Micronutrients Research Center, Federal University of Rio de Janeiro, 21941-590 Rio de Janeiro, RJ, Brazil.
Multidisciplinary Center of Bariatric and Metabolic Surgery, 22280-020 Rio de Janeiro, RJ, 22280-020, Brazil.
Can J Gastroenterol Hepatol. 2017;2017:9456897. doi: 10.1155/2017/9456897. Epub 2017 Jun 8.
To evaluate the relationship of nonalcoholic fatty liver disease (NAFLD) with nutritional status of vitamin D in extreme obesity.
Descriptive cross-sectional study in individuals with class III obesity (BMI ≥ 40 kg/m), aged ≥ 20 years to < 60 years. Data were obtained for weight, height, waist circumference (WC), and serum 25-hydroxyvitamin D (25(OH)D) levels. Vitamin D analysis was performed by high performance liquid chromatography (HPLC) and the cutoff points used for its classification were < 20 ng/mL for deficiency and 20-29.9 ng/ml for insufficiency. NAFLD gradation was conducted through histological evaluation by liver biopsy.
The sample is comprised of 50 individuals (86% female). BMI and average weight were 44.1 ± 3.8 kg/m and 121.4 ± 21.4 kg, respectively. Sample distribution according to serum 25(OH)D levels showed 42% of deficiency and 48% of insufficiency. The diagnosis of NAFLD was confirmed in 100% of the individuals, of which 70% had steatosis and 30% had steatohepatitis. The highest percentage of 25(OH)D insufficiency was seen in individuals with steatosis (66%/ = 21) and steatohepatitis (93%/ = 16). All individuals with steatohepatitis presented VDD ( < 0.01).
The results of this study showed high prevalence of serum 25(OH)D inadequacy in individuals with class III obesity, which worsens as the stage of liver disease progresses.
评估非酒精性脂肪性肝病（NAFLD）与极度肥胖患者维生素 D 营养状况的关系。
这是一项在 BMI≥40kg/m²、年龄 20 岁至＜60 岁的 3 类肥胖患者中进行的描述性横断面研究。收集体重、身高、腰围（WC）和血清 25-羟维生素 D（25(OH)D）水平数据。采用高效液相色谱法（HPLC）进行维生素 D 分析，将其分类的切点值为＜20ng/mL 为缺乏，20-29.9ng/ml 为不足。通过肝活检进行组织学评估来对 NAFLD 进行分级。
该样本由 50 名个体（86%为女性）组成。BMI 和平均体重分别为 44.1±3.8kg/m²和 121.4±21.4kg。根据血清 25(OH)D 水平的分布，有 42%的个体存在维生素 D 缺乏，48%的个体存在维生素 D 不足。100%的个体被诊断为 NAFLD，其中 70%存在脂肪变性，30%存在脂肪性肝炎。脂肪变性患者（66%/=21）和脂肪性肝炎患者（93%/=16）中 25(OH)D 不足的比例最高。所有脂肪性肝炎患者均存在 VDD（＜0.01）。
本研究结果表明，3 类肥胖患者血清 25(OH)D 不足的发生率较高，且随着肝病的进展而恶化。
