J Obes Metab Syndr 2018; 27(2): 128-129
Published online June 30, 2018 https://doi.org/10.7570/jomes.2018.27.2.128
Copyright © Korean Society for the Study of Obesity.
Bo-Yeon Kim* , Dug-Hyun Choi, Chan-Hee Jung, Ji-Oh Mok, Sung Koo Kang, and Chul-Hee Kim
Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
Correspondence to:
Bo-Yeon Kim,
https://orcid.org/0000-0002-3658-2351,
Division of Endocrinology and Metabolism,
Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea,
Tel: +82-32-621-5157,
Fax: +82-32-621-5018,
E-mail: byby815@schmc.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
The association between vitamin D level and nonalcoholic fatty liver disease (NAFLD) has not yet been established. However, several studies suggest that vitamin D deficiency is associated with NAFLD and obesity and abdominal obesity.1–3 Our study evaluated the association between NAFLD and abdominal fat accumulation according to vitamin D status in patients with type 2 diabetes. Ours is a clinic-based study showing that low vitamin D level is associated with NAFLD and abdominal visceral fat accumulation in Korean patients with type 2 diabetes, as reported in
As a reader mentioned, the association between vitamin D level and visceral adiposity/prevalence of NAFLD could be influenced by the different treatments, and the contradicting findings observed in this study might be affected by antidiabetic medications, antihypertensive medications, and other drugs. Insulin resistance is a very important contributor to the pathogenesis of NAFLD. Therefore, we plan to analyze the effect on abdominal fat accumulation of each antidiabetic medication in future study including these participants.
The other question was about the effect of vitamin D level on the prevalence of NAFLD independent of visceral fat thickness in the logistic regression model. When we analyzed further as the reader mentioned, vitamin D deficiency was associated with the prevalence of NAFLD after adjusting for visceral fat thickness in addition to the given logistic regression model. Because vitamin D is known to be involved in immune regulation and inflammatory responses, low vitamin D is thought to play a role in the pathogenesis of NAFLD by hepatic inflammation through adipocytokines.5 We thank you for your very important comment on this and plan to evaluate whether visceral adiposity is an important factor in the association of vitamin D status with NAFLD in the next study. Because of the lack of data, outdoor activity, dietary habits, and seasonal variations in vitamin D were also not included in our study. This is a limitation of our current study.
Lastly, our finding showed that the vitamin D deficiency group has increased visceral fat accumulation compared with the vitamin D sufficient group. However, in our study, body mass index (BMI) was not statistically different among the three groups (24.4± 4.0 kg/m2 in the vitamin D deficient group, 24.8±4.2 kg/m2 in the vitamin D insufficient group, and 25.2±3.8 kg/m2 in the vitamin D sufficient group;
The authors declare no conflict of interest.
Online ISSN : 2508-7576Print ISSN : 2508-6235
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