Vitamin D Levels are Associated with Liver Disease Severity in Patients with Cirrhosis

Abstract

Vitamin D deficiency is common in advanced liver disease but its clinical significance remains controversial. The aim of this study was to examine the correlation of 25-hydryoxyvitamin D levels with liver disease severity and calcium levels in adults with cirrhosis. This cross-sectional study included 180 adults with cirrhosis enrolled in a clinical cohort study at a single university hospital. The mean age was 58.8 (±9.2) years, and cirrhosis was attributed to alcohol use in 27.2%, hepatitis C in 35.0%, non-alcoholic steatohepatitis in 27.2%, and both alcohol and hepatitis C in 10.6%. The median model for end-stage liver disease-sodium (MELD-Na) score was 12.0 (interquartile range 9.0-16.0), and mean serum albumin levels were 3.4 (±0.7) gm/dl. Median serum 25-hydroxyvitamin D levels were 28.0 (interquartile range 20-38) ng/mL, with 16 patients (8.9%) having levels <12 ng/ml and 43 (23.9%) with 25(OH)D levels <20 ng/ml. No correlation was noted between levels of 25-hydroxyvitamin D and albumincorrected calcium in the total group and in groups stratified by vitamin D supplementation. In contrast, both serum albumin (r = 0.32; P < 0.001) and MELD-Na scores were significantly correlated with 25-hydroxyvitamin D levels (r = -0.29; P < 0.001). Correlations between 25-hydroxyvitamin D levels and serum albumin (r = −0.39; P < 0.001) and MELD-Na scores did not change substantially after excluding 67 patients receiving vitamin D supplementation (r = −0.33; P = 0.009). In conclusion, total 25-hydroxyvitamin D levels correlate inversely with liver disease severity in adults with cirrhosis.

Study of vitamin D levels and its correlation with child PUGH score in patients of chronic liver disease

“…Choubey and Ratlamwala [101] had higher number of Male patients (72%) than females (28%). In the study by Rech MA et al, [18] 53.3% patients were males [8] . Gupta et al [19] reported that 91% were male and 9% were female.…”

“…Choubey and Ratlamwala [17] had majority of patients (52%) were in age group 41-60 years followed by 21-40 years (30%). The mean age of patients in a study by Rech MA et al [18] was 58.8±9.2 years. Gupta et al [19] reported that mean age of the patients was 46.05±11.31years.…”

Study of vitamin D level in patients with different etiologies of chronic liver disease and its correlation with Child Pugh class in a tertiary care centre in North India

“…This study shows that total 25(OH)D levels correlate inversely with liver disease severity in adults with cirrhosis, while no correlation exists between 25(OH)D levels and albumin-corrected serum calcium levels. 12 On classifying patients (N=200 Certain limitation of the study was that sample size was small and we have not followed patients after supplementation of vitamin D. After completion of my study so we were not able to know impact of correction of vitamin D level in patients with chronic liver disease, which required further long term and large sample size study…”

A study of the correlation of serum vitamin D levels to Child-Pugh and MELD-Na scoring system in cirrhosis of the liver

“…Similarly in 180 patients with cirrhosis study done by Rech et al; they found no association of lower vitamin D level with increasing age and female sex but significant association with albumin, PT-INR, bilirubin and alcohol etiology. 22 Finkelmeier et al reported that patients with severe 25(OH) D3 deficiency had the highest mortality risk (hazard ratio 2.225, p=0.002). 21 These results suggest that vitamin D might be both a biomarker of severity and a potential therapeutic target in CLD.…”