Medical news
of the North Caucasus
Scientific journal
Mass media registration certificate dated December 7, 2006.
Series ПИ #ФС 77-26521.
Federal service for surveillance over non-violation of the legislation in the sphere of mass communications and protection of cultural heritage.
ISSN 2073-8137

Site search

Correspondence address
310 Mira Street, Stavropol, Russia, 355017

+7 865 2352511, +7 865 2353229.


Vitamin D as a marker of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus

[Original research] [Internal diseases]
Alexandr Yagoda; Pavel Koroy; Elena Otarievna Demurcheva; Nikolay Evgenyevich Hvatalin; Anna Daniilovna Svetogurova; Vijaya Sarithala;

Ninety patients with type 2 diabetes mellitus (DM) aged 39 to 76 years were examined. Women were 71 (78.9 %), men – 19 (21.1 %). The diagnosis of non-alcoholic fatty liver disease (NAFLD) was made based on an ultrasound examination of the abdominal cavity. The levels of vitamin D in the blood were determined by enzyme immunoassay. NAFLD was detected in 66.7 % of patients with type 2 DM. Vitamin D levels in the blood of patients with NAFLD on the background of type 2 DM were lower, and its deficiency was more common than in cases of DM without NAFLD. Serum vitamin D levels in patients with NAFLD and cholestatic syndrome were lower than in cases of NAFLD without signs of cholestasis. According to regression analysis, the development of NAFLD in type 2 DM is affected by reduced vitamin D levels in the blood and increased values of glucose, alanine aminotransferase, and low-density lipoproteins.

Thus, the development of NAFLD against the background of type 2 DM is associated with a decrease in vitamin D concentration in the blood. Serum level of vitamin D less than 16.18 ng/ml can be used as a predictor of NAFLD in patients with type 2 DM.


1. Maevskaya M. V., Kotovskaya Yu. V., Ivashkin V. T., Tkacheva O. N., Troshina E. A. [et al.] The National Consensus statement on the management of adult patients with non-alcoholic fatty liver disease and main comorbidities. Terapevticheskii Arkhiv. – Ter. Arkh. 2022; 94(2):216-253. https://doi.org/10.26442/00403660.2022.02.201363
2. Perumpail B. J., Khan M. A., Yo E. R., Cholankeril G., Kimet D. [et al.] Clinical epidemiology and disease burden of nonalcoholic fatty liver disease. world J. Gastroenterol. 2017;23(47):8263-8276. https://doi.org/10.3748/wjg.v23.i47.8263
3. Younossi Z. M., Koenig A. B., Abdelatif D., Fazel Y., Henry L. [et al.] Global epidemiology of nonalcoholic fatty liver disease: meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84. https://doi.org/10.1002/hep.28431
4. Younossi Z. M., Golabi P., de Avila L., Paik J. M., Srishord M. [et al.] The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: a systematic review and meta-analysis. J. Hepatol. 2019;71(4):793-801. https://doi.org/10.1016/j.jhep.2019.06.021
5. Kwok R. M., Torres D. M., Harrison S. A. Vitamin D and nonalcoholic fatty liver disease (NAFLD): is it more than just an association? Hepatology. 2013;58:1166-1174. https://doi.org/10.1002/hep.26390
6. Barchetta I., Cimini F. A., Cavallo M. G. Vitamin D and metabolic dysfunction-associated fatty liver disease (MAFLD): an update. Nutrients. 2020;12(11):3302-3315. https://doi.org/10.3390/nu12113302
7. Gad A. I., Elmedames M. R., Abdelhai A. R., Marei A. M. The association between vitamin D status and non-alcoholic fatty liver disease in adults: a hospital-based study. Egyptian Liver J. 2020;10:25. https://doi.org/10.1186/s43066-020-00033-z
8. Dasarathy J., Periyalwar P., Allampati S., Bhinder V., Hawkinset C. [et al.] Hypovitaminosis D is associated with increased whole body fat mass and greater severity of non alcoholic fatty liver disease. Liver Int. 2014;34(6):e118-e127. https://doi.org/10.1111/liv.12312
9. Xing Y., Cheng T., Zhou F., Ma H. The association between vitamin D and type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease: an observational cross-sectional study. Diabetes, Metabolic syndrome and Obesity: Targets and Therapy. 2022;15:269-280. https://doi.org/10.2147/DMSO.S348870
10. Xiu L., Jiang T., Yao X.-A., Wen Z. Correlation between 25 hydroxyvitamin D levels and nonalcoholic fatty liver disease in Chinese patients with type 2 diabetes mellitus: a cross-sectional study. Int. J. General Med. 2021;14:3099-3107. https://doi.org/10.2147/IJGM.S319449
11. Zhang Y., Li J., Ni Y., Wang Y., Liu H. Correlational study on the levels of 25-hydroxyvitamin D and non-alcoholic fatty liver disease in type 2 diabetic patients. BMC Endocrine Disorders. 2021;21:100. https://doi.org/10.1186/s12902-021-00762-1
12. Ha Y., Hwang S. G., Rim K. S. The association between vitamin D insufficiency and nonalcoholic fatty liver disease: a population-based study. Nutrients. 2017;9:806. https://doi.org/10.3390/nu9080806
13. Park D., Kwon H., Oh S.-W., Joh H. K., Hwang S. S. [et al.] Is vitamin D an independent risk factor of nonalcoholic fatty liver disease? A cross-sectional study of the healthy population. J. Korean Med. sci. 2017;32:95-101. https://doi.org/10.3346/jkms.2017.32.1.95
14. Zhu Sh., Wang Y., Luo F., Liu J., Xiu L. [et al.] The level of vitamin D in children and adolescents with nonalcoholic fatty liver disease: a meta-analysis. BioMed. Research International. 2019;2019:7643542. https://doi.org/10.1155/2019/7643542
15. Lazebnik L. B., Golovanova E. V., Turkina S. V., Raikhelson K. L., Okovityy S. V. [et al.] Non-alcoholic fatty liver disease in adults: clinic, diagnostics, treatment. Guidelines for therapists, third version. Experimental and Clinical Gastroenterology. 2021;185(1):4-52. https://doi.org/10.31146/1682-8658-ecg-185-1-4-52
16. Barchetta I., Angelico F., Del Ben M., Baroni M. G., Pozzilli P. [et al.] Strong association between non alcoholic fatty liver disease (NAFLD) and low 25(OH) vitamin D levels in an adult population with normal serum liver enzymes. BMC Medicine. 2011;9:85. https://doi.org/10.1186/1741-7015-9-85
17. Zhang H., Shen Z., Lin Y., Zhang J., Zhang Y. [et al.] Vitamin D receptor targets hepatocyte nuclear factor 4α and mediates protective effects of vitamin D in nonalcoholic fatty liver disease. J. Biol. Chem. 2020;295(12):3891-3905. https://doi.org/10.1074/jbc.RA119.011487
18. Roth C. L., Elfers C. T., Figlewicz D. P., Melhorn S. J., Morton G. J. [et al.] Vitamin D deficiency in obese rats exacerbates nonalcoholic fatty liver disease and increases hepatic resistin and toll-like receptor activation. Hepatology. 2012;55(4):1103-1111. https://doi.org/10.1002/hep.24737
19. Chung G. E., Kim D., Kwak M.-S., Yang J. I., Yim J. Y. [et al.] The serum vitamin D level is inversely correlated with nonalcoholic fatty liver disease. Clin. Mol. Hepatol. 2016;22:146-151. https://doi.org/10.3350/cmh.2016.22.1.146

Keywords: non-alcoholic fatty liver disease, type 2 diabetes mellitus, vitamin D

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy