Elif OZSU, Derya ACAR TEPE

Is vitamin D an important factor in hepatosteatosis in childhood obesity?

Childhood obesity is one of the most serious public health problems with obesity-related complications such as hepatosteatosis or type 2 diabetes occurring during early childhood. The aim of this study was to examine the relationship between 25-hydroxy vitamin D levels and obesity with hepatosteatosis (HS) in children. 128 obese children participated in this study. Hepatosteatosis was diagnosed and graded using ultrasonography in all patients. Serum levels of 25-hydroxy vitamin D, calcium, phosphate, alkaline phosphatase (ALP), parathormone (PTH), lipid, glucose and insulin were also measured. The data was analyzed across two groups of obese children – those with hepatosteatosis and those without hepatosteatosis. Forty-two percent of the study group were male. The mean age of the subjects was 12.1±3.1 years (range 4-18 years). Hepatosteatosis was identified in 39% of children (n: 50). A high prevalence (122/128 cases, 95%) of either 25-hydroxy vitamin D deficiency or insufficiency was determined. However, there was no statistically significant association between 25-hydroxy vitamin D levels and hepatosteatosis. Uric acid, alanine aminotransferase (ALT) and triglyceride levels were significantly higher in the HS group compared to non-HS group. There is a high prevalence of 25-hydroxy vitamin D deficiency and insufficiency among children with hepatosteatosis. However, in this study, no association was observed between 25-hydroxy vitamin D deficiency and hepatosteatosis.

PDF

___

Koyuncuoğlu Güngör Neslihan. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol. 2014;6:129-43.

Nobili V , Alkhouri N, Alisi A, et al. Nonalcoholic fatty liver disease: a challenge for pediatrician Jama Pediatr. 2015;169:170-6.

Kurtoğlu S, Hatipoğlu N, Mazıcıoğlu M, et al. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. Clin Res Pediatr Endocrinol. 2010;2:100-6.

Styne DM, Arslanian SA, Connor EL, et al. Pediatric obesity-assessment, treatment, and prevention: an endocrine societyclinical practice guideline. Clin Endocrinol Metab. 2017;102:709-57.

Saggese G, Vierucci F, Boot AM, et al. Vitamin D in childhood and adolescence: an expert position statement. Eur J Pediatr. 2015;174:565-76.

Katz K, Brar PC, Parekh N, et al. Suspected nonalcoholic Fatty liver disease is not associated with vitamin d status in adolescents after adjustment for obesity.J Obes. 2010;2010:1-7.

Abdelghany AH, BaSalamah MA, Idris S, et al. The fibrolytic potentials of vitamin D and thymoquinone remedial therapies: insights from liver fibrosis established by CCl4 in rats. J Transl Med. 2016;14:281.

Roth CL, Elfers CT, Figlewicz DP, et al. Vitamin D deficiency in obese rats exacerbates nonalcoholic fatty liver disease and increases hepatic resistin and toll-like receptor activation. Hepatology. 2012;55:1103-11.

Liu XJ, Wang BW, Zhang C et al. Vitamin D deficiency attenuates high-fat diet-induced hyperinsulinemia and hepatic lipid accumulation in male mice. Endocrinology. 2015;156:2103-13.

10. Hourigan SK, Abrams S, Yates K et al. Relation between vitamin D status and nonalcoholic fatty liver disease in children. AO.J Pediatr Gastroenterol Nutr. 2015;60:396-404.

11. Yildiz I, Erol OB, Toprak S, et al. Role of vitamin D in children with hepatosteatosis. J Pediatr Gastroenterol Nutr. 2014;59:106-11.

12. Nobili V, Giorgio V, Liccardo D et al. Vitamin D levels and liver histological alterations in children with nonalcoholic fatty liver disease. Eur J Endocrinol. 2014;8:547-53.

13. 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 ;17:51724.

14. Karagüzel G , Dilber B, Çan G, et al. Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status. J Pediatr Gastroenterol Nutr. 2014;58:654-60.

15. Day C, Saksena S: Non-alcoholic steatohepatitis: Definitions and pathogenesis. J Gastroenterol Hepatol. 2002;17:377–84.

16. Xiong MA, Zhiping L, Sisheaansegshai Branch. Pathogenesis of nonalcoholic steatohepatitis (NASH). Chin J Digestive Diseases 2006;7:7–11.

17. Zhou Y, Wei F, Fan Y. High serum uric acid and risk of nonalcoholic fatty liver disease: A systematic review and meta-analysis. Clin Biochem. 2016;49:63642.

18. Kim YS, Jung ES, Hur W. et al . Noninvasive predictors of nonalcoholic steatohepatitis in Korean patients with histologically proven nonalcoholic fatty liver disease. Clin Mol Hepatol. 2013;19:120-30.