ESPE2023 Poster Category 1 Fat, Metabolism and Obesity (97 abstracts)
The Association between Vitamin D deficiency and Hepatosteatosis in Obese Children and Adolescents. (Underreview in Hormone Research Journal- HRP-2023-1-19)
Huseyin Anil Korkmaz 1 , Ved Bhushan Arya 2 , Vatan Barisik 3 , Dincer Atila 4 , Fulya Coskunol 5 , Serra Alci 6 , Yasin Ertug Cekdemir 7 , Derun Torlak 8 & Behzat Ozkan 9
1Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Department of Pediatrics, Division of Pediatric Endocrinology, Izmir, Turkey. 2Variety Club Children's Hospital, King's College Hospital NHS Foundation Trust, Division of Pediatric Endocrinology, London, United Kingdom. 3Metropol Medical Center, izmir, Turkey. 4Family Health Center, Number 1. Menemen, izmir, Turkey. 5Manisa City Hospital, Department of Pediatrics, Manisa, Turkey. 6Umraniye Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey. 7Dokuz Eylul University, Department of Radiology, izmir, Turkey. 8Acibadem University Hospital, Department of Pediatrics, Istanbul, Turkey. 9Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Department of Pediatrics, Division of Pediatric Endocrinology, izmir, Turkey
Objective: To compare the serum 25-hydroxy Vitamin D [25(OH)D] concentrations in children and adolescents with obesity with and without hepatosteatosis, and investigate the relationship between serum 25(OH)D concentrations and severity of hepatosteatosis. We also aimed to assess the effect of vitamin D treatment after 6 months on hepatosteatosis and liver biochemistry.
Methods: One hundred thirty-three obese patients with vitamin D deficiency [serum 25(OH)D < 12 ng/ml] and body mass index (BMI) > +2 standard deviations (SD) for their age and gender were recruited. Anthropometric measurements, biochemical parameters [serum calcium, phosphate, alkaline phosphatase, parathyroid hormone, 25(OH)D, glucose and insulin concentrations] and ultrasonographic findings of hepatosteatosis were recorded before and six months after Vitamin D treatment.
Results: Grade 1, 2 and 3 hepatosteatosis at baseline was present in 51 (38.4%), 43 (32.3%) and 10 (7.5%) subjects respectively. Mean (± SD) serum 25(OH)D concentrations were significantly lower in those with hepatosteatosis (8.4 ± 2.4 ng/ml) compared with those without hepatosteatosis (9.9 ± 2.4 ng/ml, P < 0.005). Multivariable logistic regression analysis showed serum 25(OH)D concentration was the independent predictor for hepatosteatosis (P < 0.005), whereas age, sex, weight SD, BMI SD and HOMA-IR were not (P > 0.05) (Table 1). There was no significant difference in BMI SD, HOMA-IR and liver enzymes between subjects with and without hepatosteatosis (P > 0.05). Despite improvement in serum 25(OH)D concentrations at 6 months post-treatment (34.7 ± 10.6 ng/ml vs. 8.7 ± 2.4 ng/ml; p < 0.0001), there was no significant difference in the proportion of patients with different severity of hepatosteatosis as compared to before treatment (P= 0.88).
| Variable | Regression Coefficient | 95% CI | Significance (P-value) |
| Age | -0.045 | -0.298 to 0.198 | 0.721 |
| Sex | -0.017 | -1.086 to 1.075 | 0.975 |
| Weight SDS | -0.338 | -2.051 to 1.159 | 0.678 |
| Height SDS | 0.157 | -0.605 to 0.992 | 0.698 |
| BMI SDS | 0.836 | -1.152 to 3.177 | 0.443 |
| 25 (OH) Vitamin D | -0.377 | -0.657 to -0.146 | <0.005 |
| HOMA-IR | 0.988 | -0.381 to 2.649 | 0.182 |
| Glucose | -0.026 | -0.125 to 0.045 | 0.508 |
| Insulin | -0.247 | -0.624 to 0.071 | 0.146 |
Conclusion: Serum 25(OH)D concentrations were lower in obese children and adolescents with hepatic steatosis as compared to those without hepatic steatosis, with an inverse association between the severity of hepatosteatosis and serum 25(OH)D concentrations. Vitamin D treatment in obese children and adults with hypovitaminosis D did not improve severity of hepatic steatosis on ultrasonography at 6 months.
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