title: Low vitamin D status is associated with nonalcoholic Fatty liver disease independent of visceral obesity in Korean adults.
abstract: OBJECTIVE
  To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and nonalcoholic fatty liver disease (NAFLD) independent of visceral obesity in Koreans and to examine whether the associations differ according to the presence of diabetes or insulin resistance.
  
  
  METHODS
  A total of 1081 adults were enrolled from a population-based cohort in Ansan city. Serum 25(OH)D concentrations were measured in all subjects. Insulin resistance was measured by homeostasis model assessment of insulin resistance (HOMA-IR). Using computed tomography, NAFLD was diagnosed if the liver attenuation index (LAI, the difference between the mean hepatic and splenic attenuation) was <5 Hounsfield Units.
  
  
  RESULTS
  In subjects with diabetes (n = 282), 25(OH)D levels were negatively associated with waist circumference, fasting insulin, HOMA-IR, triglyceride levels, and visceral abdominal fat, and were positively associated with LAI after adjusting for age, sex, season, exercise, and vitamin supplementation. In subjects without diabetes, only triglyceride level was negatively associated with 25(OH)D. The adjusted odds ratio (OR) for NAFLD increased sequentially across decreasing quartiles of 25(OH)D in subjects with diabetes even after adjusting for visceral fat [Q1 vs. Q4; OR for NAFLD 2.5 (95% CI:1.0-6.2)]. In contrast, no significant difference in OR was observed in subjects without diabetes. When we classified non-diabetic subjects by HOMA-IR, an increase in the OR for NAFLD across decreasing quartiles of 25(OH)D was observed in the high HOMA-IR (≥2.5) group [n = 207, Q1 vs. Q4; OR 3.8(1.4-10.3)], but not in the low HOMA-IR (<2.5) group [n = 592, OR 0.8 (0.3-1.9)].
  
  
  CONCLUSIONS
  Low vitamin D status is closely associated with NAFLD, independent of visceral obesity in subjects with diabetes or insulin resistance.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ji A
authors.initials: JA
authors.lastname: Seo
authors.forename: Chai Ryoung
authors.initials: CR
authors.lastname: Eun
authors.forename: Hyunjoo
authors.initials: H
authors.lastname: Cho
authors.forename: Seung Ku
authors.initials: SK
authors.lastname: Lee
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Yoo
authors.forename: Sin Gon
authors.initials: SG
authors.lastname: Kim
authors.forename: Kyung Mook
authors.initials: KM
authors.lastname: Choi
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Baik
authors.forename: Dong Seop
authors.initials: DS
authors.lastname: Choi
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
authors.forename: Nan Hee
authors.initials: NH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D005234:Fatty Liver / Q000097:blood* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D056128:Obesity, Abdominal / Q000150:complications*; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D