Skip to main content
Erschienen in: Obesity Surgery 9/2016

19.01.2016 | Original Contributions

Severe Vitamin D Deficiency Is Not Associated with Liver Damage in Morbidly Obese Patients

verfasst von: Rodolphe Anty, Audrey Hastier, Clémence M. Canivet, Stéphanie Patouraux, Anne-Sophie Schneck, Patricia Ferrari-Panaia, Imed Ben-Amor, Marie Christine Saint-Paul, Jean Gugenheim, Philippe Gual, Antonio Iannelli, Albert Tran

Erschienen in: Obesity Surgery | Ausgabe 9/2016

Einloggen, um Zugang zu erhalten

Abstract

Background and Aims

A deficiency in vitamin D could be deleterious during chronic liver diseases. However, contradictory data have been published in patients with non-alcoholic fatty liver disease. The aim of the study was to compare the blood level of 25 hydroxy vitamin D (25-OH vitamin D) with the severity of liver lesions, in a large cohort of morbidly obese patients.

Patients and Method

Three hundred ninety-eight morbidly obese patients had a liver biopsy. The non-alcoholic steatohepatitis (NASH) Clinical Research Network Scoring System Definition and Scores were used. 25-OH vitamin D was evaluated with a Diasorin®Elisa Kit. Logistic regression analyses were performed to obtain predictive factors of the severity of liver histology.

Results

20.6 % of patients had NASH. The stage of fibrosis was F0 12.9 %, F1 57.36 %, F2 25.32 %, F3 (bridging fibrosis) 3.88 %, and F4 (cirrhosis) 0.52 %. The 25-OH vitamin D level inversely correlated to the NAS (r = 0.12 and p = 0.01) and to steatosis (r = 0.14 and p = 0.007); however, it was not associated with the presence of NASH. The level of vitamin D was significantly lower in patients with significant fibrosis compared to those without (15.9 (11.1–23.5) vs 19.6 (13.7–24.7) ng/ml, p = 0.02). There was an inverse correlation between the severity of fibrosis and the values of 25-OH vitamin D (r = 0.12 and p = 0.01).
In a logistic regression analysis, no parameters were independently associated with the severity of fibrosis except the presence of steatohepatitis (1.94 (1.13–3.35) p = 0.017).

Conclusion

Low levels of 25-OH vitamin D were not independently associated with liver damage in morbidly obese patients with non-alcoholic fatty liver diseases (NAFLD).
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Wacker M, Holick MF. Vitamin D—effects on skeletal and extraskeletal health and the need for supplementation. Nutr. 2013;5:111–48. Wacker M, Holick MF. Vitamin D—effects on skeletal and extraskeletal health and the need for supplementation. Nutr. 2013;5:111–48.
2.
Zurück zum Zitat Rahman AH, Branch AD. Vitamin D for your patients with chronic hepatitis C? J Hepatol. 2013;58:184–9.CrossRefPubMed Rahman AH, Branch AD. Vitamin D for your patients with chronic hepatitis C? J Hepatol. 2013;58:184–9.CrossRefPubMed
3.
Zurück zum Zitat Kwok RM, Torres DM, Harrison SA. Vitamin D and nonalcoholic fatty liver disease (NAFLD): is it more than just an association? Hepatol Baltim Md. 2013;58:1166–74.CrossRef Kwok RM, Torres DM, Harrison SA. Vitamin D and nonalcoholic fatty liver disease (NAFLD): is it more than just an association? Hepatol Baltim Md. 2013;58:1166–74.CrossRef
4.
Zurück zum Zitat Blachier M, Leleu H, Peck-Radosavljevic M, et al. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol. 2013;58:593–608.CrossRefPubMed Blachier M, Leleu H, Peck-Radosavljevic M, et al. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol. 2013;58:593–608.CrossRefPubMed
5.
Zurück zum Zitat Wortsman J, Matsuoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72:690–3.PubMed Wortsman J, Matsuoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72:690–3.PubMed
6.
Zurück zum Zitat Stein EM, Strain G, Sinha N, et al. Vitamin D insufficiency prior to bariatric surgery: risk factors and a pilot treatment study. Clin Endocrinol (Oxf). 2009;71:176–83.CrossRef Stein EM, Strain G, Sinha N, et al. Vitamin D insufficiency prior to bariatric surgery: risk factors and a pilot treatment study. Clin Endocrinol (Oxf). 2009;71:176–83.CrossRef
7.
8.
Zurück zum Zitat 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 NMCD. 2007;17:517–24.CrossRefPubMed 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 NMCD. 2007;17:517–24.CrossRefPubMed
9.
Zurück zum Zitat 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 Eur Fed Endocr Soc. 2014;170:547–53.CrossRef 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 Eur Fed Endocr Soc. 2014;170:547–53.CrossRef
10.
Zurück zum Zitat Manco M, Ciampalini P, Nobili V. Low levels of 25-hydroxyvitamin D(3) in children with biopsy-proven nonalcoholic fatty liver disease. Hepatol Baltim Md. 2010;51:2229. author reply 2230.CrossRef Manco M, Ciampalini P, Nobili V. Low levels of 25-hydroxyvitamin D(3) in children with biopsy-proven nonalcoholic fatty liver disease. Hepatol Baltim Md. 2010;51:2229. author reply 2230.CrossRef
11.
Zurück zum Zitat Dasarathy J, Periyalwar P, Allampati S, et al. Hypovitaminosis D is associated with increased whole body fat mass and greater severity of non-alcoholic fatty liver disease. Liver Int. 2014;34:e118–27.CrossRefPubMed Dasarathy J, Periyalwar P, Allampati S, et al. Hypovitaminosis D is associated with increased whole body fat mass and greater severity of non-alcoholic fatty liver disease. Liver Int. 2014;34:e118–27.CrossRefPubMed
12.
Zurück zum Zitat Bril F, Maximos M, Portillo-Sanchez P, et al. Relationship of vitamin D with insulin resistance and disease severity in non-alcoholic steatohepatitis. J Hepatol. 2015;62:405–11.CrossRefPubMed Bril F, Maximos M, Portillo-Sanchez P, et al. Relationship of vitamin D with insulin resistance and disease severity in non-alcoholic steatohepatitis. J Hepatol. 2015;62:405–11.CrossRefPubMed
13.
14.
Zurück zum Zitat Baeke F, Takiishi T, Korf H, et al. Vitamin D: modulator of the immune system. Curr Opin Pharmacol. 2010;10:482–96.CrossRefPubMed Baeke F, Takiishi T, Korf H, et al. Vitamin D: modulator of the immune system. Curr Opin Pharmacol. 2010;10:482–96.CrossRefPubMed
15.
Zurück zum Zitat Dey A, Cederbaum AI. Alcohol and oxidative liver injury. Hepatol Baltim Md. 2006;43:S63–74.CrossRef Dey A, Cederbaum AI. Alcohol and oxidative liver injury. Hepatol Baltim Md. 2006;43:S63–74.CrossRef
16.
Zurück zum Zitat Anty R, Canivet CM, Patouraux S, et al. Severe vitamin D deficiency may be an additional cofactor for the occurrence of alcoholic steatohepatitis. Alcohol Clin Exp Res. 2015;39:1027–33.CrossRefPubMed Anty R, Canivet CM, Patouraux S, et al. Severe vitamin D deficiency may be an additional cofactor for the occurrence of alcoholic steatohepatitis. Alcohol Clin Exp Res. 2015;39:1027–33.CrossRefPubMed
17.
Zurück zum Zitat NIH conference. Gastrointestinal surgery for severe obesity—consensus development conference panel. Ann Intern Med. 1991;115:956–61.CrossRef NIH conference. Gastrointestinal surgery for severe obesity—consensus development conference panel. Ann Intern Med. 1991;115:956–61.CrossRef
18.
Zurück zum Zitat Brunt EM, Janney CG, Di Bisceglie AM, et al. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol. 1999;94:2467–74.CrossRefPubMed Brunt EM, Janney CG, Di Bisceglie AM, et al. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol. 1999;94:2467–74.CrossRefPubMed
19.
Zurück zum Zitat Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatol Baltim Md. 2005;41:1313–21.CrossRef Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatol Baltim Md. 2005;41:1313–21.CrossRef
20.
Zurück zum Zitat Kitson MT, Dore GJ, George J, et al. Vitamin D status does not predict sustained virologic response or fibrosis stage in chronic hepatitis C genotype 1 infection. J Hepatol. 2013;58:467–72.CrossRefPubMed Kitson MT, Dore GJ, George J, et al. Vitamin D status does not predict sustained virologic response or fibrosis stage in chronic hepatitis C genotype 1 infection. J Hepatol. 2013;58:467–72.CrossRefPubMed
21.
Zurück zum Zitat Anty R, Tonohouan M, Ferrari-Panaia P, et al. Low levels of 25-hydroxy vitamin D are independently associated with the risk of bacterial infection in cirrhotic patients. Clin Transl Gastroenterol. 2014;5, e56.CrossRefPubMedPubMedCentral Anty R, Tonohouan M, Ferrari-Panaia P, et al. Low levels of 25-hydroxy vitamin D are independently associated with the risk of bacterial infection in cirrhotic patients. Clin Transl Gastroenterol. 2014;5, e56.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Trépo E, Ouziel R, Pradat P, et al. Marked 25-hydroxyvitamin D deficiency is associated with poor prognosis in patients with alcoholic liver disease. J Hepatol. 2013;59:344–50.CrossRefPubMed Trépo E, Ouziel R, Pradat P, et al. Marked 25-hydroxyvitamin D deficiency is associated with poor prognosis in patients with alcoholic liver disease. J Hepatol. 2013;59:344–50.CrossRefPubMed
23.
Zurück zum Zitat Eliades M, Spyrou E, Agrawal N, et al. Meta-analysis: vitamin D and non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2013;38:246–54.CrossRefPubMed Eliades M, Spyrou E, Agrawal N, et al. Meta-analysis: vitamin D and non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2013;38:246–54.CrossRefPubMed
24.
Zurück zum Zitat Barchetta I, Carotti S, Labbadia G, et al. Liver vitamin D receptor, CYP2R1, and CYP27A1 expression: relationship with liver histology and vitamin D3 levels in patients with nonalcoholic steatohepatitis or hepatitis C virus. Hepatol Baltim Md. 2012;56:2180–7.CrossRef Barchetta I, Carotti S, Labbadia G, et al. Liver vitamin D receptor, CYP2R1, and CYP27A1 expression: relationship with liver histology and vitamin D3 levels in patients with nonalcoholic steatohepatitis or hepatitis C virus. Hepatol Baltim Md. 2012;56:2180–7.CrossRef
25.
Zurück zum Zitat Barchetta I, Angelico F, Del Ben M, et al. Strong association between non alcoholic fatty liver disease (NAFLD) and low 25(OH) vitamin D levels in an adult population with normal serum liver enzymes. BMC Med. 2011;9:85.CrossRefPubMedPubMedCentral Barchetta I, Angelico F, Del Ben M, et al. Strong association between non alcoholic fatty liver disease (NAFLD) and low 25(OH) vitamin D levels in an adult population with normal serum liver enzymes. BMC Med. 2011;9:85.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Earthman CP, Beckman LM, Masodkar K, et al. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. Int J Obes. 2005;36:387–96. 2012.CrossRef Earthman CP, Beckman LM, Masodkar K, et al. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. Int J Obes. 2005;36:387–96. 2012.CrossRef
27.
Zurück zum Zitat Coupaye M, Breuil MC, Rivière P, et al. Serum vitamin D increases with weight loss in obese subjects 6 months after Roux-en-Y gastric bypass. Obes Surg. 2013;23:486–93.CrossRefPubMed Coupaye M, Breuil MC, Rivière P, et al. Serum vitamin D increases with weight loss in obese subjects 6 months after Roux-en-Y gastric bypass. Obes Surg. 2013;23:486–93.CrossRefPubMed
28.
Zurück zum Zitat Beckman LM, Earthman CP, Thomas W, et al. Serum 25(OH) vitamin D concentration changes after Roux-en-Y gastric bypass surgery. Obes Silver Spring Md. 2013;21:E599–606.CrossRef Beckman LM, Earthman CP, Thomas W, et al. Serum 25(OH) vitamin D concentration changes after Roux-en-Y gastric bypass surgery. Obes Silver Spring Md. 2013;21:E599–606.CrossRef
29.
Zurück zum Zitat Wamberg L, Christiansen T, Paulsen SK, et al. Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss. Int J Obes. 2005;37:651–7. 2013.CrossRef Wamberg L, Christiansen T, Paulsen SK, et al. Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss. Int J Obes. 2005;37:651–7. 2013.CrossRef
30.
Zurück zum Zitat Makki K, Froguel P, Wolowczuk I. Adipose tissue in obesity-related inflammation and insulin resistance: cells, cytokines, and chemokines. ISRN Inflamm. 2013;2013:139239.CrossRefPubMedPubMedCentral Makki K, Froguel P, Wolowczuk I. Adipose tissue in obesity-related inflammation and insulin resistance: cells, cytokines, and chemokines. ISRN Inflamm. 2013;2013:139239.CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Bekri S, Gual P, Anty R, et al. Increased adipose tissue expression of hepcidin in severe obesity is independent from diabetes and NASH. Gastroenterology. 2006;131:788–96.CrossRefPubMed Bekri S, Gual P, Anty R, et al. Increased adipose tissue expression of hepcidin in severe obesity is independent from diabetes and NASH. Gastroenterology. 2006;131:788–96.CrossRefPubMed
32.
Zurück zum Zitat Bertola A, Deveaux V, Bonnafous S, et al. Elevated expression of osteopontin may be related to adipose tissue macrophage accumulation and liver steatosis in morbid obesity. Diabetes. 2009;58:125–33.CrossRefPubMedPubMedCentral Bertola A, Deveaux V, Bonnafous S, et al. Elevated expression of osteopontin may be related to adipose tissue macrophage accumulation and liver steatosis in morbid obesity. Diabetes. 2009;58:125–33.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Anty R, Bekri S, Luciani N, et al. The inflammatory C-reactive protein is increased in both liver and adipose tissue in severely obese patients independently from metabolic syndrome, Type 2 diabetes, and NASH. Am J Gastroenterol. 2006;101:1824–33.CrossRefPubMed Anty R, Bekri S, Luciani N, et al. The inflammatory C-reactive protein is increased in both liver and adipose tissue in severely obese patients independently from metabolic syndrome, Type 2 diabetes, and NASH. Am J Gastroenterol. 2006;101:1824–33.CrossRefPubMed
Metadaten
Titel
Severe Vitamin D Deficiency Is Not Associated with Liver Damage in Morbidly Obese Patients
verfasst von
Rodolphe Anty
Audrey Hastier
Clémence M. Canivet
Stéphanie Patouraux
Anne-Sophie Schneck
Patricia Ferrari-Panaia
Imed Ben-Amor
Marie Christine Saint-Paul
Jean Gugenheim
Philippe Gual
Antonio Iannelli
Albert Tran
Publikationsdatum
19.01.2016
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 9/2016
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2070-y

Weitere Artikel der Ausgabe 9/2016

Obesity Surgery 9/2016 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.