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Int J Clin Exp Med. 2015 Oct 15;8(10):17221-34. eCollection 2015.

Association between vitamin D and non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: results from a meta-analysis.

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Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University Zhengzhou, China.
Department of Oncology, The First Hospital of Yangquan City Yangquan, China.


The prevalence and impact of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) have continued to increase in recent years. Previous reports have shown that hypovitaminosis D is associated with the prevalence and severity of non-alcoholic fatty liver disease (NAFLD). The aim of this study was to systematically evaluate the association of vitamin D levels, as measured by serum 25-hydroxy vitamin D [25(OH)D], with NAFLD and NASH. We searched all of the publications that assessed the association between vitamin D and NAFLD/NASH in the PubMed and EMBASE databases up to November 2014. In total, twenty-nine articles met the eligibility criteria, including twenty-seven studies about NAFLD and four studies about NASH, which were identified and included in the meta-analysis. Twenty-nine cross-sectional and case-control studies evaluated the association between vitamin D and NAFLD/NASH. Twenty-three studies provided data for a quantitative meta-analysis. Compared with the controls, the NAFLD patients had significantly lower levels of 25(OH)D (SMD-0.76; 95% CI-0.97 to-0.54) and were 1.26 times more likely to be vitamin D deficient (OR 1.26, 95% CI: 1.15 to 1.38). Compared with the controls, the NASH patients had significantly lower levels of 25(OH)D (SMD-1.30; 95% CI-2.37 to -0.23). Although the cross-sectional studies did not allow us to determine a causal nexus, our meta-analysis found lower serum 25(OH)D levels in NAFLD/NASH patients than in subjects without NAFLD/NASH, which suggests that hypovitaminosis D could play a role in the pathogenesis of NAFLD/NASH. Further studies are required to establish the causality between vitamin D status and NAFLD.


Non-alcoholic steatohepatitis; meta-analysis; non-alcoholic fatty liver disease; vitamin D


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