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

Authors

  • Csilla Putz-Bankuti,

    1. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz,, Graz, Austria
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    • Both authors contributed equally to the manuscript
  • Stefan Pilz,

    1. Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
    2. Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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    • Both authors contributed equally to the manuscript
  • Tatjana Stojakovic,

    1. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz,, Graz, Austria
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  • Hubert Scharnagl,

    1. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz,, Graz, Austria
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  • Thomas R. Pieber,

    1. Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
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  • Michael Trauner,

    1. Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna,, Vienna, Austria
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  • Barbara Obermayer-Pietsch,

    1. Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
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  • Rudolf E. Stauber

    Corresponding author
    • Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz,, Graz, Austria
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Correspondence

Rudolf E. Stauber, MD, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria

Tel: +43 316 385 80268

Fax: +43 316 385 17108

e-mail: rudolf.stauber@medunigraz.at

Abstract

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, = 0.003) and CP score (r = −0.21, = 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; = 0.005) for hepatic decompensation and 4.31 (1.38–13.5; = 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.

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