Abstract：Objective To investigate the changes of serum 25-hydroxyvitamin D3 (25(OH)D3) levels in elderly patients with non-alcoholic fatty liver disease (NAFLD) and the relationship between them and insulin resistance and oxidative stress.Methods A total of 125 elderly NAFLD patients treated in our hospital from January 2018 to April 2020 were selected as the observation group and divided into three subgroups according to serum 25(OH)D3 levels: vitamin D deficiency group, vitamin D insufficiency group and vitamin D normal group;Another 30 elderly healthy subjects were selected as the control group. The serum 25(OH)D3 level was compared between the observation group and the control group.The differences of body mass index (BMI), blood lipid, liver function, fasting blood glucose (FBG), fasting insulin (FINS), insulin resistance index (HOMA-IR), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) between three subgroups of the observation group were compared. The correlation between serum 25(OH)D3 level and the above indexes in observation group was analyzed.Results Compared with the control group, the levels of 25 (OH) D3, SOD and GSH-Px in the observation group were significantly decreased, and the levels of BMI, FINS, HOMA-IR and MDA were significantly increased (P<0.05). Compared with vitamin D normal group, the levels of FINS, HOMA-IR and MDA in vitamin D deficiency group and vitamin D insufficiency group were significantly increased, while the levels of SOD and GSH-Px were significantly decreased (P<0.05); The levels of each index in vitamin D deficiency group were higher or lower than those in vitamin D insufficiency group (P<0.05). 25 (OH) D3 level was significantly negatively correlated with HOMA-IR and MDA (r=-0.395, r=-0.328, all P<0.05), and positively correlated with SOD and GSH-Px In the observation group (r=0.388, r=0.376, all P<0.05).Conclusions The level of serum 25(OH)D3 in elderly patients with NAFLD decreased significantly, and the deficiency of serum 25(OH)D3 was closely related to insulin resistance and oxidative stress.
Younossi Z M,Koenig A B,Abdelatif D,et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence,incidence,and outcomes[J]. Hepatology, 2016, 64(1):73- 84.
[2]
Koroglu E,Canbakan B,Atay K,et al.Role of oxidative stress and insulin resistance in disease severity of non-alcoholic fatty liver disease[J].Turk J Gastroenterol, 2016, 27(4):361-366.
[3]
El-Boshy M, BaSalamah M A, Ahmad J, et al. Vitamin D protects against oxidative stress, inflammation and hepatorenal damage induced by acute paracetamol toxicity in rat[J]. Free Radic Biol Med, 2019, 141:310-321.
[4]
Derakhshanian H, Javanbakht M H, Zarei M,et al. Vitamin D increases IGF-I and insulin levels in experimental diabetic rats[J]. Growth Horm IGF Res, 2017, 36:57-59.
[5]
Holick M F,Binkley N C,Bischoff H A,et al. Evaluation,treatment,and prevention of vitamin D deficiency: an endocrine society clinical practice guideline[J].J Clin Endocrinol Metab,2011, 96(7) : 1911 -1930.
Maurice J,Manousou P. Non-alcoholic fatty liver disease[J]. Clin Med (Lond),2018 18(3):245-250.
[8]
王炳元,刘露露.老年人非酒精性脂肪肝[J].中华肝脏病杂志, 2016, 24(2):92-95.
[9]
Teixeira J S, Bull A, Cordeiro A,et al.Vitamin D nutritional status and its relationship with metabolic changes in adolescents and adults with severe obesity[J]. Nutr Hosp, 2018, 35(4):847-853.
[10]
Verrusio W,Andreozzi P,Renzi A,et al. Association between serum vitamin D and metabolic syndrome in middle-aged and older adults and role of supplementation therapy with vitamin D[J]. Ann Ist Super Sanita, 2017, 53(1):54-59.
[11]
Liu S,Liu Y,Wan B,et al.Association between vitamin D status and non-alcoholic fatty liver disease: A Population-based study[J]. J Nutr Sci Vitaminol (Tokyo) , 2019, 65(4):303-308.
[12]
赖勇昌.血清维生素D水平与非酒精性脂肪性肝病相关性研究[D].沈阳:中国医科大学, 2018.
[13]
Kitade H,Chen G,Ni Y,et al.Nonalcoholic fatty liver disease and insulin resistance: new insights and potential new treatments[J]. Nutrients, 2017, 9(4): 387.
[14]
Kjalarsdottir L,Tersey S A,Vishwanath M,et al.1,25-Dihydroxyvitamin D3 enhances glucose-stimulated insulin secretion in mouse and human islets:a role for transcriptional regulation of voltage-gated calcium channels by the vitamin D receptor[J]. J Steroid Biochem Mol Biol, 2019, 185:17-26.
[15]
Masarone M,Rosato V,Dallio M,et al.Role of oxidative stress in pathophysiology of nonalcoholic fatty liver disease[J]. Oxid Med Cell Longev, 2018, 2018:9547613.
[16]
Kroglu E,Canbakan B,Atay K,et al.Role of oxidative stress and insulin resistance in disease severity of non-alcoholic fatty liver disease[J].Turk J Gastroenterol, 2016, 27(4):361-366.
[17]
Zhu CG,Liu YX,Wang H,et al. Active form of vitamin D ameliorates non-alcoholic fatty liver disease by alleviating oxidative stress in a high-fat diet rat model [J].Endocr J, 2017, 64(7):663-673.
[18]
Farhangi MA,Nameni G,Hajiluian G,et al. Cardiac tissue oxidative stress and inflammation after vitamin D administrations in high fat-diet induced obese rats[J].BMC Cardiovasc Disord, 2017, 17(1):161.
2021, Vol. 32 
