Objective To analyze the level of serum 25 hydroxyvitamin D[25 (OH)D] in obese children with non-alcoholic fatty liver disease (NAFLD) and the effect of vitamin D (VD) supplements on NAFLD, and to provide a clinical basis for VD in the treatment of children with NAFLD. Methods 1) From January 2020 to August 2021, 102 obese children aged 6 to 14 years were enrolled in this study and were divided into two groups according to liver ultrasound results:obesity with NAFLD group (n=58) and obesity without NAFLD group (n=44). Meanwhile, 40 healthy children were included as controls. The differences of serum 25(OH)D, lipid, transaminase and homoeostasis model assessment of insulin resistance (HOMA-IR) among the three groups were compared. 2) Fifty eight obese children with NAFLD were randomly divided into VD intervention group and VD non-intervention group.Children of both groups were given diet and exercise guidance, and the VD intervention group was supplemented with calcitriol 800 U/d for 16 weeks additionally. The changes of parameters were compared. Results 1) Serum 25(OH)D level of children in obesity with NAFLD group [(20.94±6.88) ng/ml] was significantly lower than that in obesity without NAFLD group [(24.31±7.69) ng/ml, P<0.05] and healthy control group [(29.19±5.44) ng/ml, P<0.01]. Serum 25(OH)D level was negatively correlated with body mass index (BMI) and HOMA-IR (r=－0.37,－0.71, P<0.01). 2) The detection rate of VD deficiency and insufficiency in obese children with NAFLD (84.48%) was higher than that in obese children without NAFLD (68.18%) and healthy control group (35.00%), and the difference was significant (χ2=25.85, P<0.01). 3) Before intervention, there was no significant difference in parameters between VD intervention group and VD non-intervention group. After 16-week intervention, compared with the VD non-intervention group, serum 25(OH)D level was significantly higher (t=2.22, P<0.05) while the levels of serum lipid, transaminase, BMI and HOMA-IR were significantly lower in VD intervention group (P<0.05). The hepatic pathology also improved after intervention. Conclusions VD deficiency is common in obese children with NAFLD. VD supplementation can effectively improve serum 25(OH)D level, attenuate liver function, hyperlipidemia, insulin resistance and fatty liver.
Key words
vitamin D /
children /
obesity /
nonalcoholic fatty liver disease /
insulin resistance
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