INTRODUCTION Increasingly, research groups have been studying the association of serum vitamin D and metabolic health indicators, especially in patients with obesity. We compared the serum 25-hydroxy Vitamin D [25(OH)D] concentrations in children and adolescents who had obesity and hepatosteatosis with children and adolescents who had obesity 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 patients with obesity (body mass index (BMI) > +2 standard deviations (SD) for their age and gender) and vitamin D deficiency [serum 25(OH)D < 12 ng/ml] 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. Chi-square, Student's t tests and multivariate analysis were performed. 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). 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). CONCLUSION Serum 25(OH)D concentrations were lower in children and adolescents with obesity and 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 children and adolescents with obesity and hypovitaminosis D did not improve severity of hepatic steatosis on ultrasonography at 6 months.

中文翻译：

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肥胖儿童和青少年维生素 D 缺乏与肝脂肪变性之间的关联。

简介 研究小组越来越多地研究血清维生素 D 与代谢健康指标的关系，尤其是肥胖患者的关系。我们比较了患有肥胖和肝脂肪变性的儿童和青少年与患有肥胖但无肝脂肪变性的儿童和青少年的血清 25-羟基维生素 D [25(OH)D] 浓度，并研究了血清 25(OH)D 浓度与严重程度之间的关系。肝脂肪变性。我们还旨在评估 6 个月后维生素 D 治疗对肝脂肪变性和肝脏生化的影响。方法 招募了 133 名肥胖症患者（体重指数 (BMI) > +2 年龄和性别标准差 (SD)）和维生素 D 缺乏症 [血清 25(OH)D < 12 ng/ml]。在维生素 D 治疗前和治疗后六个月记录人体测量、生化参数 [血清钙、磷酸盐、碱性磷酸酶、甲状旁腺激素、25(OH)D、葡萄糖和胰岛素浓度] 以及肝脂肪变性的超声检查结果。进行了卡方、Student's t 检验和多变量分析。结果 基线时 1 级、2 级和 3 级肝脂肪变性分别存在于 51 名 (38.4%)、43 名 (32.3%) 和 10 名 (7.5%) 受试者中。与无肝脂肪变性的患者相比，肝脂肪变性患者的平均 (± SD) 血清 25(OH)D 浓度 (8.4 ± 2.4 ng/ml) 显着较低 (9.9 ± 2.4 ng/ml，P < 0.005)。多变量logistic回归分析显示血清25(OH)D浓度是肝脂肪变性的独立预测因子(P < 0.005)，而年龄、性别、体重SD、BMI SD和HOMA-IR则不是(P > 0.05)。患有和不患有肝脂肪变性受试者的BMI SD、HOMA-IR和肝酶差异无统计学意义（P > 0.05）。尽管治疗后 6 个月血清 25(OH)D 浓度有所改善（34.7 ± 10.6 ng/ml 对比 8.7 ± 2.4 ng/ml；p < 0.0001），但不同严重程度的患者比例没有显着差异与治疗前相比，肝脂肪变性的发生率（p = 0.88）。结论 与无脂肪肝的儿童和青少年相比，肥胖合并肝脂肪变性的儿童和青少年血清 25(OH)D 浓度较低，肝脂肪变性的严重程度与血清 25(OH)D 浓度呈负相关。对肥胖和维生素 D 缺乏的儿童和青少年进行维生素 D 治疗并没有改善 6 个月时超声检查显示的肝脂肪变性的严重程度。