Skip to main content
Top
Published in: Digestive Diseases and Sciences 7/2011

01-07-2011 | Original Article

Serum Vitamin D Concentrations and Unexplained Elevation in ALT Among US Adults

Authors: Suthat Liangpunsakul, Naga Chalasani

Published in: Digestive Diseases and Sciences | Issue 7/2011

Login to get access

Abstract

Background

Low serum levels of vitamin D are associated with metabolic syndrome. Participants in NHANES III with unexplained elevation in ALT levels have high prevalence of metabolic syndrome. We hypothesized that the serum concentrations of vitamin D were inversely associated with unexplained elevation in ALT.

Methods

A total of 6,826 fasting subjects underwent morning physical examination and met the inclusion and exclusion criteria. From these participants, we have constructed cases with unexplained elevation in ALT (n = 308) and compared their serum vitamin D concentrations to matched controls with normal ALT (N = 979). We examined the prevalence of unexplained elevation in ALT level across different quartiles of vitamin D levels.

Results

Participants with unexplained elevation in ALT had significantly lower serum vitamin D levels compared to controls (61.8 ± 26.0 nmol/l vs. 66.8 ± 27.1 nmol/l, P < 0.01). The unadjusted prevalence of unexplained elevation in ALT in patients with highest to lowest quartiles of serum vitamin D levels were 21.4, 21.4, 25.6, and 31.5%, respectively. Compared to lowest quartile, patients with top two quartiles of serum vitamin D levels had significantly lower prevalence of unexplained elevation in ALT (OR, 95% CI for highest quartile 0.62 [0.43–0.89] and for third quartile 0.61 [0.42–0.86]). This relationship persisted even after controlling for metabolic syndrome, insulin resistance, and serum triglycerides.

Conclusions

This study suggests a significant inverse relationship between serum vitamin D levels and unexplained elevation in ALT. Further studies are needed to confirm this observation and to understand the basis for and implications of this observation.
Literature
1.
2.
go back to reference Zittermann A. Serum 25-Hydroxyvitamin D response to oral vitamin D intake in children. Am J Clin Nutr. 2003;78:496–497.PubMed Zittermann A. Serum 25-Hydroxyvitamin D response to oral vitamin D intake in children. Am J Clin Nutr. 2003;78:496–497.PubMed
3.
go back to reference Chonchol M, Scragg R. 25-Hydroxyvitamin D, insulin resistance, and kidney function in the third national health and nutrition examination survey. Kidney Int. 2007;71:134–139.PubMedCrossRef Chonchol M, Scragg R. 25-Hydroxyvitamin D, insulin resistance, and kidney function in the third national health and nutrition examination survey. Kidney Int. 2007;71:134–139.PubMedCrossRef
4.
go back to reference Baz-Hecht M, Goldfine AB. The impact of vitamin D deficiency on diabetes and cardiovascular risk. Curr Opin Endocrinol Diabetes Obes. 2010;17:113–119.PubMedCrossRef Baz-Hecht M, Goldfine AB. The impact of vitamin D deficiency on diabetes and cardiovascular risk. Curr Opin Endocrinol Diabetes Obes. 2010;17:113–119.PubMedCrossRef
5.
go back to reference Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among US adults. Diabetes Care. 2005;28:1228–1230.PubMedCrossRef Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among US adults. Diabetes Care. 2005;28:1228–1230.PubMedCrossRef
6.
go back to reference Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004;79:820–825.PubMed Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004;79:820–825.PubMed
7.
go back to reference Angulo P. GI epidemiology: nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2007;25:883–889.PubMedCrossRef Angulo P. GI epidemiology: nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2007;25:883–889.PubMedCrossRef
8.
go back to reference Vanni E, Bugianesi E, Kotronen A, De MS, Yki-Jarvinen H, Svegliati-Baroni G. From the metabolic syndrome to NAFLD or vice versa? Dig Liver Dis. 2010;42:320–330.PubMedCrossRef Vanni E, Bugianesi E, Kotronen A, De MS, Yki-Jarvinen H, Svegliati-Baroni G. From the metabolic syndrome to NAFLD or vice versa? Dig Liver Dis. 2010;42:320–330.PubMedCrossRef
9.
go back to reference Liangpunsakul S, Chalasani N. Unexplained elevations in alanine aminotransferase in individuals with the metabolic syndrome: results from the third National Health and Nutrition Survey (NHANES III). Am J Med Sci. 2005;329:111–116.PubMedCrossRef Liangpunsakul S, Chalasani N. Unexplained elevations in alanine aminotransferase in individuals with the metabolic syndrome: results from the third National Health and Nutrition Survey (NHANES III). Am J Med Sci. 2005;329:111–116.PubMedCrossRef
11.
go back to reference Executive Summary of the Third Report of the National Cholesterol Education Program. Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–2497.CrossRef Executive Summary of the Third Report of the National Cholesterol Education Program. Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–2497.CrossRef
12.
go back to reference Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–2572.PubMedCrossRef Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–2572.PubMedCrossRef
13.
go back to reference Bordelon P, Ghetu MV, Langan RC. Recognition and management of vitamin D deficiency. Am Fam Physician. 2009;80:841–846.PubMed Bordelon P, Ghetu MV, Langan RC. Recognition and management of vitamin D deficiency. Am Fam Physician. 2009;80:841–846.PubMed
14.
go back to reference Ruhl CE, Everhart JE. Determinants of the association of overweight with elevated serum alanine aminotransferase activity in the US. Gastroenterology. 2003;124:71–79.PubMedCrossRef Ruhl CE, Everhart JE. Determinants of the association of overweight with elevated serum alanine aminotransferase activity in the US. Gastroenterology. 2003;124:71–79.PubMedCrossRef
15.
go back to reference Cohen-Lahav M, Douvdevani A, Chaimovitz C, Shany S. The anti-inflammatory activity of 1,25-dihydroxyvitamin D3 in macrophages. J Steroid Biochem Mol Biol. 2007;103:558–562.PubMedCrossRef Cohen-Lahav M, Douvdevani A, Chaimovitz C, Shany S. The anti-inflammatory activity of 1,25-dihydroxyvitamin D3 in macrophages. J Steroid Biochem Mol Biol. 2007;103:558–562.PubMedCrossRef
16.
go back to reference Oh J, Weng S, Felton SK, et al. 1,25(OH)2 vitamin d inhibits foam cell formation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus. Circulation. 2009;120:687–698.PubMedCrossRef Oh J, Weng S, Felton SK, et al. 1,25(OH)2 vitamin d inhibits foam cell formation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus. Circulation. 2009;120:687–698.PubMedCrossRef
17.
go back to reference Oleson CV, Patel PH, Wuermser LA. Influence of season, ethnicity, and chronicity on vitamin D deficiency in traumatic spinal cord injury. J Spinal Cord Med. 2010;33:202–213.PubMed Oleson CV, Patel PH, Wuermser LA. Influence of season, ethnicity, and chronicity on vitamin D deficiency in traumatic spinal cord injury. J Spinal Cord Med. 2010;33:202–213.PubMed
18.
go back to reference Greene-Finestone LS, Berger C, de Grof M, et al. 25-Hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates. Osteoporos Int. 2010;35:256–264. Greene-Finestone LS, Berger C, de Grof M, et al. 25-Hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates. Osteoporos Int. 2010;35:256–264.
Metadata
Title
Serum Vitamin D Concentrations and Unexplained Elevation in ALT Among US Adults
Authors
Suthat Liangpunsakul
Naga Chalasani
Publication date
01-07-2011
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 7/2011
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-011-1707-x

Other articles of this Issue 7/2011

Digestive Diseases and Sciences 7/2011 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.