Z Gastroenterol 2016; 54(12): 1343-1404
DOI: 10.1055/s-0036-1597425
3. Metabolism/Transport
Georg Thieme Verlag KG Stuttgart · New York

Association of Elevated Liver Enzymes and Vitamin D Deficiency

S Gehring
2   Philipps University Marburg, Gastroenterology, Marburg, Germany
,
P Difazio
1   Philipps University Marburg, Department of Visceral and Thoracic Surgery, Marburg, Germany
,
T Gress
2   Philipps University Marburg, Gastroenterology, Marburg, Germany
,
TT Wissniowski
2   Philipps University Marburg, Gastroenterology, Marburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
19 December 2016 (online)

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Background: Vitamin D deficiency is a frequent burden in northern countries, mainly caused by decreased intake and reduced sun exposure. Clinical manifestations of vitamin D deficiency are often skeletal, like osteoporosis, osteomalacia, and rickets. In addition, low vitamin D levels are associated with chronic renal disease, muscle weakness, hypertension, cardiovascular events, and diabetes.

Younger studies suggest an association of low vitamin D levels with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), as well as metabolic syndrome, and diabetes mellitus.

Unfortunately, a causality could not yet be proven.

Our aim was to assess the role of vitamin D levels in relationship with elevated liver enyzmes and life-style diseases such as hypertension, diabetes, and fat metabolism disorders.

Material and Methods: 181 patients, whose plasma vitamin D concentration and liver enzyme levels had been quantified beforehand, were recruited and a retrospective investigation of laboratory parameters (including electrolytes, hormones, and vitamins) and pre-existing medical conditions (including high blood pressure, diabetes, hyperlipoproteinaemia, and more) followed.

Results: Patients were divided into 4 groups according to plasma vitamin D levels (normal > 25 ng/ml; low < 25 ng/ml) and transaminase levels (AST/ALT/γ-GT > 30 U/l; normal: AST/ALT/γ-GT < 30 U/l).

A significant correlation of low vitamin d levels and elevated liver enzymes could not be shown. Nevertheless, low 1,25-hydroxyvitamin D levels correlated with high kreatinine, urea, and LDL levels, while low 25-hydroxyvitamin D levels correlated with high cholesterol and trigylceride levels, suggesting a relationship between low vitamin D levels and fat metabolism disorders.

Discussion:

Our results suggest that

  • The prevalence of vitamin D deficiency directly correlates with the season (winter>summer).

  • Vitamin D deficiency is often present in patients with kidney diseases such as chronic renal failure.

  • Vitamin D levels are correlated to age and sex of the patient.

  • A significant correlation of vitamin D deficiency and elevated liver enzymes can only be shown if a very low cut-off is chosen.

  • Vitamin D deficiency is associated with metabolic syndrome.