title: Is Vitamin D an Independent Risk Factor of Nonalcoholic Fatty Liver Disease?: a Cross-Sectional Study of the Healthy Population.
abstract: The association between vitamin D levels and nonalcoholic fatty liver disease (NAFLD) has been recognized. However, few studies showed independent associations between vitamin D deficiency and NAFLD after a sex-related adjustment for metabolic factors. We aimed to study whether vitamin D deficiency is an independent risk factor of NAFLD even after controlling for metabolic syndrome and visceral fat in both sexes. In this cross-sectional study, 7,514 Korean adults (5,278 men, 2,236 women) participated in a health check-up program. They underwent blood tests, abdominal computed tomography (CT) of the visceral fat area, and ultrasonography for NAFLD screening. Multiple logistic regression analysis was used to investigate the association of vitamin D deficiency with NAFLD according to the sex differences. Vitamin D deficiency is associated with NAFLD. The adjusted odds ratio (aOR) for NAFLD increased sequentially with decreasing vitamin D level, even after adjusting for metabolic syndrome and visceral fat. The subjects in the vitamin D sufficiency group (20-30 ng/mL) had an aOR for NAFLD of 1.18 (95% CI, 1.00-1.39), whereas the deficiency group (< 20 ng/mL) had an aOR of 1.29 (95% CI, 1.10-1.52). However, we have detected a significant sex-related interaction when analyzing the results. A significant relationship between vitamin D deficiency and NAFLD was found in men (aOR, 1.33; 95% CI, 1.11-1.60) but not in women.
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Danbee
authors.identifier: http://orcid.org/0000-0003-1402-4890
authors.initials: D
authors.lastname: Park
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.|Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea. hyuktae@gmail.com.
authors.forename: Hyuktae
authors.identifier: http://orcid.org/0000-0002-0312-3650
authors.initials: H
authors.lastname: Kwon
authors.affiliation: Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Seung Won
authors.identifier: http://orcid.org/0000-0003-3800-0754
authors.initials: SW
authors.lastname: Oh
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.|Department of Medicine, Seoul National University College of Medicine, Seoul, Korea.|Department of Family Medicine, Seoul National University Health Service Center, Seoul, Korea.
authors.forename: Hee Kyung
authors.identifier: http://orcid.org/0000-0003-3854-7012
authors.initials: HK
authors.lastname: Joh
authors.affiliation: Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Seung Sik
authors.identifier: http://orcid.org/0000-0002-1558-7831
authors.initials: SS
authors.lastname: Hwang
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jin Ho
authors.identifier: http://orcid.org/0000-0002-3942-6813
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jae Moon
authors.identifier: http://orcid.org/0000-0003-0927-4721
authors.initials: JM
authors.lastname: Yun
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyejin
authors.identifier: http://orcid.org/0000-0001-5279-340X
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: Goh Eun
authors.identifier: http://orcid.org/0000-0001-9755-0452
authors.initials: GE
authors.lastname: Chung
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Sangjoon
authors.identifier: http://orcid.org/0000-0003-3641-8081
authors.initials: S
authors.lastname: Ze
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jae Hong
authors.identifier: http://orcid.org/0000-0002-7653-491X
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Yeseul
authors.identifier: http://orcid.org/0000-0003-0763-5458
authors.initials: Y
authors.lastname: Bae
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Arang
authors.identifier: http://orcid.org/0000-0002-5899-3602
authors.initials: A
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D016017:Odds Ratio; D012307:Risk Factors; D012737:Sex Factors; D015898:Tomography Scanners, X-Ray Computed; D014463:Ultrasonography; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000150:complications*
chemical_list: D014807:Vitamin D
keywords: Intra-Abdominal Fat; Metabolic Syndrome X; Non-Alcoholic Fatty Liver Disease; Sex; Vitamin D