title: Vitamin D Status and Bone Mineral Density in Obese Children with Nonalcoholic Fatty Liver Disease.
abstract: Whether nonalcoholic fatty liver disease (NAFLD) is related to vitamin D and bone health in obese children is unknown. The aim of this study was to evaluate vitamin D status and bone mineral density (BMD) in obese children according to their condition within the NAFLD spectrum. Anthropometric data, laboratory tests, and abdominal ultrasonography were obtained from 94 obese children. The subjects were divided into three groups according to NAFLD spectrum: normal liver, simple steatosis, and nonalcoholic steatohepatitis (NASH). Although there were no differences in vitamin D levels between the three groups, these groups showed significant differences in highly sensitive C-reactive protein (P=0.044), homeostasis model assessment of insulin resistance (HOMA-IR) (P=0.02), hepatic fibrosis scores (P<0.05), and trunk fat percentage (P=0.025). Although there were significant differences in BMDs, the age-matched BMD z-scores were not significantly different between the three groups. Serum vitamin D levels were negatively correlated with age (r=-0.368, P=0.023), serum uric acid levels (r=-0.371, P=0.022), fibrosis 4 (FIB4) (r=-0.406, P=0.011), and HOMA-IR (r=-0.530, P=0.001) in obese children with NASH. Multiple regression analysis for vitamin D in the NASH group revealed age and HOMA-IR as significant factors. In conclusion, inflammatory markers, hepatic fibrosis scores, trunk fat, and insulin resistance may reflect the spectrum of NAFLD in obese children, whereas vitamin D levels and BMD may not. In patients with NASH, however, low serum vitamin D is associated with hepatic fibrosis and insulin resistance, but not with bone health status.
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eun Jae
authors.identifier: 0000-0003-0595-0972
authors.initials: EJ
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Dae Yong
authors.identifier: 0000-0002-4168-7131
authors.initials: DY
authors.lastname: Yi
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hye Ran
authors.identifier: 0000-0002-3423-6922
authors.initials: HR
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition; D015519:Bone Density; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000473:pathology; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000150:complications* / Q000473:pathology; D009765:Obesity / Q000097:blood* / Q000150:complications*; D012044:Regression Analysis; D014527:Uric Acid / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D055815:Young Adult
chemical_list: D014807:Vitamin D; D014527:Uric Acid; D002097:C-Reactive Protein; C104450:25-hydroxyvitamin D
keywords: Body Composition; Bone Density; Child; Insulin Resistance; Nonalcoholic Fatty Liver Disease; Obesity; Vitamin D