Endocrine Abstracts

Background: Diabetes mellitus, hypovitaminosis D, and non-alcoholic fatty liver disease (NAFLD) are common medical conditions that share some risk factors, one of which is obesity. Both NAFLD and vitamin D deficiency have been linked to the development of metabolic syndrome and type 2 diabetes. The aim of this study is to evaluate the level of serum 25-hydroxy vitamin D [25(OH)D] in type 2 obese diabetic Egyptian patients with variable degrees of hepatic steatosis.

Methods: Sixty type 2 obese diabetic patients were recruited. BMI, HbA1c, aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ glutamyl transpeptidase (GGT), lipid profile, and 25(OH)D were measured. NAFLD was assessed semi-quantitatively by ultrasound on a scale of 0–3.

Results: There was a significant negative correlation between 25(OH)D and age, P=0.027; HbA1c, P=0.000; triglycerides (TG), P=0.022 and degree of steatosis, P=0.047. 25(OH)D showed a significant positive correlation with HDL, P=0.046. ANOVA showed a significant association between the degree of steatosis and BMI, P=0.000. Using multivariate analysis HbA1c was the only significant predictor for vitamin D level when tested with BMI and duration of diabetes, P=0.000. Patients were divided into two subgroups according to 25(OH)D level; group 1 had normal levels, group 2 were deficient in 25(OH)D. There was a significant difference between both groups as regards age, P=0.035; HbA1c_, P=0.000; TG, P=0.004; and HDL, P=0.028, with vitamin D deficient patients showing higher age, higher HbA1c, higher TG and lower HDL levels. The two groups did not differ significantly as regards the grading of hepatic steatosis.

Conclusion: Poor glycaemic control is associated with lower levels of 25(OH)D independent of BMI. Higher degrees of steatosis correlated with hypovitaminosis D.