Lauren Trahan, 2017 PharmD Candidate

Nonalcoholic fatty liver disease (NAFLD) is the buildup of extra fat in the liver that isn’t caused by alcohol abuse. 

Up to 25% of individuals in the United States are affected by NAFLD. Risk factors include being overweight or obese; having diabetes, high cholesterol, or high triglycerides; experiencing rapid weight loss; and having poor eating habits. However, patients can also develop NAFLD without these risk factors. 

NAFLD is often a silent, asymptomatic disease. If left undiagnosed, this condition can lead to further complications, such as steatohepatitis and cirrhosis. There’s no approved treatment for NAFLD. with the exception of a healthy diet and regular exercise.

 recently published a cross-sectional study that shows a relationship between patients with NAFLD and levels of vitamin D and sex hormone-binding globulin (SHBG) in men and postmenopausal women. The researchers investigated the documented role of SHBG in metabolic diseases alone and in relation to vitamin D levels. 

Patients with NAFLD often have 25-hydroxy-vitamin D (25(OH)D) deficiency. This deficiency is associated with suboptimal bone health and immune system function. SHBG is a serum-steroid transporting protein produced in the liver. Lower levels can affect sex hormone activity throughout the body. Data suggest SHBG levels can impact inflammation, diabetes, obesity, and the risk for cardiovascular disease. 

The researchers enrolled patients from 16 sites and measured 25(OH)D and SHBG levels. Each patient also had a liver ultrasound, which is the best way to confirm the presence of NAFLD. 

Patients who had low 25(OH)D or low SHBG had a higher risk of mild and moderate-severe NAFLD when compared with patients with normal levels. The combined association of low 25(OH)D and low SHBG was more significant for patients with moderate-severe NAFLD and was independent of age, total testosterone, abdominal obesity, diabetes, and lipid profile. 

No recommendation is made for 25(OH)D supplementation in the effort of preventing NAFLD. The study authors recommended further studies to explore the relationship between 25(OH)D and SHBG levels and NAFLD.

Articles

Nonalcoholic fatty liver disease is the buildup of extra fat in the liver that isn't caused by alcohol abuse. 



Low Vitamin D May Increase Risk of Nonalcoholic Fatty Liver Disease

More than one-third of US adults are obese, according to the CDC.

Obese patients who are otherwise healthy are still at risk for impaired immune function, which can lead to increased risk of infection.

New research suggests that chronic inflammation can make it difficult for certain patients to lose weight with lifestyle modifications. In fact, inflammation may lead to weight gain and insulin resistance. As a result, reducing inflammation may make it easier for patients to lose weight.

A team of researchers recently investigated how a daily flavonoid-fish oil supplement could potentially reduce inflammation and long-term complications in overweight and obese female patients.

, blood samples were tested for cytokines, C-reactive protein (CRP), F2-isoprostanes, and whole-blood-derived mRNA. Each of these categories represent a way to measure inflammation and immune function.

		Cytokines are released by immune cells to regulate the maturation, growth, and responsiveness of certain types of cells

		CRP is a plasma protein that is a nonspecific marker of inflammation

		F2-isoprostanes are peroxidized polyunsaturated fatty acids that act as inflammatory mediators

		Whole-blood-derived mRNA is a measure of the DNA transcription activity within the blood cells

Patients received either placebo or a mixed flavonoid-fish oil supplement that contained 1000 mg quercetin, 400 mg isoquercetin, 120 mg epigallocatechin from green tea extract, 1000 mg vitamin C, 40 mg niacinamide, 800 g folic acid, and 400 mg omega-3 polyunsaturated fatty acid consisting of 220 mg eicosapentaenoic acid (EPA) and 180 mg docosahexaenoic acid (DHA) from fish oil.

After 10 weeks, patients showed increases in plasma quercetin, EPA, DHA, and docosapentaenoic acid. The researchers also found an antiviral and inflammation whole-blood transcriptomic response in overweight women.

Patients didn’t experience changes in CRP, F2-isoprostanes, cytokines, blood lipids, and body weight.

These results suggest that the supplementation improved patients’ viral defense and reduced leukocyte trafficking, which is part of the inflammatory response. The researchers considered this intervention promising.

However, they were unable to observe long-term effects of the supplementation in this short study. Therefore, they recommended long-term studies that include various doses and added lifestyle modifications.

Future research may also determine the effect on traditional inflammation biomarkers like CRP and F2-isoprostanes.

More than one-third of US adults are obese, according to the CDC.
