title: Combined Association of Vitamin D and Sex Hormone Binding Globulin With Nonalcoholic Fatty Liver Disease in Men and Postmenopausal Women: A Cross-Sectional Study.
abstract: This study aimed to explore the combined associations of 25(OH)-vitamin D and sex hormone binding globulin (SHBG) with nonalcoholic fatty liver disease (NAFLD) in men and postmenopausal women. Our data, which were based on the population, were collected from 16 sites in East China in 2014. There were 2700 men with a mean age of 53 years and 1461 women over 55 who were considered postmenopausal enrolled in the study. Levels of 25(OH)D and SHBG were measured using chemiluminescence assay. NAFLD was measured using liver ultrasound. Multivariable-adjusted logistic regression models examined associations of 25(OH)D and SHBG tertiles with odds of mild and moderate-severe NAFLD. Both the low 25(OH)D and low SHBG groups were significantly associated with higher odds of mild NAFLD (men: OR 1.37, 95% CI 1.05, 1.78 in low 25(OH)D group; OR 1.73, 95% CI 1.23, 2.45 in low SHBG group; women: OR 1.51, 95% CI 1.08, 2.12 in low 25(OH)D group; OR 2.16, 95% CI 1.48, 3.14 in low SHBG group) and moderate-severe NAFLD (men: OR 1.61, 95% CI 1.24, 2.10 in low 25(OH)D group; OR 3.42, 95% CI 2.41, 4.87 in low SHBG group; women: OR 1.66, 95% CI 1.14, 2.42 in low 25(OH)D group; OR 6.84, 95% CI 4.31, 10.84 in low SHBG group). However, the combined association of low 25(OH)D and low SHBG was much larger, especially in moderate-severe NAFLD (men: OR 6.57, 95% CI 3.87, 11.18; women: OR 8.16, 95% CI 3.98, 16.73). The associations were independent of age, total testosterone, abdominal obesity, diabetes, and lipid profile. The negative associations of 25(OH)D and SHBG levels with NAFLD are strongest when viewed in combination in men and postmenopausal women. Further studies should determine the cause-effect relationship and investigate the underlying mechanisms of this finding.
authors.affiliation: From the Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China (NW, HZ, QL, BH, YC, CZ, YC, FX, DL, YL); Department of Endocrinology and Metabolism, The First Affiliated Hospital of Henan University of Science and Technology, Henan, China (CZ).
authors.forename: Ningjian
authors.initials: N
authors.lastname: Wang
authors.forename: Hualing
authors.initials: H
authors.lastname: Zhai
authors.forename: Chaoxia
authors.initials: C
authors.lastname: Zhu
authors.forename: Qin
authors.initials: Q
authors.lastname: Li
authors.forename: Bing
authors.initials: B
authors.lastname: Han
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.forename: Chunfang
authors.initials: C
authors.lastname: Zhu
authors.forename: Yingchao
authors.initials: Y
authors.lastname: Chen
authors.forename: Fangzhen
authors.initials: F
authors.lastname: Xia
authors.forename: Dongping
authors.initials: D
authors.lastname: Lin
authors.forename: Yingli
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001794:Blood Pressure; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017698:Postmenopause / Q000097:blood; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D008075:Lipoproteins, HDL; D012738:Sex Hormone-Binding Globulin; D014280:Triglycerides; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D000410:Alanine Transaminase
references.citation: J Clin Endocrinol Metab. 2012 Jun;97(6):2005-11
references.pmid: 22442277
references.citation: Diabetes Res Clin Pract. 2011 Oct;94(1):156-62
references.pmid: 21862168
references.citation: Diabetes. 2010 Dec;59(12):3167-73
references.pmid: 20841609
references.citation: Lancet. 2005 Sep 24-30;366(9491):1059-62
references.pmid: 16182882
references.citation: Obes Rev. 2012 Apr;13(4):381-7
references.pmid: 22239319
references.citation: Clin Endocrinol (Oxf). 2015 Jul;83(1):105-10
references.pmid: 25557316
references.citation: Endocr J. 2013;60(6):743-52
references.pmid: 23411507
references.citation: J Clin Endocrinol Metab. 2008 Jan;93(1):96-102
references.pmid: 17956950
references.citation: Gut. 2011 Dec;60(12):1728-37
references.pmid: 21816960
references.citation: Hepatology. 2013 Sep;58(3):1166-74
references.pmid: 23504808
references.citation: Med Glas (Zenica). 2014 Feb;11(1):170-6
references.pmid: 24496360
references.citation: J Clin Endocrinol Metab. 2015 Dec;100(12):4514-23
references.pmid: 26509871
references.citation: J Gastroenterol Hepatol. 2014 Jun;29(6):1215-22
references.pmid: 24611991
references.citation: Zhonghua Liu Xing Bing Xue Za Zhi. 2011 Sep;32(9):888-91
references.pmid: 22340876
references.citation: Clin Endocrinol (Oxf). 2010 Aug;73(2):243-8
references.pmid: 20050857
references.citation: Reprod Biol Endocrinol. 2015 Jul 16;13:74
references.pmid: 26177638
references.citation: J Clin Endocrinol Metab. 2009 Nov;94(11):4127-35
references.pmid: 19789205
references.citation: Clin Gastroenterol Hepatol. 2015 Sep;13(9):1686-93.e2
references.pmid: 25592661
references.citation: Liver Int. 2015 Feb;35(2):542-9
references.pmid: 24923704
references.citation: Horm Metab Res. 2011 Mar;43(3):223-5
references.pmid: 21154195
references.citation: Obesity (Silver Spring). 2012 Jan;20(1):186-91
references.pmid: 21760630
references.citation: J Clin Endocrinol Metab. 2012 Apr;97(4):1159-68
references.pmid: 22344196
references.citation: Ann N Y Acad Sci. 2013 Apr;1281:106-22
references.pmid: 23363012
references.citation: BMC Med. 2011 Jul 12;9:85
references.pmid: 21749681
references.citation: Diabetol Metab Syndr. 2011 Feb 23;3(1):3
references.pmid: 21345221
references.citation: Aliment Pharmacol Ther. 2005 Nov;22 Suppl 2:64-70
references.pmid: 16225477
references.citation: Clin Endocrinol (Oxf). 2014 Jun;80(6):877-83
references.pmid: 24303796
references.citation: Nat Rev Gastroenterol Hepatol. 2013 Jun;10(6):330-44
references.pmid: 23507799
references.citation: J Clin Invest. 2007 Dec;117(12):3979-87
references.pmid: 17992261
references.citation: N Engl J Med. 2009 Dec 31;361(27):2675-6; author reply 2677-8
references.pmid: 20042761
references.citation: J Clin Endocrinol Metab. 2007 Apr;92(4):1289-95
references.pmid: 17244779
references.citation: CMAJ. 2005 Mar 29;172(7):899-905
references.pmid: 15795412
references.citation: World J Gastroenterol. 2015 Feb 14;21(6):1718-27
references.pmid: 25684936
references.citation: Minerva Endocrinol. 2015 Sep;40(3):213-30
references.pmid: 25714787
references.citation: Aging Male. 2015;18(3):175-9
references.pmid: 26004987
references.citation: JAMA. 2013 Sep 4;310(9):948-59
references.pmid: 24002281
references.citation: Hum Reprod. 2010 Jan;25(1):212-20
references.pmid: 19887498
references.citation: Gastroenterology. 2002 Sep;123(3):745-50
references.pmid: 12198701
references.citation: Trends Endocrinol Metab. 2015 Jul;26(7):376-83
references.pmid: 26044465
references.citation: Acta Diabetol. 2016 Apr;53(2):227-36
references.pmid: 25959422