The serum vitamin D level is inversely correlated with nonalcoholic fatty liver disease.

BACKGROUND/AIMS: A low vitamin D level has been associated with metabolic syndrome and diabetes. However, an association between a low vitamin D level and nonalcoholic fatty liver disease (NAFLD) has not yet been definitively established. This study aimed to characterize the relationship between a vitamin D level and NAFLD in Korea. METHODS: A cross-sectional study involving 6,055 health check-up subjects was conducted. NAFLD was diagnosed on the basis of typical ultrasonographic findings and a history of alcohol consumption. RESULTS: The subjects were aged 51.7 ± 10.3 years (mean ± SD) and 54.7% were female. NAFLD showed a significant inverse correlation with the vitamin D level after adjusting for age and sex [odds ratio (OR)=0.85, 95% confidence interval (CI)=0.75-0.96]. The age- and sex-adjusted prevalence of NAFLD decreased steadily with increasing vitamin D level [OR=0.74, 95% CI=0.60-0.90, lowest quintile (≤14.4 ng/mL) vs highest quintile (≥28.9 ng/mL), p for trend <0.001]. Multivariate regression analysis after adjusting for other metabolic factors revealed that NAFLD showed a significant inverse correlation with both the vitamin D level (>20 ng/mL) [OR=0.86, 95% CI=0.75-0.99] and the quintiles of the vitamin D level in a dose-dependent manner (p for trend=0.001). CONCLUSIONS: The serum level of vitamin D, even when within the normal range, was found to be inversely correlated with NAFLD in a dose-dependent manner. Vitamin D was found to be inversely correlated with NAFLD independent of known metabolic risk factors. These findings suggest that vitamin D exerts protective effects against NAFLD.

Incidence of aspiration and gastrointestinal complications in critically ill patients using continuous versus bolus infusion of enteral nutrition: a pseudo-randomised controlled trial.

UNLABELLED: Enteral nutrition (EN) for the critically ill and mechanically ventilated patients can be administered either via the continuous or bolus methods. However, there is insufficient evidence supporting which of these methods may have a lower risk of aspiration and gastrointestinal (GI) complications. This study was conducted in order to identify the incidence of aspiration and GI complications using continuous enteral nutrition (CEN) and bolus enteral nutrition (BEN) in critically ill patients at the Rafik Hariri University Hospital (RHUH), Beirut, Lebanon. METHODS: A pseudo-randomised controlled trial was conducted on 30 critically ill mechanically ventilated patients receiving EN for more than 72 h. Patients were randomly assigned into the following groups: an experimental group that received CEN and a control group that received BEN. Furthermore, patients' health characteristics data as well as the incidence of aspiration and GI complications (high gastric residual volume "HGRV", vomiting, diarrhoea, and constipation) were subsequently collected. RESULTS: There were no statistically significant differences between the effects of CEN versus BEN groups on the occurrence of aspiration, HGRV, diarrhoea, or vomiting (P>0.05). However, constipation was significantly greater in patients receiving CEN (10 patients (66.7%)) as compared with those receiving BEN (3 patients (20%)) (P=0.025). CONCLUSION: CEN versus BEN methods did not affect the incidence of aspiration, HGRV, vomiting or diarrhoea. However, the incidence of constipation was significantly greater in patients receiving CEN.