Impact of vitamin D3 status on major clinical and laboratory parameters of patients with non-alcoholic fatty liver disease

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Non-alcoholic fatty liver disease (NAFLD) is a non-specific, integral and multifactorial organ damage in type 2 diabetes mellitus (T2DM), obesity, insulin resistance (IR), metabolic syndrome. Recently, vitamin D3 deficiency is considered one of the factors associa­ted with the development of NAFLD. Objective — to evaluate the functional state of the liver, steatosis indices, and metabolic profile parameters in patients with NAFLD depending on the availability of vitamin D3 to the patient’s body. Materials and methods. Аccording to the recom­men­dations of the European Association of Endocri­nologists, all patients were divided into 3 groups: group 1 — with an optimal level of vitamin D3 (30 ng/ml) group 2 — D3 insufficiency (21—29 ng/ml) and group 3 — D3 deficiency (< 20 ng/ml). The diagnosis of NAFLD was made on the basis of clinical analysis, transaminase activity and ultrasound examination. Results and discussion. The study included 126 patients with T2DM and concomitant NAFLD. Over 90 % of all examined showed overweight or obesity of varying degrees, and BMI and WC increased in parallel with a decrease in the concentration of vitamin D3. There was also a tendency to an increase in transaminase activity in parallel with a decrease in vitamin D3 levels, however, no significant difference between the groups was revealed. The maximum value of fatty hepatosis indices was diagnosed in patients with D3 deficiency, which was statistically significantly different from patients from the optimal support group (HSI — 43.34 ± 6.59 versus 39.67 ± 4.37; p = 0.032 and, respectively, for FLI — 79.21 ± 19,61 versus 64.96 ± 17.72; p = 0.007). For the TyG index, a tendency to its increase was demonstrated at the same time as the D3 status worsened (p = 0.175). The subanalysis found that the pronounced D3 deficiency (< 10 ng/ml) is characterized by statistically significantly higher indicators of fatty hepatosis indices, anthropometric parameters and transaminase activity compared with patients with a D3 level in the range of 10—20 ng/ml. Conclusions. Vitamin D3 deficiency in patients with NAFLD is characterized by statistically significantly higher indices of fatty hepatosis indices, anthropomet­ric parameters and transaminase activity compared to the optimal level or its insufficiency.