Changes in vitamin D binding protein and vitamin D concentrations associated with liver transplantation
Article first published online: 8 SEP 2011
© 2011 John Wiley & Sons A/S
Volume 32, Issue 2, pages 287–296, February 2012
How to Cite
Reese, P. P., Bloom, R. D., Feldman, H. I., Huverserian, A., Thomasson, A., Shults, J., Hamano, T., Goral, S., Shaked, A., Olthoff, K., Rickels, M. R., Bleicher, M. and Leonard, M. B. (2012), Changes in vitamin D binding protein and vitamin D concentrations associated with liver transplantation. Liver International, 32: 287–296. doi: 10.1111/j.1478-3231.2011.02638.x
- Issue published online: 9 JAN 2012
- Article first published online: 8 SEP 2011
- Manuscript Accepted: 7 AUG 2011
- Manuscript Received: 20 MAY 2011
- NIH. Grant Numbers: K23 - DK078688-01, K24 - DK002651, R01 DK073192, K24 DK076808, R01 DK064966
- liver transplantation;
- vitamin D;
- vitamin D binding protein
Vitamin D deficiency is associated with fractures, infections and death. Liver disease impairs vitamin D and vitamin D binding protein (DBP) metabolism.
We aimed to determine the impact of liver transplantation on vitamin D, particularly on DBP and free vitamin D concentrations.
Serum 25(OH)D, 1,25(OH)2D and DBP concentrations were measured in 202 adults before liver transplantation and 3 months later in 155. Free vitamin D concentrations were estimated from these values. Risk factors for 25(OH)D deficiency (<20 ng/ml) and low 1,25(OH)2D (<20 pg/ml) were examined with logistic regression, and changes in concentrations following transplantation with linear regression.
Pretransplant, 84% were 25(OH)D deficient, 13% had 25(OH)D concentrations <2.5 ng/ml, and 77% had low 1,25(OH)2D. Model for end-stage liver disease score ≥20 (P < 0.005) and hypoalbuminemia (P < 0.005) were associated with low 25(OH)D and 1,25(OH)2D concentrations. Following transplantation, 25(OH)D concentrations increased a median of 17.8 ng/ml (P < 0.001). Albumin increased from a median of 2.7 to 3.8 g/dl (P < 0.001) and DBP from 8.6 to 23.8 mg/dl (P < 0.001). Changes in total 25(OH)D were positively and independently associated with changes in DBP (P < 0.05) and albumin (P < 0.001). Free 25(OH)D concentrations rose from 6.0 to 9.7 pg/ml (P < 0.001). In contrast, total 1,25(OH)2 Dconcentrations rose only by 4.3 pg/ml (P < 0.001) and free 1,25(OH)2 Dconcentrations declined (P < 0.001).
Serum total and free 25(OH)D and DBP concentrations rose substantially following transplantation, while 1,25(OH)2D concentrations showed modest changes and free 1,25(OH)2D decreased. Studies of the effects of vitamin D status on diverse transplant complications are needed.