Non-Alcoholic Fatty Liver Disease is Not Associated with Vitamin D Deficiency in Essential Hypertension

  • Cristiana Catena
  • Chiara Cosma
  • Valentina Camozzi
  • Mario Plebani
  • Mario Ermani
  • Leonardo A. Sechi
  • Francesco Fallo
Original Research Article


An independent association between non-alcoholic fatty liver disease (NAFLD), a condition characterized by insulin-resistance, and low serum 25-hydroxyvitamin D [25(OH)D] levels has been reported. 25(OH)D concentrations are directly related with insulin sensitivity, whereas low [25(OH)D] predicts development of hypertension independent of glucose homeostasis alterations. We hypothesized that hypertensive patients with NAFLD have lower 25(OH)D than those without. Forty-four essential hypertensive (EH) patients with (n = 23) or without (n = 21) NAFLD were studied. No patient had diabetes mellitus, obesity, hyperlipidemia. The two hypertensive groups were compared with 24 healthy normotensive sex-, age-, body mass index (BMI)-matched subject, as controls. The two hypertensive groups had comparable age, sex, and blood pressure. BMI, glucose, insulin, homeostasis model assessment (HOMA) index and alanine aminotransferase were higher (P < 0.001 to <0.05) and plasma adiponectin was lower (P < 0.05) in EH patients with NAFLD than in those without NAFLD. Vitamin D deficiency, as defined by 25(OH)D levels <50 nmol/L, was similarly frequent in EH patients and controls (47.7 % vs. 45.8 %, P NS). Prevalence of hypovitaminosis D was not different in EH patients with and without NAFLD (37.5 % vs. 38.8 %, P NS). In patients with EH and no additional cardiometabolic risk factors NAFLD is not associated with vitamin D deficiency.


Essential hypertension NAFLD Vitamin D 


  1. 1.
    Angulo P. GI epidemiology: non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2007;25:883–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Kotronen A, Yki-Jarvinen H. Fatty liver: a novel component of the metabolic syndrome. Arterioscler Thromb Vasc Biol. 2008;28:27–38.PubMedCrossRefGoogle Scholar
  3. 3.
    Fallo F, Dalla Pozza A, Sonino N, Lupia M, Tona F, Federspil G, Ermani M, et al. Non-alcoholic fatty liver disease is associated with left ventricular diastolic dysfunction in essential hypertension. Nutr Metab Cardiovasc Disc. 2009;19:646–53.CrossRefGoogle Scholar
  4. 4.
    Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010;363:1341–50.PubMedCrossRefGoogle Scholar
  5. 5.
    Barchetta I, Angelico F, Del Ben M, Baroni MG, Pozzilli P, Morini S, 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.PubMedCrossRefGoogle Scholar
  6. 6.
    Zúñiga S, Firrincieli D, Housset C, Chignard N. Vitamin D and the vitamin D receptor in liver pathophysiology. Clin Res Hepatol Gastroenterol. 2011;35:295–302.PubMedCrossRefGoogle Scholar
  7. 7.
    Kitson MT, Roberts SK. D-Livering the message: the importance of vitamin D status in chronic liver disease. J Hepatol. 2012;57:897–909.PubMedCrossRefGoogle Scholar
  8. 8.
    Rosen CJ. Clinical practice. Vitamin D insufficiency. N Engl J Med. 2011;364:248–54.PubMedCrossRefGoogle Scholar
  9. 9.
    Forouhi NG, Luan J, Cooper A, Boucher BJ, Wareham NJ. Baseline serum 25-hydroxyvitamin D is predictive of future glycemic status and insulin resistance: the Medical Research council Ely Prospective Study 1990–2000. Diabetes. 2008;57:2619–25.PubMedCrossRefGoogle Scholar
  10. 10.
    Liu E, Meigs JB, Pittas AG, McKeown NM, Economos CD, Booth SL, et al. Plasma 25-hydroxyvitamin D is associated with markers of the insulin resistance phenotype in nondiabetic adults. J Nutr. 2009;139:329–34.PubMedGoogle Scholar
  11. 11.
    Pilz S, Tomaschitz A, Ritz E, Pleber TR. Vitamin D status and arterial hypertension: a systematic review. Nat Rev Cardiol. 2009;6:621–30.PubMedCrossRefGoogle Scholar
  12. 12.
    Muldowney S, Kiely M. Vitamin D and cardiometabolic health: a review of the evidence. Nutr Res Rev. 2011;1:1–20.CrossRefGoogle Scholar
  13. 13.
    Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germanò G, et al. ESH-ESC Task Force on the Management of Arterial Hypertension 2007 Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87.PubMedCrossRefGoogle Scholar
  14. 14.
    Fallo F, Dalla Pozza A, Sonino N, Federspil G, Ermani M, Baroselli S, et al. Nonalcoholic fatty liver disease, adiponectin and insulin resistance in dipper and nondipper essential hypertensive patients. J Hypertens. 2008;26:2191–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Fallo F, Catena C, Camozzi V, Luisetto G, Cosma C, Plebani M, et al. Low serum 25-hydroxyvitamin D levels are associated with left ventricular hypertrophy in essential hypertension. Nutr Metab Cardiovasc Dis. 2012;22:871–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and cell dysfunction. Am J Clin Nutr. 2004;79:820–5.PubMedGoogle Scholar
  17. 17.
    Katz K, Brar PC, Parekh N, Liu YH, Weitzman M. Suspected nonalcoholic fatty liver disease is not associated with vitamin D status in adolescents after adjustment for obesity. J Obes. 2010; Article ID 496829.Google Scholar
  18. 18.
    Targher G, Bertolini L, Scala L, Cigolini M, Zenari L, Falezza G, 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;17:517–24.PubMedCrossRefGoogle Scholar
  19. 19.
    Tilg H, Moschen AR. Evolution of inflammation in nonalcoholic fatty liver disease: the multiple parallel hits hypothesis. Hepatology. 2010;52:1836–46.PubMedCrossRefGoogle Scholar
  20. 20.
    Zhou QG, Hou FF, Guo ZJ, Liang M, Wang GB. Dihydroxyvitamin D improved the free fatty-acid-induced insulin resistance in cultured C2C12 cells. Diabetes Metab Res. 2004;24:459–64.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Cristiana Catena
    • 1
  • Chiara Cosma
    • 2
  • Valentina Camozzi
    • 2
  • Mario Plebani
    • 2
  • Mario Ermani
    • 3
  • Leonardo A. Sechi
    • 1
  • Francesco Fallo
    • 2
  1. 1.Department of Experimental and Clinical MedicineUniversity of UdineUdineItaly
  2. 2.Department of Medicine, Clinica Medica 3University of PadovaPadovaItaly
  3. 3.Department of NeurosciencesUniversity of PadovaPadovaItaly

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