Association of 25-hydroxyvitamin D levels with liver dysfunction and mortality in chronic liver disease

• Published in: Liver international 2012-05, Vol.32 (5), p.845-851
• Main Authors: Putz-Bankuti, Csilla, Pilz, Stefan, Stojakovic, Tatjana, Scharnagl, Hubert, Pieber, Thomas R., Trauner, Michael, Obermayer-Pietsch, Barbara, Stauber, Rudolf E.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Austria - epidemiology; Comorbidity; End Stage Liver Disease - blood; End Stage Liver Disease - diagnosis; End Stage Liver Disease - mortality; Female; Humans; Liver Cirrhosis - blood; Liver Cirrhosis - diagnosis; Liver Cirrhosis - mortality; Male; Middle Aged; Severity of Illness Index; Survival Rate; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - diagnosis; Vitamin D Deficiency - epidemiology
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/j.1478-3231.2011.02735.x

Background Previous studies suggest that chronic liver disease may be related to vitamin D deficiency. It is, however, not known whether 25(OH)D levels are associated with incident hepatic decompensation and mortality in chronic liver failure. Aims We aimed to evaluate whether 25(OH)D serum levels are associated with Child–Pugh (CP) score, model for end‐stage liver disease (MELD) score, occurrence of hepatic decompensation, and survival in patients with cirrhosis. Methods We enrolled 75 consecutive cirrhotic patients admitted to our outpatient liver clinic (32% females; age: 58 ± 11 years; aetiology alcohol in 61%). At baseline, 25(OH)D was determined and the degree of liver dysfunction was estimated by CP and MELD score. Thereafter patients were followed‐up with respect to hepatic decompensation and mortality. Results 25(OH)D levels averaged 16.0 ± 9.2 ng/ml and were inversely correlated with MELD score (r = −0.34, P = 0.003) and CP score (r = −0.21, P = 0.080). Thirty‐seven patients developed hepatic decompensation and 24 patients died during a median follow‐up of 3.6 years. Age‐ and gender‐adjusted relative risk (with 95% confidence interval) was 6.37 (1.75–23.2; P = 0.005) for hepatic decompensation and 4.31 (1.38–13.5; P = 0.012) for mortality within the first vs the third 25(OH)D tertile but these associations were largely attenuated towards non‐significant trends after additional adjustments for CP or MELD score. Conclusions Our findings show a significant association of 25(OH)D with the degree of liver dysfunction and suggest that low 25(OH)D levels may predict hepatic decompensation and mortality in patients with chronic liver failure.