Vitamin D and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Novel Mechanistic Insights

Int J Mol Sci. 2024 Apr 30;25(9):4901. doi: 10.3390/ijms25094901.

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasingly prevalent condition characterized by abnormal fat accumulation in the liver, often associated with metabolic disorders. Emerging evidence suggests a potential link between vitamin D deficiency and the development and progression of MASLD. The current review provides a concise overview of recent studies uncovering novel mechanistic insights into the interplay between vitamin D and MASLD. Several epidemiological studies have highlighted a significant association between low vitamin D levels and an increased risk of MASLD. Vitamin D, traditionally known for its role in bone health, has now been recognized as a key player in various physiological processes, including immune regulation and inflammation. Experimental studies using animal models have demonstrated that vitamin D deficiency exacerbates liver steatosis and inflammation, suggesting a potential protective role against MASLD. Mechanistically, vitamin D appears to modulate MASLD through multiple pathways. Firstly, the vitamin D receptor (VDR) is abundantly expressed in liver cells, indicating a direct regulatory role in hepatic function. Activation of the VDR has been shown to suppress hepatic lipid accumulation and inflammation, providing a mechanistic basis for the observed protective effects. Additionally, vitamin D influences insulin sensitivity, a critical factor in MASLD pathogenesis. Improved insulin sensitivity may mitigate the excessive accumulation of fat in the liver, thus attenuating MASLD progression. In parallel, vitamin D exhibits anti-inflammatory properties by inhibiting pro-inflammatory cytokines implicated in MASLD pathophysiology. Experimental evidence suggests that the immunomodulatory effects of vitamin D extend to the liver, reducing inflammation and oxidative stress, key drivers of MASLD, and the likelihood of hepatocyte injury and fibrosis. Understanding the complex interplay between vitamin D and MASLD provides a basis for exploring targeted therapeutic strategies and preventive interventions. As vitamin D deficiency is a modifiable risk factor, addressing this nutritional concern may prove beneficial in mitigating the burden of MASLD and associated metabolic disorders.

Keywords: MASLD; hepatic steatosis; inflammation; insulin resistance; metabolic dysfunction-associated steatotic liver disease; vitamin D; vitamin D receptor.

Publication types

  • Review

MeSH terms

  • Animals
  • Fatty Liver* / etiology
  • Fatty Liver* / metabolism
  • Humans
  • Insulin Resistance
  • Liver / metabolism
  • Liver / pathology
  • Metabolic Diseases / etiology
  • Metabolic Diseases / metabolism
  • Receptors, Calcitriol* / metabolism
  • Vitamin D Deficiency* / complications
  • Vitamin D Deficiency* / metabolism
  • Vitamin D* / metabolism

Substances

  • Vitamin D
  • Receptors, Calcitriol

Grants and funding

This research received no external funding.