Vitamin D status in patients with cirrhosis of the liver and their relatives—A case control study from North India

• Published in: Indian journal of gastroenterology Vol. 36; no. 1; pp. 50 - 55
• Main Authors: Kumar, Ravikant, Kumar, Pavan, Saxena, Kandarp Nath, Mishra, Manjul, Mishra, Vivek Kumar, Kumari, Anju, Dwivedi, Manisha, Misra, Sri Prakash
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 2017
• Subjects: Adult; Case-Control Studies; Female; Gastroenterology; Hepatology; Humans; India - epidemiology; Liver Cirrhosis - diagnosis; Liver Cirrhosis - drug therapy; Liver Cirrhosis - etiology; Liver Cirrhosis - metabolism; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Prevalence; Vitamin D - analogs & derivatives; Vitamin D - metabolism; Vitamin D Deficiency - complications; Vitamin D Deficiency - epidemiology; Vitamin D Deficiency - metabolism; Cirrhosis; Vitamin D; Child-Turcotte-Pugh score; Model for end-stage liver disease score
• DOI: 10.1007/s12664-017-0727-7
• ISSN: 0254-8860

Background and Aim Liver diseases interfere with the production of the metabolites of vitamin D required for activation, thus resulting in abnormal calcium and bone metabolism. Previous studies show inconsistent results of vitamin D level in non-cholestatic liver diseases. Our aim was to determine the prevalence of vitamin D insufficiency in cirrhosis as compared to apparently normal relatives and its relationship with etiology and severity. Methods One hundred and sixty cirrhotic patients attending the Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, were enrolled, and 25-hydroxy vitamin D [25(OH)D] and calcium levels assessed. Vitamin D status was graded as insufficiency (20–30 ng/mL), deficiency (<20 ng/mL), and severe deficiency (<7 ng/mL). 25(OH)D levels of patients were compared with those of their healthy family members. Results Forty-six percent of the normal population had 25(OH)D inadequacy, whereas 51.85% of patients with cirrhosis had 25(OH)D deficiency, and 28.12% had insufficiency. Thus, 80% of patients with cirrhosis of the liver had some form of vitamin D inadequacy. 12.5% of cirrhotics had severe vitamin D deficiency. Serum calcium (Ca ++ ) was not significantly different between the patients and control group. The etiology of cirrhosis had no relation with vitamin D levels. Prevalence of deficiency and insufficiency increased with increasing age and mean Child-Turcotte-Pugh and model for end-stage liver disease scores. Conclusion Vitamin D insufficiency is highly prevalent in patients with cirrhosis irrespective of etiology and significantly more common than their healthy relatives. Measurement of 25(OH) vitamin D and replacement may be considered as part of the overall management of patients with cirrhosis of the liver as well as apparently healthy individuals.