Dynamics of Serum Retinol and Alpha-Tocopherol Levels According to Non-Alcoholic Fatty Liver Disease Status

Nutrients. 2021 May 19;13(5):1720. doi: 10.3390/nu13051720.


The available data on the association between micronutrients in the blood and non-alcoholic fatty liver disease (NAFLD) are limited. To investigate the clinical implications of this relationship, we sought to identify the difference in the serum levels of vitamins A and E according to NAFLD status using data from the seventh Korea National Health and Nutrition Examination Survey. In this cross-sectional study of the Korean population, NAFLD and its severity were defined using prediction models. Differences in the prevalence and severity of NAFLD were analyzed according to serum retinol (vitamin A) and alpha (α)-tocopherol (vitamin E) levels. Serum levels of retinol and α-tocopherol were positively correlated with the prevalence of NAFLD. In most prediction models of the NAFLD subjects, serum retinol deficiency was significantly correlated with advanced fibrosis, while serum α-tocopherol levels did not differ between individuals with or without advanced fibrosis. Similar trends were also noted with cholesterol-adjusted levels of α-tocopherol. In summary, while circulating concentrations of retinol and α-tocopherol were positively associated with the presence of NAFLD, advanced liver fibrosis was only correlated with serum retinol levels. Our findings could provide insight into NAFLD patient care at a micronutrient level.

Keywords: advanced liver fibrosis; non-alcoholic fatty liver disease; vitamin A; vitamin E.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Fibrosis
  • Humans
  • Male
  • Micronutrients / blood
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease*
  • Nutrition Surveys*
  • Republic of Korea
  • Vitamin A / blood*
  • Vitamin A Deficiency
  • Vitamin E / blood
  • Vitamins / blood
  • alpha-Tocopherol / blood*


  • Micronutrients
  • Vitamins
  • Vitamin A
  • Vitamin E
  • alpha-Tocopherol

Supplementary concepts

  • Keratomalacia