Abstract:
Worldwide, obesity is considered a major public health problem. In the last four decades, its prevalence has tripled, currently affecting more than 650 million individuals, about 13% of the world population. Considered one of the major risk factors for chronic noncommunicable diseases.
Metabolic Associated Fatty Liver Disease (MALFLD) is the new term to Nonalcoholic fatty liver disease (NAFLD), that has become one of the most common chronic liver diseases worldwide. MAFLD is characterized by an accumulation of fat in the liver in the absence of such secondary causes as alcohol abuse, viral hepatitis, and so forth, while presenting such wide-ranging histological features as simple macrovesicular steatosis and nonalcoholic steatohepatitis (NASH) that can evolve into fibrosis, cirrhosis, or hepatocellular carcinoma.
In addition to comorbidities, obesity is also related to nutritional deficiencies, which contributes to worsening the individual's health status. In this context, Vitamin D (VD) stands out because it has an inverse correlation with body adiposity. and this relationship can be explained by several factors. Vitamin D deficiency (VDD), one of the most prevalent micronutrient deficiencies in the world, can result from problems relating to the absorption of VD (25(OH)D), hydroxylation due to liver failure, inadequate exposure to sunlight and other factors. Individuals with obesity, including those suffering from liver disease, are more susceptible to VDD. A potential explanation for this deficiency is, when there is damage of the liver, synthesis of 25(OH)D may be impaired by the presence of steatosis. VDD can exacerbate MAFLD at least in part through an inflammatory-mediated pathway, given how VD mediates its intracellular signals via the vitamin D receptor (VDR), which is constitutively expressed in the liver.
Currently, the most widely used parameter in clinical practice to classify obesity is the Body Mass Index (BMI), often combined with other anthropometric measurements. However, attention should be paid to its limitations, once information on the presence or severity of comorbidities, functional limitations, mental health, and quality of life of the individual with obesity are not considered. Given these limitations of the obesity classification parameters used so far, the Edmonton Obesity Staging System (EOSS), an ordinal five-stage staging system based on simple clinical analysis was developed.
Thus, the aim of this presentation will be demonstrating the relationship between nutritional status of VD and MAFLD staging in obesity according to EOSS.
