Vitamin D status and non-alcoholic fatty liver disease in patients with type 1 diabetes

Purpose: In patients with type 1 diabetes (T1D), the prevalence of non-alcoholic fatty liver disease (NAFLD) ranges from 10 to 53% and contrasting evidence suggests that vitamin D deficiency may favor liver fat accumulation. Here, we investigated the association between vitamin D status and NAFLD in adults with T1D. Methods: 220 consecutive adult T1D patients on multiple daily injections or continuous subcutaneous insulin infusion and not taking calcium or vitamin D supplements were included. Patient characteristics, 25(OH)D serum levels, and metabolic parameters were analyzed. Vitamin D status was defined as sufficiency (≥ 75 nmol/L; 30 ng/ml), insufficiency (50–75 nmol/L; 20–30 ng/ml), or deficiency (< 50 nmol/L; 20 ng/ml). NAFLD was diagnosed at ultrasound examination and graded 0–3. Results: NAFLD was present in 57 patients (29.5%): 51 grade 1, 5 grade 2, and 1 grade 3. Median 25(OH)D levels were 53 nmol/L (IQR 38–70) in patients with NAFLD and 50 nmol/L (34–69) in patients without (p = 0.46). At multivariable analysis, NAFLD was not associated with 25(OH)D levels (p = 0.42) or vitamin D deficiency (p = 0.55), while BMI (OR 1.16, 95% CI 1.07–1.27) and serum triglycerides (OR 1.02, 95% CI 1.01–1.03) were independently associated with NAFLD. Conclusions: Vitamin D status appears to have no link with low-grade NAFLD in patients with type 1 diabetes.