Vitamin D deficiency is associated with hepatic decompensation and inflammation in patients with liver cirrhosis : a prospective cohort study

  • 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.

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Author:Alica KubeschORCiDGND, Leonie Quenstedt, Maged Saleh, Sabrina Rüschenbaum, Katharina Schwarzkopf, Yolanda Martinez, Christoph WelschORCiDGND, Stefan ZeuzemORCiDGND, Tania Mara WelzelGND, Christian LangeGND
Pubmed Id:
Parent Title (English):PLoS one
Place of publication:Lawrence, Kan.
Contributor(s):Pavel Strnad
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/11/08
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/11/13
Tag:Ascites; Cirrhosis; Gastrointestinal tract; Inflammation; Liver diseases; Liver fibrosis; Vitamin D; Vitamin D deficiency
Issue:(11): e0207162
Page Number:11
First Page:1
Last Page:11
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.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0