Role of micronutrients in staging of nonalcoholic fatty liver disease: A retrospective cross-sectional study

Table 1 Sample characteristics

Characteristics	Value
Age mean and standard deviation	37 ± 9.68
Female sex, n (%)	455 (79.0)
BMI, mean, and standard deviation	42.8 ± 5.57
BMI classification, n (%)
Obesity Class I	04 (0.7)
Obesity Class II	121 (22.2)
Obesity Class III	420 (77.1)
Comorbidities, n (%)	446 (83.1)
DM	95 (17.2)
DM complications	11 (8.5)
SAH	234 (41.7)
Sleep apnea	75 (14)
Smoking	41 (7.7)
Dyslipidemia	210 (40.9)
Micronutrients, median (min-max)
Vitamin D, pg/mL	20 (4.2-52.2)
Vitamin B12, pg/mL	407 (36-2000)
Zinc, mg/L	6.6 (4-19.4)
Iron, mcg/dL	79 (8-408)
Magnesium, mg/dL	2.1 (1.3-2.9)
Steatosis, n (%)	604 (100.0)
0	42 (7.0)
1	221 (36.6)
2	182 (30.1)
3	159 (26.3)
NASH, n (%)	584 (100.0)
0	171 (29.3)
1	282 (48.3)
2	125 (21.4)
3	06 (1.0)
Fibrosis, n (%)	602 (100.0)
0	302 (50.2)
1	224 (37.2)
2	35 (5.8)
3	38 (6.3)
4	03 (0.5)

n = 614, sample size. BMI: Body mass index; DM: Diabetes mellitus; NASH: Nonalcoholic steatohepatitis; SAH: Systemic arterial hypertension.

Table 2 Mean serum levels of micronutrients according to liver histopathology staging

	Grade	Vitamin D, pg/mL	Vitamin B12, pg/mL	Zinc, mg/L	Iron, mcg/dL	Magnesium, mg/dL
Steatosis	0	21	433	6.7	82	2.2
	1	21	390	6.6	78	2.0
	2	19	400	6.6	77	2.1
	3	19	444	6.6	80	2.1
	P value	0.047	0.040	0.681	0.959	0.166
NASH	0	21	416	6.7	76	2.1
	1	20	395	6.6	79	2.0
	2	18	404	6.5	79	2.0
	3	-	304	-	80	-
	P value	0.198	0.553	0.950	0.521	0.536
Fibrosis	0	20	401	6.8	79	2.1
	1	21	400	6.6	75	2.1
	2	19	447	6.8	82	2.0
	3	17	444	6.8	83	2.0
	4	-	-	-	-	-
	P value	0.732	0.110	0.877	0.468	0.316

Kruskal-Wallis test. Insufficient numbers for comparison are represented with “-“. NASH: Nonalcoholic steatohepatitis.

Table 3 Serum levels of micronutrients and liver histopathological analysis

		Vitamin D, pg/mL	Vitamin B12, pg/mL	Zinc, mg/L	Iron, mcg/dL	Magnesium, mg/dL
Steatosis	Absent/mild	21	394	6.6	78	2.0
	Advanced	19	418	6.6	79	2.1
	P value	0.008	0.134	0.618	0.814	0.961
NASH	Absent/mild	21	402	6.6	77	2.1
	Advanced	18	403	6.5	79	2.0
	P value	0.135	0.960	0.900	0.726	0.562
Fibrosis	Absent/mild	20	402	6.6	78	2.1
	Advanced	17	477	6.8	83	2.0
	P value	0.182	0.030	0.858	0.457	0.149

Mann-Whitney test. Absent/mild steatosis: Grades 0, 1 and 2; Advanced steatosis: Grade 3; Absent/mild NASH: Grades 0, 1 and 2; Advanced NASH: Grade 3; Absent/mild fibrosis: Grades 0, 1 and 2; Advanced fibrosis: Grades 3 and 4. NASH: Nonalcoholic steatohepatitis.

Table 4 Severity of nonalcoholic fatty liver disease and serum levels of micronutrients

		Vitamin D, pg/mL	Vitamin B12, pg/mL	Zinc, mg/L	Iron, mcg/dL	Magnesium, mg/dL
Steatosis	r	-0.120	0.095	0.58	0.007	-0.053
	P value	0.042	0.047	0.359	0.879	0.468
NASH	r	-0.126	-0.012	-0.018	0.030	-0.078
	P value	0.034	0.812	0.775	0.553	0.291
Fibrosis	r	-0.061	0.095	-0.029	0.031	-0.080
	P value	0.303	0.048	0.647	0.538	0.272

Spearman’s correlation. NASH: Nonalcoholic steatohepatitis.