As part of AP&T's peer-review process, a technical check of this meta-analysis was performed by Dr P. Collins.
Meta-analysis: vitamin D and non-alcoholic fatty liver disease
Article first published online: 20 JUN 2013
© 2013 John Wiley & Sons Ltd
Alimentary Pharmacology & Therapeutics
Volume 38, Issue 3, pages 246–254, August 2013
How to Cite
Eliades, M., Spyrou, E., Agrawal, N., Lazo, M., Brancati, F. L., Potter, J. J., Koteish, A. A., Clark, J. M., Guallar, E. and Hernaez, R. (2013), Meta-analysis: vitamin D and non-alcoholic fatty liver disease. Alimentary Pharmacology & Therapeutics, 38: 246–254. doi: 10.1111/apt.12377
- Issue published online: 1 JUL 2013
- Article first published online: 20 JUN 2013
- Manuscript Accepted: 30 MAY 2013
- Manuscript Revised: 29 MAY 2013
- Manuscript Revised: 16 APR 2013
- Manuscript Received: 31 MAR 2013
Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent condition. Emerging evidence suggests that vitamin D may play a role in the pathogenesis of NAFLD.
To review systematically the association between vitamin D levels, measured as serum 25-hydroxy vitamin D [25(OH)D], and NAFLD.
We used PubMed and EMBASE databases to identify all studies that assessed the association between vitamin D and NAFLD up until 22 April 2013, without language restrictions. We included studies that compared vitamin D levels between NAFLD cases and controls and also those that compared the odds of vitamin D deficiency by NAFLD status. Pooled standardised differences and odds ratios were calculated using an inverse variance method.
Seventeen cross-sectional and case–control studies have evaluated the association between vitamin D and NAFLD. NAFLD was diagnosed using biopsy (4 studies), ultrasound or CT (10 studies) and liver enzymes (3 studies). Nine studies provided data for a quantitative meta-analysis. Compared to controls, NAFLD patients had 0.36 ng/mL (95% CI: 0.32, 0.40 ng/mL) lower levels of 25(OH)D and were 1.26 times more likely to be vitamin D deficient (OR 1.26, 95% CI: 1.17, 1.35).
NAFLD patients have decreased serum 25(OH)D concentrations, suggesting that vitamin D may play a role in the development of NAFLD. The directionality of this association cannot be determined from cross-sectional studies. Demonstration of a causal role of hypovitaminosis D in NAFLD development in future studies could have important therapeutic implications.