We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Low 25-OH-vitamin D levels reflect hepatic dysfunction and are associated with mortality in patients with liver cirrhosis.
- Authors
Paternostro, Rafael; Wagner, Doris; Reiberger, Thomas; Mandorfer, Mattias; Schwarzer, Remy; Ferlitsch, Monika; Trauner, Michael; Peck-Radosavljevic, Markus; Ferlitsch, Arnulf
- Abstract
Background and aims: Vitamin D deficiency is frequent in patients with cirrhosis. The aims of this study were to evaluate the relation of vitamin D status to portal hypertension, degree of liver dysfunction and survival. Methods: Patients with cirrhosis who have been tested for 25-OH-vitamin D levels were retrospectively included. Vitamin D deficiency was defined as 25-OH-vitamin D levels <10 ng/ml. Child-Pugh score, model for end-stage liver disease (MELD) and available hepatic venous pressure gradient (HVPG) were recorded. Mortality was documented during follow-up. Results: A total of 199 patients were included. Prevalence of vitamin D deficiency (<10 ng/ml) was 40% (79/199), with 14% in Child-Pugh stage A, 39% in Child-Pugh stage B and 47% in Child-Pugh stage C ( p = 0.001). Vitamin D deficiency was more common in patients with clinically significant portal hypertension (CSPH, HVPG ≥ 10 mm Hg) than in patients without (43.5% vs. 24.4%, p = 0.025). Significantly more deaths were observed in patients with vitamin D deficiency (32.9%, 26/79 vs. 13.3%, 16/120; p = 0.001). COX regression found presence of hepatocellular carcinoma ( p < 0.001; HR: 5.763 95%CI:2.183-15.213), presence of CSPH ( p = 0.026; HR: 5.487 95%CI: 1.226-24.55) and Child-Pugh stage C ( p = 0.003; HR:5.429 95%CI: 1.771-16.638) as independent risk factors for mortality. Furthermore we could show a tendency towards group vitamin D deficiency being an independent risk factor ( p = 0.060; HR: 1.86 95%CI:0.974-3.552). Conclusions: Vitamin D levels progressively decrease in more advanced Child stages and in patients with increasing HVPG. Vitamin D deficiency might be a valuable predictor of mortality in cirrhosis.
- Subjects
VITAMIN D deficiency; CIRRHOSIS of the liver; PORTAL hypertension; VITAMIN D; LIVER cancer; LIVER transplantation; PATIENTS
- Publication
Wiener Klinische Wochenschrift, 2017, Vol 129, Issue 1/2, p8
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-016-1127-1