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

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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).

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Abbreviations

25-OH vitamin D:

25 hydroxy vitamin D

BMI:

Body mass index

AST:

Aspartate amino-transferase

ALT:

Alanine amino-transferase

γGT:

Gamma glutamyl-transferase

HDL cholesterol:

High-density-lipoprotein cholesterol

NAFLD:

Non-alcoholic fatty liver disease

NAS:

NAFLD activity score

NASH:

Non-alcoholic steatohepatitis

W:

Women

M:

Men

NS:

Not significant

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Acknowledgments

We thank Ms. C. Brahimi-Horn for the medical editing of the paper and Ms. A. Fafin for her work and her unfailing support. This study is in memory of Jean Gabriel Bernard-Cuisinier and Prof Pierre-Michel Huet.

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Authors and Affiliations

  1. Institut National de la Santé et de la Recherche Médicale (INSERM), U1065, Team 8, “Hepatic Complications in Obesity”, Nice, F-06204, Cedex 3, France

    Rodolphe Anty, Clémence M. Canivet, Stéphanie Patouraux, Anne-Sophie Schneck, Jean Gugenheim, Philippe Gual, Antonio Iannelli & Albert Tran

  2. Pôle Référence Hépatite C, Hôpital de l’Archet 2, Centre Hospitalier Universitaire of Nice, 151, Route Saint-Antoine de Ginestière, BP 3079, F-06202, Nice, Cedex 3, France

    Rodolphe Anty, Audrey Hastier, Clémence M. Canivet, Anne-Sophie Schneck, Imed Ben-Amor, Jean Gugenheim, Antonio Iannelli & Albert Tran

  3. Faculty of Medecine, University of Nice-Sophia-Antipolis, Nice, F-06107, Cedex 2, France

    Rodolphe Anty, Clémence M. Canivet, Stéphanie Patouraux, Anne-Sophie Schneck, Jean Gugenheim, Philippe Gual, Antonio Iannelli & Albert Tran

  4. Biological Centre, Centre Hospitalier Universitaire of Nice, Nice, F-06107, Cedex 2, France

    Stéphanie Patouraux, Patricia Ferrari-Panaia & Marie Christine Saint-Paul

Authors
  1. Rodolphe Anty
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  2. Audrey Hastier
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  3. Clémence M. Canivet
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  4. Stéphanie Patouraux
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  5. Anne-Sophie Schneck
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  8. Marie Christine Saint-Paul
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  9. Jean Gugenheim
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  10. Philippe Gual
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  11. Antonio Iannelli
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  12. Albert Tran
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Corresponding author

Correspondence to Rodolphe Anty.

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Conflict of Interest

The authors declare that they have no competing interests.

Financial Support

This work was supported by grants from the Institut National de la Santé et de la Recherche Médicale (INSERM) (France), the University of Nice and the Programme Hospitalier de Recherche Clinique (Centre Hospitalier Universitaire of Nice). This work was funded by the French Government (National Research Agency, ANR) through the “Investments for the Future” LABEX SIGNALIFE: program reference no. ANR-11-LABX-0028-01.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Additional information

This work was done in the Digestive centre of the “Centre hospitalier universitaire” of Nice France.

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Anty, R., Hastier, A., Canivet, C.M. et al. Severe Vitamin D Deficiency Is Not Associated with Liver Damage in Morbidly Obese Patients. OBES SURG 26, 2138–2143 (2016). https://doi.org/10.1007/s11695-016-2070-y

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