Correlation Between 25 Hydroxyvitamin D Levels and Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Abstract

Purpose

We aimed to analyze the serum vitamin D level in Chinese patients with type 2 diabetes mellitus (T2DM) and discuss its correlation with nonalcoholic fatty liver disease (NAFLD).

Patients and Methods

A total of 300 patients with T2DM (92 patients without NAFLD and 208 patients with NAFLD) were enrolled, and 25-hydroxyvitamin D [25-(OH)D] levels were compared between the two groups. Second, the NAFLD fibrosis score (NFS) and fatty liver index (FLI) were used to group patients with T2DM complicated by NAFLD, and the differences in serum 25-(OH)D in patients with different degrees of liver fibrosis were compared. Third, multiple regression analysis was used to analyze the independent predictors of liver fibrosis in patients with T2DM complicated by NAFLD.

Results

The level of 25-(OH)D in patients with T2DM complicated by NAFLD was significantly lower than that in patients with T2DM alone. Based on the NFS and FLI, the 25-(OH)D level of the hepatic fibrosis subgroup was significantly lower than that of the subgroup without liver fibrosis. 25-(OH)D was found to be an independent predictor of liver fibrosis in patients with T2DM complicated by NAFLD.

Conclusion

The serum 25-(OH)D level in patients with T2DM complicated by NAFLD was significantly reduced, and the 25-(OH)D level showed a gradual downward trend with the degree of liver fibrosis. Low concentrations of 25-(OH)D may be indicative of the degree of liver fibrosis in diabetic patients.

Keywords:

• type 2 diabetes mellitus
• nonalcoholic fatty liver disease
• 25-hydroxyvitamin D
• liver fibrosis

Abbreviations

T2DM, type 2 diabetes mellitus; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; 25-(OH)D, 25-hydroxyvitamin D; NFS, NAFLD fibrosis score; FLI, fatty liver index; FIB-4, Fibrosis-4; BTMs, Bone turnover markers; PINP, N-terminal collagen type I extension peptide; ALP, alkaline phosphatase; β-CTX, β-isomerized C-terminal peptide of type I collagen; PTH, parathyroid hormone; ALT, alanine transaminase; AST, aspartate aminotransferase; GGT, amma-glutamyl transpeptidase; TG, triglyceride.

Data Sharing Statement

The main data analyzed in this study were included in the published article.

Ethics Approval and Informed Consent

The authors take responsibility for all aspects of the work and for ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study conformed to the provisions of the Declaration of Helsinki (as revised in 2013). The study was approved by the Scientific Research Ethics Committee of Beijing Shijitan Hospital affiliated with Capital Medical University (research ethics No. 37 in 2021), and informed consent was obtained from the research subjects.

Consent for Publication

All participants agreed to publication of the study.

Disclosure

All authors have no conflicts of interest to declare.

Additional information

Funding

This work was supported by the China Railway Corporation (grant number J2016Z029).