Ravikant Kumar1, Pavan Kumar2, Kandarp Nath Saxena2, Manjul Mishra2, Vivek Kumar Mishra2, Anju Kumari3, Manisha Dwivedi2, Sri Prakash Misra2. 1. Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, 211 001, India. drravi0609@gmail.com. 2. Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, 211 001, India. 3. Department of Physiology, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, 800 014, India.
Abstract
BACKGROUND AND AIM: Liver diseases interfere with the production of the metabolites of vitamin D required for activation, thus resulting in abnormal calcium and bone metabolism. Previous studies show inconsistent results of vitamin D level in non-cholestatic liver diseases. Our aim was to determine the prevalence of vitamin D insufficiency in cirrhosis as compared to apparently normal relatives and its relationship with etiology and severity. METHODS: One hundred and sixty cirrhotic patients attending the Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, were enrolled, and 25-hydroxy vitamin D [25(OH)D] and calcium levels assessed. Vitamin D status was graded as insufficiency (20-30 ng/mL), deficiency (<20 ng/mL), and severe deficiency (<7 ng/mL). 25(OH)D levels of patients were compared with those of their healthy family members. RESULTS: Forty-six percent of the normal population had 25(OH)D inadequacy, whereas 51.85% of patients with cirrhosis had 25(OH)D deficiency, and 28.12% had insufficiency. Thus, 80% of patients with cirrhosis of the liver had some form of vitamin D inadequacy. 12.5% of cirrhotics had severe vitamin D deficiency. Serum calcium (Ca++) was not significantly different between the patients and control group. The etiology of cirrhosis had no relation with vitamin D levels. Prevalence of deficiency and insufficiency increased with increasing age and mean Child-Turcotte-Pugh and model for end-stage liver disease scores. CONCLUSION: Vitamin D insufficiency is highly prevalent in patients with cirrhosis irrespective of etiology and significantly more common than their healthy relatives. Measurement of 25(OH) vitamin D and replacement may be considered as part of the overall management of patients with cirrhosis of the liver as well as apparently healthy individuals.
BACKGROUND AND AIM: Liver diseases interfere with the production of the metabolites of vitamin D required for activation, thus resulting in abnormal calcium and bone metabolism. Previous studies show inconsistent results of vitamin D level in non-cholestatic liver diseases. Our aim was to determine the prevalence of vitamin Dinsufficiency in cirrhosis as compared to apparently normal relatives and its relationship with etiology and severity. METHODS: One hundred and sixty cirrhotic patients attending the Department of Gastroenterology and Hepatology, M L N Medical College, Allahabad, were enrolled, and 25-hydroxy vitamin D [25(OH)D] and calcium levels assessed. Vitamin D status was graded as insufficiency (20-30 ng/mL), deficiency (<20 ng/mL), and severe deficiency (<7 ng/mL). 25(OH)D levels of patients were compared with those of their healthy family members. RESULTS: Forty-six percent of the normal population had 25(OH)D inadequacy, whereas 51.85% of patients with cirrhosis had 25(OH)D deficiency, and 28.12% had insufficiency. Thus, 80% of patients with cirrhosis of the liver had some form of vitamin D inadequacy. 12.5% of cirrhotics had severe vitamin D deficiency. Serum calcium (Ca++) was not significantly different between the patients and control group. The etiology of cirrhosis had no relation with vitamin D levels. Prevalence of deficiency and insufficiency increased with increasing age and mean Child-Turcotte-Pugh and model for end-stage liver disease scores. CONCLUSION:Vitamin Dinsufficiency is highly prevalent in patients with cirrhosis irrespective of etiology and significantly more common than their healthy relatives. Measurement of 25(OH) vitamin D and replacement may be considered as part of the overall management of patients with cirrhosis of the liver as well as apparently healthy individuals.
Entities:
Keywords:
Child-Turcotte-Pugh score; Cirrhosis; Model for end-stage liver disease score; Vitamin D
Authors: M P Duarte; M L Farias; H S Coelho; L M Mendonça; L M Stabnov; M do Carmo d Oliveira; R A Lamy; D S Oliveira Journal: J Gastroenterol Hepatol Date: 2001-09 Impact factor: 4.029