TY  - JOUR
A1  - Kubesch, Alica
A1  - Quenstedt, Leonie
A1  - Saleh, Maged
A1  - Rüschenbaum, Sabrina
A1  - Schwarzkopf, Katharina
A1  - Martinez, Yolanda
A1  - Welsch, Christoph
A1  - Zeuzem, Stefan
A1  - Welzel, Tania Mara
A1  - Lange, Christian
T1  - Vitamin D deficiency is associated with hepatic decompensation and inflammation in patients with liver cirrhosis : a prospective cohort study
T2  - PLoS one
N2  - Background: Vitamin D is required to maintain the integrity of the intestinal barrier and inhibits inflammatory signaling pathways.
Objective: Vitamin D deficiency might be involved in cirrhosis-associated systemic inflammation and risk of hepatic decompensation in patients with liver cirrhosis.
Methods: Outpatients of the Hepatology Unit of the University Hospital Frankfurt with advanced liver fibrosis and cirrhosis were prospectively enrolled. 25-hydroxyvitamin D (25(OH)D3) serum concentrations were quantified and associated with markers of systemic inflammation / intestinal bacterial translocation and hepatic decompensation.
Results: A total of 338 patients with advanced liver fibrosis or cirrhosis were included. Of those, 51 patients (15%) were hospitalized due to hepatic decompensation during follow-up. Overall, 72 patients (21%) had severe vitamin D deficiency. However, patients receiving vitamin D supplements had significantly higher 25(OH)D3 serum levels compared to patients without supplements (37 ng/mL vs. 16 ng/ml, P<0.0001). Uni- and multivariate analyses revealed an independent association of severe vitamin D deficiency with the risk of hepatic decompensation during follow-up (multivariate P = 0.012; OR = 3.25, 95% CI = 1.30–8.2), together with MELD score, low hemoglobin concentration, low coffee consumption, and presence of diabetes. Of note, serum levels of C-reactive protein, IL-6 and soluble CD14 were significantly higher in patients with versus without severe vitamin D deficiency, and serum levels of soluble CD14 levels declined in patients with de novo supplementation of vitamin D (median 2.15 vs. 1.87 ng/mL, P = 0.002).
Conclusions: In this prospective cohort study, baseline vitamin D levels were inversely associated with liver-cirrhosis related systemic inflammation and the risk of hepatic decompensation.
KW  - Vitamin D
KW  - Vitamin D deficiency
KW  - Cirrhosis
KW  - Liver fibrosis
KW  - Ascites
KW  - Gastrointestinal tract
KW  - Liver diseases
KW  - Inflammation
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/47815
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-478154
SN  - 1932-6203
N1  - Copyright: © 2018 Kubesch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 13
IS  - (11): e0207162
SP  - 1
EP  - 11
PB  - PLoS
CY  - Lawrence, Kan.
ER  -