Frequency of Vitamin D Deficiency in Cirrhotic Versus Non-Cirrhotic Liver Disease Patients

Authors

  • Ali Haroon
  • Anita Haroon
  • Zahabia Sohail
  • Rabbia Akhtar Nizami
  • Ajeet Kumar

Keywords:

vitamin D deficiency, chronic liver disease, cirrhotic liver disease

Abstract

Objective: To compare the frequency of vitamin D levels between cirrhotic and non-cirrhotic liver disease patients.
Methodology: This retrospective comparative cross-sectional study compressed 296 diagnosed chronic liver disease patients who visited the Department of Gastroenterology at the Aga Khan University Hospital in Karachi, fulfilling the study inclusion criteria. Demographic and clinical characteristics such as age, sex, disease duration, etiology and severity of all patients were obtained. Cirrhotic status and vitamin D levels were noted. Data was analyzed on Statistical Package for Social Sciences (SPSS), Version 22.
Results: The mean age was 41.48+/-9.88 years, and the mean vitamin D level in chronic liver disease patients was 14.61+/-8.37 (ng/ml). In cirrhosis and non-cirrhosis patients, mean vitamin D levels were (12.97 vs 16.08; P: 0.001), respectively. Significantly reduced levels were observed in Cirrhotic patients. In cirrhotic patients, vitamin D deficiency was more prevalent than the non-cirrhotic group (80.7% vs 66%; P: 0.004); overall, 73% of chronic liver disease patients were diagnosed as vitamin D deficient.
Conclusion: In chronic liver disease patients, liver cirrhosis increases the likelihood of vitamin D deficiency. Factors like young age, male sex, and etiology (hepatitis C virus) strongly correlate with vitamin D deficiency. Furthermore, patients with advanced liver disease are more prone to be vitamin D deficient.

References

Cheemerla S, Balakrishnan M. Global Epidemiology of Chronic Liver Disease. Clin Liver Dis(Hoboken). 2021; 17(5): 365-370. doi: 10.1002/cld.1061.

Qazi Arisar FA, Kamran M, Nadeem R, Jafri W. Impact of Severity of Chronic Liver Disease on Health Related Economics. Hepatitis Monthly. 20(6): e97933. doi: 10.5812/hepatmon.97933.

Jamil Z, Arif S, Khan A, Durrani AA, Yaqoob N. Vitamin D Deficiency and Its Relationship with Child-Pugh Class in Patients with Chronic Liver Disease. J Clin Transl Hepatol. 2018; 6(2): 135-140. doi: 10.14218/JCTH.2017.00055.

Razzaque MR, Tebha SS, Tukruna A, Arif A, Kogut LM, Afsar NA et al. 25-Hydroxyvitamin D deficiency in chronic kidney disease stages III, IV, and V in South Asian population: a retrospective cohort. SAGE Open Med. 2023; 11: 20503121221148613. doi: 10.1177/20503121221148613.

Malham M, Jørgensen SP, Ott P, Agnholt J, Vilstrup H, Borre M et al. Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology. World J Gastroenterol. 2011; 17(7): 922-5. doi: 10.3748/wjg.v17.i7.922.

Konstantakis C, Tselekouni P, Kalafateli M, Triantos C. Vitamin D deficiency in patients with liver cirrhosis. Ann Gastroenterol. 2016; 29(3): 297-306. doi: 10.20524/aog.2016.0037.

Ravaioli F, Pivetti A, Di Marco L, Chrysanthi C, Frassanito G, Pambianco M et al. Role of Vitamin D in Liver Disease and Complications of Advanced Chronic Liver Disease. Int J Mol Sci. 2022; 23(16): 9016. doi: 10.3390/ijms23169016.

Stokes CS, Volmer DA, Grünhage F, Lammert F. Vitamin D in chronic liver disease. Liver Int. 2013; 33(3): 338-52. doi: 10.1111/liv.12106.

Kumar R, Kumar P, Saxena KN, Mishra M, Mishra VK, Kumari A et al. Vitamin D status in patients with cirrhosis of the liver and their relatives - A case-control study from North India. Indian J Gastroenterol. 2017; 36(1): 50-5. doi: 10.1007/s12664-017-0727-7. Epub 2017 Feb 8.

Kubesch A, Quenstedt L, Saleh M, Rüschenbaum S, Schwarzkopf K, Martinez Y et al. Vitamin D deficiency is associated with hepatic decompensation and inflammation in patients with liver cirrhosis: a prospective cohort study. PLoS One. 2018; 13(11): e0207162. doi: 10.1371/journal.pone.0207162.

Buonomo AR, Scotto R, Zappulo E, Nerilli M, Pinchera B, Perruolo G et al. Severe vitamin D deficiency increases mortality among patients with liver cirrhosis regardless of the presence of HCC. In Vivo. 2019; 33(1): 177-82. doi: 10.21873/invivo.11456.

Arteh J, Narra S, Nair S. Prevalence of vitamin D deficiency in chronic liver disease. Digest Dis Sci. 2010; 55(9): 2624-8. doi: 10.1007/s10620-009-1069-9. Epub 2009 Dec 4.

Zhao XY, Li J, Wang JH, Habib S, Wei W, Sun SJ et al. Vitamin D serum level is associated with Child-Pugh score and metabolic enzyme imbalances, but not viral load in chronic hepatitis B patients. Medicine(Baltimore). 2016; 95(27): e3926. doi: 10.1097/MD.0000000000003926.

Lange CM, Bojunga J, Ramos-Lopez E, von Wagner M, Hassler A, Vermehren J et al. Vitamin D deficiency and a CYP27B1-1260 promoter polymorphism are associated with chronic hepatitis C and poor response to interferon-alfa based therapy. J Hepatol. 2011; 54(5): 887-93. doi: 10.1016/j.jhep.2010.08.036. Epub 2011 Jan 20.

Wang H, Chen W, Li D, Yin X, Zhang X, Olsen N et al. Vitamin D and Chronic Diseases. Aging Dis. 2017; 8(3): 346-53. doi: 10.14336/AD.2016.1021.

Nakagawa Y, Koizumi M, Fukagawa M. Current Topics on Vitamin D. Vitamin D and chronic kidney disease. [Article in Japanese]. Clin Calcium. 2015; 25(3): 413-23.

Hamid S, Faheem M, Ambreen S, Umar M. Comparison of vitamin D deficiency and magnitude of severity of its deficiency in cirrhotic and non-cirrhotic patients with chronic hepatitis C in a tertiary care hospital Rawalpindi, Pakistan. Rawal Med J. 2017; 42(3): 281-5.

Memon S, Alam A, Iftikhar S. The frequency of vitamin D deficiency in chronic kidney disease and its relation with baseline mineral bone markers. J Pak Med Assoc. 2020; 70(3): 432-6. doi: 10.5455/JPMA.302411.

Ahmad MS, Dawood N, Abaidullah S, Nazim R, Iqbal S. Correlation Between Vitamin D Deficiency and Severity of Liver Disease among Cirrhotic Patients. Ann King Edw Med Univ. 2021; 27(Special Issue (Jul-Sep)): 362-7.

Paternostro R, Wagner D, Reiberger T, Mandorfer M, Schwarzer R, Ferlitsch M et al. Low 25-OH-vitamin D levels reflect hepatic dysfunction and are associated with mortality in patients with liver cirrhosis. Wien Klin Wochenschr. 2017; 129(1): 8-15. doi: 10.1007/s00508-016-1127-1.

García?Álvarez M, Pineda?Tenor D, Jiménez?Sousa MA, Fernández?Rodríguez A, Guzmán?Fulgencio M, Resino S. Relationship of vitamin D status with advanced liver fibrosis and response to hepatitis C virus therapy: A meta?analysis. Hepatology. 2014; 60(5): 1541-50. doi: 10.1002/hep.27281.

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Published

30-09-2024

How to Cite

1.
Haroon A, Haroon A, Sohail Z, Akhtar Nizami R, Kumar A. Frequency of Vitamin D Deficiency in Cirrhotic Versus Non-Cirrhotic Liver Disease Patients. J Liaq Uni Med Health Sci [Internet]. 2024 Sep. 30 [cited 2024 Oct. 18];23(03):238-43. Available from: http://ojs.lumhs.edu.pk/index.php/jlumhs/article/view/1331