Expression of serum 25-hydroxyvitamin D and its clinical significance in patients with nonalcoholic fatty liver disease and obesity / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the serum level of 25-hydroxyvitamin D in patients with nonalcoholic fatty liver disease （NAFLD） and obesity， as well as the correlation of 25-hydroxyvitamin D with liver function， blood lipids， and inflammatory indicators. MethodsA total of 90 patients with NAFLD who attended Shanxi Bethune Hospital from January 2022 to March 2023 were enrolled， and according to the body mass index （BMI）， they were divided into NAFLD+obesity group with 60 patients （BMI≥28 kg/m2） and NAFLD group with 30 patients （BMI<28 kg/m2）； 30 individuals who underwent physical examination during the same period of time were enrolled as control group. Related indications were measured for all three groups， including serum 25-hydroxyvitamin D， liver function parameters （alanine aminotransferase ［ALT］， aspartate aminotransferase ［AST］， alkaline phosphatase ［ALP］， gamma-glutamyl transpeptidase ［GGT］， total bilirubin ［TBil］， and direct bilirubin ［DBil］）， blood lipid parameters （high-density lipoprotein ［HDL］， low-density lipoprotein ［LDL］， total cholesterol ［TC］， and triglyceride ［TG］）， inflammatory indicators （high-sensitivity C-reactive protein ［H-CRP］ and Golgi protein 73 ［GP-73］）， cytokines （interleukin-2 ［IL-2］， interleukin-4 ［IL-4］， interleukin-6 ［IL-6］， interleukin-10 ［IL-10］， interleukin-17 ［IL-17］， interleukin-1β ［IL-1β］， tumor necrosis factor-α ［TNF-α］， and interferon gamma ［IFN-γ］）， and liver/spleen volume ratio. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the least significant difference t-test or the Tamhane’s T2 test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and further comparison between two groups. A Pearson or Spearman correlation analysis was performed. ResultsCompared with the control group， the NAFLD+obesity group had significant reductions in 25-hydroxyvitamin D， HDL， cytokines （IL-2， IL-4， IL-10， and IFN-γ）， and liver/spleen volume ratio （all P<0.05）， as well as significant increases in liver function parameters （ALT， AST， ALP， GGT， TBil， and DBil）， blood lipid parameters （LDL， TC， and TG）， inflammatory indicators （H-CRP and GP-73）， and cytokines （IL-1β， IL-17， and TNF-α） （all P<0.05）. There were significant differences between the NAFLD+obesity group and the NAFLD group in all the above indicators except liver/spleen volume ratio and H-CRP （all P<0.05）. The correlation analysis showed that 25-hydroxyvitamin D level was negatively correlated with ALT （r=-0.324， P=0.012）， AST （r=-0.421， P=0.001）， ALP （r=-0.435， P=0.001）， GGT （r=-0.343， P=0.007）， TBil （r=-0.532， P<0.001）， DBil （r=-0.521， P<0.001）， LDL （r=-0.405， P=0.001）， TC （r=-0.466， P<0.001）， TG （r=-0.551， P<0.001）， H-CRP （r=-0.434， P=0.014）， GP-73 （r=-0.421， P=0.001）， IL-1β （r=-0.433， P=0.001）， IL-17 （r=-0.465， P<0.001）， and TNF-α （r=-0.533， P<0.001）， and it was positively correlated with HDL （r=0.632， P<0.001）， IL-2 （r=0.546， P<0.001）， IL-4 （r=0.533， P<0.001）， IL-10 （r=0.456， P<0.001）， and liver/spleen volume ratio （r=0.543， P<0.001）. ConclusionSerum 25-hydroxyvitamin D is significantly correlated with liver function parameters， blood lipid parameters， and inflammatory indicators in patients with NAFLD and obesity， and it may alleviate the symptoms of patients with NAFLD and obesity by reducing inflammatory response， which provides new intervention strategies for the treatment of NAFLD.