No Link Seen Between Smoking and Fatty Liver
Written by Editor   
Saturday, February 13, 2016 12:00 AM

Smoking was not associated with prevalent non-alcoholic fatty liver disease, but low levels of certain micronutrients did appear to have an association.  Vitamin D is involved in the regulation of inflammation, and is probably important in the pathogenesis of fatty liver disease. 

This report states that considering how prevalent fatty liver is, if we were able to do something as easy as measure vitamin D and treat the deficiency, it would be one less hurdle for patients.


Smoking was not associated with prevalent non-alcoholic fatty liver disease, but low levels of certain micronutrients did appear to have an association, a large cross-sectional analysis suggested.

In a multivariate analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III), levels of the tobacco biomarker serum cotinine showed no association with non-alcoholic fatty liver disease.  This study suggests that after controlling for multiple factors, that cigarette smoking is not directly related to the prevalence of nonalcoholic fatty liver disease.

However, be quite cautious with counseling patients with fatty liver disease about smoking, because they certainly are at much higher risk for cardiovascular disease, and while smoking may not be directly associated with liver injury in this analysis, it must be taken into consideration that smoking may further increase their underlying already elevated cardiovascular risk.

Previous research into the potential effects of smoking on non-alcoholic fatty liver disease has resulted in controversial findings. In the current study researchers analyzed data for 11,004 adults who underwent ultrasonography, with 2,561 being classified as having non-alcoholic fatty liver disease and the other 8,443 acting as controls.

Low serum levels of vitamin A and lycopene were associated with prevalent non-alcoholic fatty liver disease.  Many epidemiologic studies have found that low serum vitamin D or vitamin E levels were associated with nonalcoholic fatty liver disease. However, few data are available on possible associations with other vitamins such as A, C, B12, and folate.

Only serum vitamin A and lycopene were significantly associated with prevalent fatty liver disease at low levels. No association was seen for vitamin B12, vitamin C, vitamin D, vitamin E , or folate.

In another study, patients with non-alcoholic fatty liver disease have more than double the risk of vitamin D deficiency, a retrospective case-control study found.

Among 33,217 patients with non-alcoholic fatty liver disease included in a national database, the unadjusted odds ratio for vitamin D deficiency was 3.160.  Non-alcoholic fatty liver disease is the deposition of fat in the liver in the absence of other recognized causes of fatty liver. This condition has increased markedly in the past 20 years, and is now estimated to be present in one-quarter of the U.S. population.

Vitamin D is involved in the regulation of inflammation, and is probably important in the pathogenesis of fatty liver disease.  Considering how prevalent fatty liver is, if we were able to do something as easy as measure vitamin D and treat the deficiency, it would be one less hurdle for patients.

There has been much interest recently in linking vitamin D with diseases that are mediated by inflammation.  Vitamin D has been implicated in the regulation of immunity, inflammation, and apoptosis, mechanisms that are key to regulating fibrosis and that are crucial in the progression of nonalcoholic fatty liver disease.

In addition, both non-alcoholic fatty liver disease and vitamin D deficiency are associated with considerable patient morbidity, and with the development of insulin resistance, diabetes, and cardiovascular disease.

Based on our data, we recommend that all patients with nonalcoholic fatty liver disease be screened for micronutrient deficiencies, including vitamin D.


Sources:  http://www.medpagetoday.com/MeetingCoverage/ACG/54185

http://www.medpagetoday.com/MeetingCoverage/ACG/54181