15 May 2018 --- Children with non-alcoholic fatty liver disease (NAFLD) have particularly low vitamin D status and suffer from vitamin D insufficiency throughout the year, new research has found. The research, published in Pediatric Obesity, charted vitamin D levels and variations in genes that determine vitamin D status, in British children diagnosed with the liver disease. The findings open up potential future possibilities for treatment using vitamin D.
“The children in our study had very low levels of vitamin D throughout the year and this raises the question of whether or not increasing vitamin D levels could prevent or treat the disease. Our earlier study showed that dietary intakes of vitamin D in children with NAFLD are very low,” Dr. Bernadette Moore, from the School of Food Science and Nutrition at the University of Leeds, tells NutritionInsight.
“Currently the Department of Health recommends vitamin D supplementation from 6 months to 5 years but our children were older (an average of 13 to 14 years old). This raises the question of whether or not children over the age of 5 would benefit from continuing supplementation.”
“Despite the high prevalence of non-alcoholic fatty liver disease, thus far lifestyle change is the only proven effective treatment for those diagnosed. However the lack of understanding regarding the disease's molecular pathogenesis makes it very difficult to identify patients who are most likely to suffer disease progression and therefore to benefit from intervention.”
“Our research hopes to add to the growing body of work that would make it easier to identify those at risk of progression, allowing for more targeted individualized therapy,” Moore adds.
Scientists at the University of Leeds, England, examined vitamin D levels in children with non-alcoholic fatty liver disease over a 12 month period. The study found the majority of children in the cohort had insufficient vitamin D levels throughout the year, with severe vitamin D deficiency during the winter months.
The study is the first to find a relationship between genetic variations in the vitamin D metabolic pathway and the severity of liver damage in UK children. The researchers found that polymorphisms in the vitamin D related genetic variants NADSYN1/DHCR7 and VDR were independently associated with increased liver fat while a GC variant was associated with increased inflammation in liver biopsies.
Non-alcoholic fatty liver disease is now the most common chronic liver disease in children. However, “because liver disease is difficult to diagnose, the exact prevalence in children in the UK is unknown. In adults and children, fatty liver tracks with obesity prevalence; currently 1 in 3 children are overweight or obese [by age 11], “adds Moore.
Both genetic and nutritional factors are thought to influence the development and progression of the disease, adding to the challenge of identifying patients at risk for progression to advanced disease.
Regarding future research options, Moore asserts that although there have been a handful of studies in adult NAFLD suggesting minimal benefit from vitamin D supplementation, “a child’s liver is quite different and intervention with vitamin D earlier on could be effective.” Therefore, randomized trials must be conducted to examine this and establish dosage levels and time.
NutritionInsight has previously reported on significant research into a lethal form of liver cancer, which found that Acyclic retinoid, an artificial compound derived from vitamin A, may prevent the recurrence of tumors.
By Laxmi Haigh
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