title: Low vitamin D levels and non-alcoholic fatty liver disease, evidence for their independent association in men in East China: a cross-sectional study (Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China)).
abstract: Recent studies have suggested an association between vitamin D and non-alcoholic fatty liver disease (NAFLD); however, some results are subject to debate. This study was carried out to evaluate the correlation between NAFLD and vitamin D in men and women in East China. The data were obtained from a cross-sectional study that focused on the health and metabolic status of adults in sixteen areas of East China. According to ultrasonic assessments, the patients were divided into normal and NAFLD groups. Demographic characteristics and biochemical measurements were obtained. Binary logistic regression analysis was used to explore the association. In total, 5066 subjects were enrolled, and 2193 (43·3 %) were diagnosed with NAFLD; 84·56 % of the subjects showed vitamin D deficiency. Subjects with high vitamin D levels had a lower prevalence of NAFLD, particularly male subjects. Within the highest quartile of vitamin D levels, the prevalence of NAFLD was 40·8 %, whereas the lowest quartile of vitamin D levels showed a prevalence of 62·2 %, which was unchanged in women across the vitamin D levels. Binary logistic analysis showed that decreased vitamin D levels were associated with an increased risk of NAFLD (OR 1·54; 95 % CI 1·26, 1·88). This study suggests that vitamin D levels are significantly associated with NAFLD and that vitamin D acts as an independent factor for NAFLD prevalence, particularly in males in East China. Vitamin D interventional treatment might be a new target for controlling NAFLD; elucidating the mechanism requires further research.
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Hua-Ling
authors.initials: HL
authors.lastname: Zhai
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Ning-Jian
authors.initials: NJ
authors.lastname: Wang
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Bing
authors.initials: B
authors.lastname: Han
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Li
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Chun-Fang
authors.initials: CF
authors.lastname: Zhu
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Ying-Chao
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Fang-Zhen
authors.initials: FZ
authors.lastname: Xia
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Cang
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Chao-Xia
authors.initials: CX
authors.lastname: Zhu
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Meng
authors.initials: M
authors.lastname: Lu
authors.affiliation: Institute and Department of Endocrinology and Metabolism,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,People's Republic of China.
authors.forename: Ying-Li
authors.initials: YL
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D014463:Ultrasonography; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology
chemical_list: D014807:Vitamin D
keywords: 25(OH)D3
                  25-hydroxyvitamin D3; BMI; HOMA-IR homoeostatic model assessment for insulin resistance; HbA1c glycated Hb; Homoeostasis model assessment; Insulin resistance; NAFLD non-alcoholic fatty liver disease; Non-alcoholic fatty liver disease; US ultrasonography; VDD vitamin D deficiency; Vitamin D