Vitamin D and liver fibrosis: let's start soon before it's too late

Nobili, Valério; Reif, Shimon

doi:10.1136/gutjnl-2014-308175

Cited by 10 publications

(9 citation statements)

References 13 publications

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“…The average serum 25OHD level in August in this patient group was 44.1 nmol·L À1 , considerably lower than the 60.1 nmol·L À1 average found in the 2470 UK adolescents within the Avon Longitudinal Study of Parents and Children (18). While we used conservative cutoffs to define deficiency and insufficiency here, it is important to note that these have been defined based on skeletal effects of vitamin D, and serum OHD levels predicted August 25OHD status demonstrates lower levels in patients with more severe disease using standard cut-offs for simple steatosis (score 0-2), Borderline NASH (3-4) and NASH (5)(6)(7)(8). (c) Utilizing a score of <5 and ≥5 to define severity of disease, those with less severe disease had significantly lower 25OHD in the group as a whole, with a similar trend in Caucasian patients only (d).…”

Section: Discussionmentioning

confidence: 99%

“…By analysing both serum levels and known variants that may contribute to the metabolism and action of vitamin D, this study attempts to define some of those who may have a susceptibility to NAFLD at a young age. The antifibrotic effects of vitamin D in human hepatic stellate cells have previously been demonstrated , and a valid question is whether vitamin D treatment may have anti‐fibrotic therapeutic potential in paediatric NAFLD . While the efficacy of vitamin D supplementation on endothelial function in obese children has recently been examined , studies with liver endpoints are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…Lifestyle change is the only proven effective treatment for paediatric NAFLD and identifying those at increased risk of progression may allow more targeted individualized therapy. Recent studies have demonstrated that low vitamin D status associates with paediatric NAFLD independently of body mass index (BMI) in Australian and Italian cohorts, raising the question of whether improvement in vitamin D status through diet or supplementation may be beneficial in some patients .…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D status and associated genetic polymorphisms in a cohort of UK children with non‐alcoholic fatty liver disease

et al. 2018

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SummaryBackgroundVitamin D deficiency has been associated with non‐alcoholic fatty liver disease (NAFLD). However, the role of polymorphisms determining vitamin D status remains unknown.ObjectivesThe objectives of this study were to determine in UK children with biopsy‐proven NAFLD (i) their vitamin D status throughout a 12‐month period and (ii) interactions between key vitamin D‐related genetic variants (nicotinamide adenine dinucleotide synthase‐1/dehydrocholesterol reductase‐7, vitamin D receptor, group‐specific component, CYP2R1) and disease severity.MethodsIn 103 paediatric patients with NAFLD, serum 25‐hydroxyvitamin D (25OHD) levels and genotypes were determined contemporaneously to liver biopsy and examined in relation to NAFLD activity score and fibrosis stage.ResultsOnly 19.2% of children had adequate vitamin D status; most had mean 25OHD levels considered deficient (<25 nmol·L−1, 25.5%) or insufficient (<50 nmol·L−1, 55.3%). Patients had significantly lower 25OHD levels in winter months (95% CI: 22.7–31.2 nmol·L−1) when compared with spring (30.5–42.1 nmol·L−1; P = 0.0089), summer (36.3–47.2 nmol·L−1; P < 0.0001) and autumn (34.2–47.5 nmol·L−1; P = 0.0003). Polymorphisms in the nicotinamide adenine dinucleotide synthase‐1/dehydrocholesterol reductase‐7 (rs3829251, rs12785878) and vitamin D receptor (rs2228570) genes were independently associated with increased steatosis; while a group‐specific component variant (rs4588) was associated with increased inflammation in liver biopsies.ConclusionsChildren with NAFLD in the UK have particularly low winter vitamin D status, with vitamin D insufficiency prevalent throughout the year. Polymorphisms in the vitamin D metabolic pathway are associated with histological severity of paediatric NAFLD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vitamin D status and associated genetic polymorphisms in a cohort of UK children with non‐alcoholic fatty liver disease

et al. 2018

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“…Based on experimental evidence and epidemiological data, vitamin D has been proposed as a potential therapeutic option for liver damage in NAFLD and non-alcoholic steatohepatitis (NASH) [ 24 ].…”

Section: Clinical Trialsmentioning

confidence: 99%

Vitamin D Supplementation and Non-Alcoholic Fatty Liver Disease: Present and Future

2017

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Non-alcoholic fatty liver disease (NAFLD) is the most common chronic hepatic disease throughout the Western world and is recognized as the main cause of cryptogenic cirrhosis; however, the identification of an effective therapy for NAFLD is still a major challenge. Vitamin D deficiency is a wide-spread condition which reaches epidemic proportions in industrialized countries, mainly in relation to current lifestyle and limited dietary sources. Epidemiological studies point towards an association between hypovitaminosis D and the presence of NAFLD and steatohepatitis (NASH), independently of confounders such as obesity and insulin resistance. Furthermore, several pieces of experimental data have shown the anti-fibrotic, anti-inflammatory and insulin-sensitizing properties exerted by vitamin D on hepatic cells. However, results from trials evaluating the effects of oral vitamin D supplementation on liver damage in NAFLD and NASH are controversial. The aim of this review is to give an overview of the evidence currently available from clinical trials and to discuss possible shortcomings and new strategies to be considered in future investigations.

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“…However, there is currently no clinical evidence that VD supplements can delay or prevent the progression of liver fibrosis 19 . To support this hypothesis, we conducted a randomized double-blinded, placebo-controlled trial to assess the dynamic changes in serum fibrogenic cytokines/enzymes in CHC patients with VD deficiency after short-term supplementation with VD.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D supplementation improves serum markers associated with hepatic fibrogenesis in chronic hepatitis C patients: A randomized, double-blind, placebo-controlled study

Komolmit

Kimtrakool

Suksawatamnuay

et al. 2017

Sci Rep

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Hepatic fibrosis is the net accumulation of matrix tissue components which controlled by pro-fibrolytic enzymes, matrix metalloproteinases (MMPs), and pro-fibrotic cytokine, TGF-β1, and enzymes, tissue inhibitors of MMPs (TIMPs). Vitamin D (VD) supplementation has been shown to reverse these processes in vitro and in vivo. This study sought to determine the effect of VD supplementation on serum fibrotic markers in chronic hepatitis C (CHC) patients. Fifty-four CHC patients with VD deficiency were randomized into two groups, a VD group (n = 29) and a placebo group (n = 29). The serum levels of 25-hydroxy VD, TGF-β1, TIMP-1, MMP2 and MMP9 were measured at baseline and at the end of the 6-week study period. Upon correction of VD levels, TGF-β1 and TIMP-1 levels were decreased, and the MMP2 and MMP9 levels were significantly increased in the VD group. A comparison of the mean changes (delta) in the markers between groups showed that TGF-β1 and TIMP-1 levels were significantly decreased and the MMP2 and MMP9 were significantly higher in the VD group than in the placebo group. By using CHC patients as a model, this study provides additional evidence that VD plays an important role in the reversal of hepatic fibrogenesis.

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Vitamin D and liver fibrosis: let's start soon before it's too late

Cited by 10 publications

References 13 publications

Vitamin D status and associated genetic polymorphisms in a cohort of UK children with non‐alcoholic fatty liver disease

Vitamin D status and associated genetic polymorphisms in a cohort of UK children with non‐alcoholic fatty liver disease

Vitamin D Supplementation and Non-Alcoholic Fatty Liver Disease: Present and Future

Vitamin D supplementation improves serum markers associated with hepatic fibrogenesis in chronic hepatitis C patients: A randomized, double-blind, placebo-controlled study

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