Vitamin D levels do not predict the stage of hepatic fibrosis in patients with non-alcoholic fatty liver disease: A PRISMA compliant systematic review and meta-analysis of pooled data

Figure 4 Random effects pooled the mean difference of 25-hydroxyvitamin D levels in nonalcoholic fatty liver disease patients with high and low fibrosis scores. A meta-analysis of the pooled data of the six included studies according to fibrosis scores of low F0-2 vs high F3-4. Figure 4 illustrates the forest plot of the results of the six included studies, with 95%CI, and the overall effect (under the random-effects model) with 95%CI are illustrated in this forest plot. The six included studies[26-30,32] assessed the association of 25-hydroxyvitamin D among patients with nonalcoholic fatty liver disease (NAFLD). We used a random-effects model to assess the pooled data in a meta-analysis as previously described[36]. The statistical heterogeneity was not significant with I² of 37.8% (P_{heterogeneity} = 0.0766); however, we observed a trend towards high heterogeneity. We found no difference in 25-hydroxyvitamin D among NAFLD patients with high (F3-4) vs low (F0-2) fibrosis, with the summary effect size of 0.95 representing mean differences between F0-2 and F3-4 NAFLD patients. Overall, our analysis confirmed that there was no association between serum 25-hydroxyvitamin D and low vs high fibrosis score in NAFLD patients from the six included studies.