Non-alcoholic fatty liver disease (NAFLD) is common in elderly and its prevalence is known to increase with age. However, there is scarcity of evidence depicting the association between the risk of NAFLD in older adults and serum vitamin D (25-hydroxyvitamin D) and physical fitness levels. Thus, the objective of the current study was to evaluate the relationship between risk of NAFLD and serum vitamin D levels along with physical fitness in elderly population with the help of a non-invasive diagnostic approach.

A total of 533 older adults, aged 65 years or older participated in this cross-sectional study. NAFLD was identified according to the ZJU and NAFLD liver fat (LFS) score in absence of another cause of liver disease. Physical fitness was determined with the help of a senior fitness test protocol. Estimate odds ratios (ORs) and 95 % confidence intervals (CIs) of NAFLD for different combinations of serum vitamin D and physical fitness levels was examined by logistic regression analysis.

The outcome revealed that according to the ZJU (OR: 3.073, CI: 1.285-7.350) and LFS (OR = 2.443, CI = 1.071-5.572), individuals with serum vitamin D < 30 ng/ml and poor physical fitness showed a relevant higher risk of NAFLD in contrast to individuals with serum vitamin D ≥ 30 ng/ml and high fitness, after adjusting age, sex, smoking, alcohol consumption and physical inactivity. Nevertheless, negative association was found after adjusting for additional metabolic diseases. 

To conclude, risk of NAFLD in older population can be reduced by maintenance of optimum levels of serum vitamin D and/or high physical fitness along with the monitoring of metabolic diseases.

Source: Lee I, Park E, Cho J. Association of nonalcoholic fatty liver disease with serum vitamin D levels in combination of physical fitness in korean older adults. J Steroid Biochem Mol Biol. 2020;198:105569.