The Association Between Vitamin D and Type 2 Diabetes Mellitus Complicated with Non-Alcoholic Fatty Liver Disease: An Observational Cross-Sectional Study

Figures & data

Table 1 Characteristics of Patients with and without NAFLD Included in This Study

	All Participants	Without NAFLD	With NAFLD	P value
n (%)	434	200	234	–
Age	58.74±12.92	60.79±11.99	56.98±13.45	0.004
Sex (F, %)	184 (42.4%)	85 (42.5%)	99(42.3%)	0.968
Hypertension (n, %)	217 (50%)	94 (47%)	123 (52.6%)	0.248
DM course (years)	9.87 (3, 15)	10.00 (3.00, 16.00)	8.00 (2.00, 15.00)	0.049
BMI (kg/m^2)	25.72±3.95	23.71±3.27	27.44±3.65	<0.001
Albumin (g/L)	40.18 (37.68, 42.93)	39.85 (37.60, 42.60)	40.80 (37.78, 43.20)	0.030
ALT (U/L)	24.42 (13.70, 28.50)	15.70 (12.53, 22.58)	21.20 (15.50, 34.45)	<0.001
AST (U/L)	22.50 (15.70, 24.10)	17.90 (14.63, 21.88)	20.00 (16.70, 26.80)	<0.001
GGT (U/L)	38.20 (17.15, 38.65)	20.60 (14.00, 29.63)	30.00 (19.60, 46.00)	<0.001
HbA1c (%)	8.97 (7.18, 10.50)	8.40 (6.90, 10.40)	8.80 (7.40, 10.50)	0.089
FPG (mmol/l)	8.87 (6.29, 11.15)	7.62 (6.12, 10.54)	8.38 (6.42, 11.54)	0.163
TC (mmol/L)	4.77 (3.88, 5.42)	4.45 (3.76, 5.18)	4.77 (4.01, 5.59)	0.002
TG (mmol/L)	2.05 (1.03, 2.33)	1.16 (0.87, 1.75)	1.86 (1.26, 2.71)	<0.001
HDL (mmol/L)	1.05 (0.84, 1.18)	1.04 (0.89, 1.24)	0.97 (0.83, 1.15)	0.002
LDL (mmol/L)	3.11 (2.46, 3.61)	2.90 (2.33, 3.48)	3.22 (2.59, 3.72)	0.004
VLDL (mmol/l)	0.51(0.35, 0.69)	0.43(0.28, 0.58)	0.57(0.40, 0.80)	<0.001
25(OH)D (mmol/l)	17.04 (12.99, 21.63)	18.27 (14.05, 24.63)	15.89 (12.33, 19.94)	<0.001
Vitamin D deficiency (%)	296 (68.2%)	118 (59%)	178 (76.1%)	<0.001

Table 2 Characteristics of Patients with and without Vitamin D Deficiency Included in This Study

	VDND	VDD	P value
n	138	296	–
Age	58.1756±12.91658	58.9965±12.94043	0.547
Sex (F, %)	39 (28.3%)	145 (49%)	<0.001
Hypertension (n, %)	60 (43.5%)	157 (53%)	0.064
NAFLD	56 (40.6%)	178 (60.1%)	<0.001
DM course (years)	7.5(3, 15)	9(3, 15)	0.834
BMI (kg/m^2)	25.345(22.865, 26.8975)	25.755(23.7025, 28.0975)	0.03
Albumin (g/L)	41.15(38.3, 43.8)	40.1(37.025, 42.6)	0.001
ALT (U/L)	19.85(13.925, 29.8)	18.4(13.7, 27.5)	0.66
AST (U/L)	19.1(15.7, 24.6)	19.2(15.7, 23.9)	0.988
GGT (U/L)	24.65(16.75, 37.6)	25.9(17.7, 38.7)	0.383
HbA1c (%)	8.2(6.875, 9.7)	8.9(7.4, 10.5)	0.002
FPG (mmol/l)	7.55(5.84, 10.62)	8.225(6.425, 11.18)	0.079
TC (mmol/L)	4.555(3.78, 5.2425)	4.665(3.8925, 5.505)	0.072
TG (mmol/L)	1.25(0.9175, 1.855)	1.655(1.0825, 2.4625)	<0.001
HDL-C (mmol/L)	1.01(0.88, 1.1825)	1(0.83, 1.1875)	0.345
LDL-C (mmol/L)	2.98(2.325, 3.4525)	3.09(2.47, 3.72)	0.071
VLDL (mmol/L)	0.46(0.3075, 0.61)	0.53(0.37, 0.72)	0.009

Figure 1 Comparison of 25(OH)D between the NAFLD group and the non-NAFLD group in participants with T2DM: (A) all participants; (B) participants with BMI >23kg/m²; (C) participants with BMI ≤23kg/m².

Figure 2 Comparison of the prevalence of NAFLD in T2DM patients with and without vitamin D deficiency: (A) all participants; (B) participants with BMI >23kg/m²; (C) participants with BMI ≤23kg/m².

Figure 3 Spearman correlation analysis of 25(OH)D with potential risk factors for NAFLD.

Table 3 Logistic Regression Analysis of Vitamin D Deficiency for NAFLD in Patients with T2DM

	B	Std. Error	Wald	P	OR	95% CI (OR)
Model 1	0.843	0.262	10.4	0.001	2.324	(1.392, 3.88)
Model 2	0.863	0.269	10.269	0.001	2.369	(1.398, 4.016)
Model 3	0.715	0.286	6.246	0.012	2.045	(1.167, 3.583)

Notes: Model 1: adjusted for sex, age, BMI, hypertension; Model 2: adjusted for sex, age, BMI, hypertension, DM course, albumin, ALT, AST, GGT; Model 3: adjusted for sex, age, BMI, hypertension, DM course, albumin, ALT, AST, GGT, FPG, TC, TG, HDL, LDL, VLDL, HbA1c.

Table 4 Logistic Regression Analysis of Vitamin D Deficiency for NAFLD in T2DM Patients with BMI ≤23kg/m²

	B	Std. Error	Wald	P	OR	95% CI
Model 1	0.862	0.696	1.534	0.216	2.367	(0.605, 9.261)
Model 2	0.245	0.782	0.098	0.754	1.278	(0.276, 5.921)
Model 3	−0.21	1.03	0.042	0.838	0.811	(0.108, 6.097)

Notes: Model 1: adjusted for sex, age, BMI, hypertension; Model 2: adjusted for sex, age, BMI, hypertension, DM course, albumin, ALT, AST, GGT; Model 3: adjusted for sex, age, BMI, hypertension, DM course, albumin, ALT, AST, GGT, FPG, TC, TG, HDL, LDL, HbA1c.

Table 5 Logistic Regression Analysis of Vitamin D Deficiency for NAFLD in T2DM Patients with BMI >23kg/m²

	B	Std. Error	Wald	P	OR	95% CI (OR)
Model 1	0.809	0.282	8.215	0.004	2.246	(1.292, 3.906)
Model 2	0.849	0.29	8.595	0.003	2.338	(1.325, 4.126)
Model 3	0.747	0.312	5.753	0.016	2.111	(1.146, 3.888)

Notes: Model 1: adjusted for sex, age, BMI, hypertension; Model 2: adjusted for sex, age, BMI, hypertension, DM course, albumin, ALT, AST, GGT; Model 3: adjusted for sex, age, BMI, hypertension, DM course, albumin, ALT, AST, GGT, FPG, TC, TG, HDL, LDL, VLDL, HbA1c.

Table 6 Effect of Vitamin D Deficiency on NAFLD Risk Stratified by Subgroups

Characteristics	No. of Participants	OR(95% CI)	P-value
Age (years)
≤65	306	2.374(1.144, 4.923)	0.02
>65	128	1.184(0.267, 5.248)	0.824
Sex
Males	250	1.345(0.633, 2.857)	0.44
Females	184	6.641(1.571, 28.072)	0.01
Hypertension
No	217	3.275(1.225, 8.759)	0.018
Yes	217	1.561(0.661, 3.687)	0.31
HBA1C (%)
≤9	246	1.986(0.899, 4.385)	0.09
>9	188	2.007(0.587, 6.86)	0.587
TG (mmol/l)
≥1.7	187	0.673(0.183, 2.477)	0.551
<1.7	247	2.813(1.297, 6.101)	0.009
HDL (mmol/l)
≥1 in men, ≥1.3 in women	149	4.947(1.204, 20.315)	0.027
<1 in men, <1.3 in women	285	2.04(0.905, 4.598)	0.085