Independent associations of low 25 hydroxy vitamin D and high parathyroid hormonal levels with nonalcoholic fatty liver disease in Asian Indians residing in north India

Objective: We analysed the associations of 25 hydroxy vitamin D [25(OH) D] and parathyroid hormone (PTH) levels with clinical, anthropometric, biochemical and body composition parameters in Asian Indians with nonalcoholic fatty liver disease (NAFLD). Methods: In this case-control study, 162 cases and 173 age and sex matched controls were recruited. Clinical, anthropometric, biochemical parameters and liver ultrasound were done. Percentage body fat (%BF), lean body mass and bone mineral density (BMD) were assessed by dual energy X-ray absorptiometry (DXA). Fasting insulin levels, value of homeostasis model assessment of insulin resistance (HOMA-IR), serum 25(OH) D, calcium and PTH levels were measured. Results: Subjects with NAFLD had lower serum 25(OH) D (19.4 +/- 8.5 vs. 27.8 +/- 9.4 ng/ml, p = 0.0001) and higher serum PTH (54.9 +/- 19.5 vs. 41.5 +/- 18.3 pg/ml, p - 0.0001) levels as compared to controls. We observed significantly high values of systolic blood pressure (p = 0.002), waist circumference (p = 0.05), serum triglycerides (p = 0.002), total cholesterol (p = 0.002), alanine transaminase (p = 0.05), fasting insulin (p = 0.02) and HOMA-IR (p = 0.03) in the lowest 25(OH) D quartile. Multivariable-logistic regression showed that low serum 25(OH) D [OR (95%CI): 4.46 (2.58-7.72), p = 0.0001] and high PTH [OR (95%CI): 2.21 (1.50-3.30), p = 0.0001] level were independently associated with NAFLD. Conclusion: Low serum 25(OH) D and high PTH levels were independently associated with the presence of NAFLD in Asian Indians residing in north India. Crown Copyright (C) 2013 Published by Elsevier Ireland Ltd. All rights reserved.