Dasarathy J, et al. – This investigation ascertained if standard vitamin D3 supplementation could be effective in nonalcoholic fatty liver disease (NAFLD) with hypovitaminosis D. It was reported that a daily supplementation with 2000 IU cholecalciferol for 6 mo did not correct hypovitaminosis D in maximum patients with nonalcoholic steatohepatitis (NASH). Additional analyses were warranted to determine the efficacy of higher doses.

Methods

• The recruitment consisted of 65 well-characterized adults [age (mean ± SD): 51.6 ± 12.3 y] with biopsy-proven NAFLD.
• Forty-two patients (the ratio of men to women was 13:29) reported hypovitaminosis D (plasma 25-hydroxyvitamin D [25(OH)D] <30 ng/mL).
• An observational study was performed in NAFLD patients with hypovitaminosis D treated with 2000 IU cholecalciferol (vitamin D3) daily for 6 mo per clinical practice.
• Analysis was conducted of the Plasma 25(OH)D, hepatic and metabolic panels, and metabolic syndrome components prior to and after cholecalciferol supplementation.
• Body composition was estimated via bioelectrical impedance analysis.
• Body composition was estimated via bioelectrical impedance analysis.
• The primary outcome measure was plasma 25(OH)D ≥30 ng/mL at the end of the study.
• Secondary outcomes included variations in serum transaminases, fasting plasma glucose, and insulin and homeostasis model assessment of insulin resistance (HOMA-IR).
• Chi-square, Student’s t tests, correlation coefficient, and multivariate analysis were carried out.

Results

• 26 (61.9%) patients presented with nonalcoholic steatohepatitis (NASH), and 16 (38.1%) had hepatic steatosis.
• After 6 mo of cholecalciferol supplementation, plasma 25(OH)D ≥30 ng/mL was observed in 16 subjects (38.1%; responders).
• The remaining 26 patients (61.9%) were nonresponders, with plasma 25(OH)D <30 ng/mL.
• Considerably fewer (P < 0.01) patients with NASH were responders (4 of 26, 15.4%) than those with hepatic steatosis (12 of 16, 75%).
• Baseline fasting serum alanine aminotransferase, plasma glucose, and HOMA-IR were similar in the responders and nonresponders, but the NASH score on the liver biopsy was lower (16.5%) in the responders (P < 0.001).
• Nonresponders displayed a higher fat mass (10.5%) and lower fat-free mass (10.4%) than responders.
• Improvement was noted in the end-of-treatment alanine aminotransferase and HOMA-IR only in responders.
• The baseline HOMA-IR and histological NASH score served as independent predictors of nonresponse to cholecalciferol supplementation.