Serum Vitamin D Level in Lean and Obese Patients with Metabolic Associated Fatty Liver Disease: a comparative study

Abstract

Background and aim: Metabolic dysfunction associated fatty liver disease (MAFLD) affects around one third of the world population. Within the MAFLD population, 19.2% are lean. Low serum vitamin D concentrations were reported to increase the risk of MAFLD. This study aimed to explore the association between serum vitamin D concentration and MAFLD. Methods: This cross-sectional study was conducted on 50 Egyptian patients with lean MAFLD (BMI<25 kg/m2) (GI) and another group (G II) including 50 consecutive overweight/obese patients with MAFLD (BMI <25 kg/m2). MAFLD patients were evaluated by thorough history taking, full clinical examination, laboratory investigations including serum level of 25 hydroxycholecalciferol by ELISA, abdominal ultrasonography and FibroScan ® with controlled attenuation parameter (CAP). Results: Males were significantly predominant in the lean group (G I) (60%) while females were significantly predominant in G II (62%). Mean serum vit D level was not significantly higher in G I compared to GII (16.38 and 15.44 ng/ml, respectively). Vitamin D deficiency (level <20 ng/ml) was predominant in G II (70% vs 58.0% in GI) while insufficiency (level: 20-30 ng/ml) was more common in GI (34% vs 26%). Sufficient vitamin D (level <30 ng/ml) was only found in 8% of GI compared to 4% of GII. Serum vitamin D level showed a highly significant negative correlation with steatosis grades in both groups (r=0.87& 0.88 in GI &GII respectively, P-value <0.001 in both groups) . Conclusion: MAFLD patients, weather lean or obese, show low serum vitamin D levels, which negatively correlate with steatosis grades.