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Role of Vitamin D in Children With Hepatosteatosis

Yildiz, Ismail*; Erol, Oguz B.; Toprak, Sadik; Cantez, Mustafa S.§; Omer, Beyhan||; Kilic, Ayse*; Oguz, Fatma; Uysalol, Metin#; Yekeler, Ensar; Unuvar, Emin*

Journal of Pediatric Gastroenterology & Nutrition: July 2014 - Volume 59 - Issue 1 - p 106–111
doi: 10.1097/MPG.0000000000000371
Original Articles: Hepatology and Nutrition

Background: The increasing incidence of obesity in children is a significant risk factor for nonalcoholic fatty liver disease and obesity-associated morbidity. Vitamin D has a major role in bone mineral metabolism and has antimicrobial, antioxidant properties. In this study we aimed to investigate the role of vitamin D in children with obesity with hepatosteatosis.

Methods: A total of 101 children with obesity were included in this study. Hepatosteatosis was diagnosed and graded using ultrasonography. Serum levels of 25-hydroxyvitamin D (25-(OH) vitamin D), calcium, phosphate, alkaline phosphatase, and parathormone were tested. Two-sided t test and Pearson χ2 tests were used for the relation between vitamin D and hepatosteatosis.

Results: In our study group, 45.5% were girls (n = 46) and the mean age was 11.5 ± 2.8 years (range 3–17 years). Hepatosteatosis was identified in 58 children (57.4%). The diagnosis of grade 1 and grade 2 hepatosteatosis was made in 41 (40.6%) and 17 (16.8%) children, respectively. Median serum 25-(OH) vitamin D levels in children without hepatosteatosis was 16.4 ng/mL (interquartile range 12.4–24.8 ng/mL), whereas children with grade 1 and grade 2 hepatosteatosis had 25-(OH) vitamin D levels of 14.2 ng/mL (interquartile range 9.5–21.2 ng/mL) and 11.5 ng/mL (interquartile range 7.5–16.7 ng/mL), respectively (P = 0.005). There was a positive correlation between insulin resistance and the grade of hepatosteatosis (P = 0.03).

Conclusions: Serum vitamin D levels in children with obesity with hepatosteatosis are significantly lower than vitamin D levels in children with obesity without hepatosteatosis. In this observational study we only refer to the association of vitamin D deficiency/insufficiency with hepatosteatosis.

*Division of Ambulatory Pediatrics, Department of Pediatrics

Division of Pediatric Radiology, Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul

Department of Forensic Medicine, Faculty of Medicine, Bulent Ecevit University, Zonguldak

§Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics

||Department of Biochemistry, Istanbul Faculty of Medicine

Department of Social Pediatrics, Institute of Child Health

#Division of Pediatric Emergency Medicine, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Address correspondence and reprint requests to Ismail Yildiz, Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Ambulatory Pediatrics, Fatih/Capa Istanbul, 34093, Turkey (e-mail:

Received 13 March, 2014

Accepted 13 March, 2014

The authors report no conflicts of interest.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,