“The Times They Are A-Changin’” at Diabetes Care

Every five years or so, the editorial team leading Diabetes Care turns over with the appointment of new leadership. This issue of volume 46 represents the first of a new editorial team, making it the tenth group to be responsible for the scientific content of the journal. Starting in 1978 with Jay Skyler as its first editor, Diabetes Care has gone from strength to strength with new initiatives and a steady increase in its influence. This impact has been in line with the charge given at the journal’s founding by the then president of the American Diabetes Association Norbert Freinkel when he wrote, “The new journal is designed to promote better patient care by serving the expanded needs of all health professionals committed to the care of patients with diabetes.

Association between Vitamin D Levels and Nonalcoholic Fatty Liver Disease: Potential Confounding Variables

Nonalcoholic fatty liver disease (NAFLD), historically considered to be the hepatic component of the metabolic syndrome, is a spectrum of fat-associated liver conditions, in the absence of secondary causes, that may progress to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. Disease progression is closely associated with body weight or fatness, dyslipidemia, insulin resistance, oxidative stress, and inflammation. Recently, vitamin D deficiency has been linked to the pathogenesis and severity of NAFLD because of vitamin D "pleiotropic" functions, with roles in immune modulation, cell differentiation and proliferation, and regulation of inflammation. Indeed, several studies have reported an association between vitamin D and NAFLD/NASH. However, other studies have failed to find an association. Therefore, we sought to critically review the current evidence on the association between vitamin D deficiency and NAFLD/NASH, and to analyze and discuss some key variables that may interfere with this evaluation, such as host-, environment-, and heritability-related factors regulating vitamin D synthesis and metabolism; definitions of deficient or optimal vitamin D status with respect to skeletal and nonskeletal outcomes including NAFLD/NASH; methods of measuring 25(OH)D; and methods of diagnosing NAFLD as well as quantifying adiposity, the cardinal link between vitamin D deficiency and NAFLD