD in rats. Biomed Pharmacother. 2017; 90: 608–614.
  12. Kobyliak N, Abenavoli L, Falalyeyeva T, et al. Prevention of NAFLD development in rats with obesity via the improvement of pro/antioxidant state by cerium dioxide nanoparticles. Clujul Med. 2016; 89(2): 229–235.
  13. Abenavoli L, Greco M, Milic N, et al. Effect of Mediterranean Diet and Antioxidant Formulation in Non-Alcoholic Fatty Liver Disease: A Randomized Study. Nutrients. 2017; 9(8).
  14. Kobyliak N, Abenavoli L, Falalyeyeva T, et al. Efficacy of Probiotics and Smectite in Rats with Non-Alcoholic Fatty Liver Disease. Ann Hepatol. 2018; 17(1): 153–161.
  15. Kobyliak N, Abenavoli L, Mykhalchyshyn G, et al. Probiotics and smectite absorbent gel formulation reduce liver stiffness, transaminase and cytokine levels in NAFLD associated with type 2 diabetes: a randomized clinical study. Clinical Diabetology. 2019; 8(4): 205–214.
  16. Kobyliak N, Falalyeyeva T, Beregova T, et al. Probiotics for experimental obesity prevention: focus on strain dependence and viability of composition. Endokrynol Pol. 2017; 68(6): 659–667.
  17. Kobyliak N, Falalyeyeva T, Tsyryuk O, et al. New insights on strain-specific impacts of probiotics on insulin resistance: evidence from animal study. J Diabetes Metab Disord. 2020; 19(1): 289–296.
  18. Catena C, Cosma C, Camozzi V, et al. Non-alcoholic fatty liver disease is not associated with vitamin D deficiency in essential hypertension. High Blood Press Cardiovasc Prev. 2013; 20(1): 33–37.
  19. Li L, Zhang L, Pan S, et al. No significant association between vitamin D and nonalcoholic fatty liver disease in a Chinese population. Dig Dis Sci. 2013; 58(8): 2376–2382.
  20. Drincic AT, Armas LAG, Van Diest EE, et al. Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity. Obesity (Silver Spring). 2012; 20(7): 1444–1448.
  21. Eliades M, Spyrou E, Agrawal N, et al. Meta-analysis: vitamin D and non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2013; 38(3): 246–254.
  22. Hamaguchi M, Kojima T, Takeda N, et al. The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med. 2005; 143(10): 722–728.
  23. Aludwan MB, Kobylіak NM, Komisarenko Y. Metabolic predictors and vitamin D deficiency in patients with type 2 diabetes mellitus. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY. 2019; 15(6): 459–468.
  24. Abdel-Wareth L, Haq A, Turner A, et al. Total vitamin D assay comparison of the Roche Diagnostics "Vitamin D total" electrochemiluminescence protein binding assay with the Chromsystems HPLC method in a population with both D2 and D3 forms of vitamin D. Nutrients. 2013; 5(3): 971–980.
  25. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(7): 1911–1930.
  26. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6): 499–502.
  27. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7): 412–419.
  28. Bedogni G, Miglioli L, Masutti F, et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 2006; 6(5): 33–1391.
  29. Unger G, Benozzi SF, Perruzza F, et al. Triglycerides and glucose index: a useful indicator of insulin resistance. Endocrinol Nutr. 2014; 61(10): 533–540.
  30. Lee JH, Kim D, Kim HJ, et al. Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease. Dig Liver Dis. 2010; 42(7): 503–508.
  31. Holick MF. Vitamin D: a D-Lightful health perspective. Nutr Rev. 2008; 66(10 Suppl 2): S182–S194.
  32. Verstuyf A, Carmeliet G, Bouillon R, et al. Vitamin D: a pleiotropic hormone. Kidney Int. 2010; 78(2): 140–145.
  33. Ingraham BA, Bragdon B, Nohe A. Molecular basis of the potential of vitamin D to prevent cancer. Curr Med Res Opin. 2008; 24(1): 139–149.
  34. Komisarenko YI, Bobryk MI. Vitamin D Deficiency and Immune Disorders in Combined Endocrine Pathology. Front Endocrinol (Lausanne). 2018; 9: 600.
  35. Mazanova A, Shymanskyi I, Lisakovska O, et al. Effects of Cholecalciferol on Key Components of Vitamin D-Endo/Para/Autocrine System in Experimental Type 1 Diabetes. Int J Endocrinol. 2018; 2018: 2494016.
  36. Targher G, Bertolini L, Scala L, et al. Associations between serum 25-hydroxyvitamin D3 concentrations and liver histology in patients with non-alcoholic fatty liver disease. Nutr Metab Cardiovasc Dis. 2007; 17(7): 517–524.
  37. Yodoshi T, Orkin S, Arce-Clachar AC, et al. Vitamin D deficiency: prevalence and association with liver disease severity in pediatric nonalcoholic fatty liver disease. Eur J Clin Nutr. 2020; 74(3): 427–435.
  38. Blond E, Disse E, Cuerq C, et al. EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease in severely obese people: do they lead to over-referral? Diabetologia. 2017; 60(7): 1218–1222.
  39. Gómez-Ambrosi J, Silva C, Galofré JC, et al. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity. Int J Obes (Lond). 2012; 36(2): 286–294.
  40. Petta S, Di Marco V, Di Stefano R, et al. TyG index, HOMA score and viral load in patients with chronic hepatitis C due to genotype 1. J Viral Hepat. 2011; 18(7): e372–e380.
  41. Zhang S, Du T, Zhang J, et al. The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease. Lipids Health Dis. 2017; 16(1): 15.