Oral vitamin D replacement is effective in chronic liver disease

Rode, A; Fourlanos, Spiros; Nicoll, Amanda

doi:10.1016/j.gcb.2010.07.009

Cited by 56 publications

(39 citation statements)

References 10 publications

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“…Notably, in those about to undergo liver transplantation, the frequency of 25(OH)D and 1a,25(OH) 2 D deficiency is 84% and 77%, respectively, with transplantation resulting in a marked increase in 25(OH)D, 1a,25(OH) 2 D, and DBP levels [19]. The high prevalence of vitamin D deficiency in this population occurs regardless of the etiology of liver disease [20,21]. Synthetic liver dysfunction is not entirely responsible, as vitamin D deficiency is still highly prevalent in those with non-cirrhotic liver disease [17].…”

Section: Vitamin D and Chronic Liver Diseasementioning

confidence: 95%

D-livering the message: The importance of vitamin D status in chronic liver disease

Kitson

Roberts

2012

Journal of Hepatology

200

171

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Vitamin D is synthesized predominantly in the liver and functions as an important secosteroid hormone with pleiotropic effects. While its key regulatory role in calcium and bone homeostasis is well established, recently there is increasing recognition that vitamin D also regulates cell proliferation and differentiation, and has immunomodulatory, anti-inflammatory and anti-fibrotic properties. These non-skeletal effects are relevant in the pathogenesis and treatment of many causes of chronic liver disease. Vitamin D deficiency is frequently present in chronic liver disease and may predict non-response to antiviral therapy in chronic hepatitis C. Small studies suggest that vitamin D supplementation improves sustained viral response rates, while 1α-hydroxylase polymorphisms and vitamin D-binding protein are also implicated in therapeutic outcomes. Vitamin D deficiency also closely relates to the severity of non-alcoholic fatty liver disease (NAFLD) and is implicated in the pathogenesis of insulin resistance, a key factor in the development of NAFLD. In preclinical studies, phototherapy and vitamin D supplementation ameliorate NAFLD histopathology, while vitamin D is a powerful anti-fibrotic against thioacetamide liver injury. In liver transplant recipients severe vitamin D deficiency predicts, and vitamin D supplementation prevents, acute cellular rejection. The role of vitamin D in the activation and regulation of both innate and adaptive immune systems may explain its importance in the above liver diseases. Further prospective studies are therefore warranted to investigate the therapeutic impact of vitamin D supplementation in chronic liver disease.

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Section: Vitamin D and Chronic Liver Diseasementioning

confidence: 95%

D-livering the message: The importance of vitamin D status in chronic liver disease

Kitson

Roberts

2012

Journal of Hepatology

200

171

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“…Therefore, it is likely that these results were largely attributable to the small proportion of patients with NAFLD (14%) in our cohort. Rode et al 30. found that that the vitamin D level correlated with that of albumin.…”

Section: Discussionmentioning

confidence: 98%

Relationship between 25-Hydroxyvitamin D Levels and Liver Fibrosis as Assessed by Transient Elastography in Patients with Chronic Liver Disease

Kim

et al. 2016

Gut and Liver

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Background/AimsDeficiencies of 25-hydroxyvitamin D (25(OH)D) are prevalent in patients with chronic liver disease (CLD). Liver fibrosis is the main determinant of CLD prognosis. The present study was performed to evaluate the correlation between 25(OH)D levels and liver fibrosis as assessed by transient elastography (TE) in patients with compensated CLD.MethodsSerum 25(OH)D levels and liver stiffness were determined in a total of 207 patients who were subjected to the following exclusion criteria: patients with decompensated CLD; patients who had malignancies; patients who were taking medications; and patients who were pregnant.ResultsThe most common etiology was chronic hepatitis B (53.1%). Advanced liver fibrosis (defined by TE [≥9.5 kPa]) was present in 75 patients (36.2%). There was a significant correlation between 25(OH)D deficiency and liver stiffness. Based on the multivariate analysis, the following factors were independently associated with advanced liver fibrosis: 25(OH)D deficiency (odds ratio [OR], 3.46; p=0.004), diabetes mellitus (OR, 3.04; p=0.041), and fibrosis-4 index (OR, 2.01; p<0.001).ConclusionsPatients with compensated CLD exhibit a close correlation between vitamin D level and liver stiffness as assessed by TE. Vitamin D deficiency was independently associated with advanced liver fibrosis.

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“…56 Current European or American guidelines for the management of cirrhotic patients do not clearly propose a systematic assessment and potential supplementation in vitamin D and calcium. Concerning the risk of osteoporosis, the European Association for the Study of the Liver guidelines for the management of patients suffering from cholestatic liver diseases suggest supplementation with calcium (1,000–1,200 mg/day) and vitamin D (400–800 IU/day), but little clinical data are available to support this.…”

Section: Discussionmentioning

confidence: 99%

Low Levels of 25-Hydroxy Vitamin D are Independently Associated with the Risk of Bacterial Infection in Cirrhotic Patients

Anty

Tonohouan

Ferrari

et al. 2014

Clinical and Translational Gastroenterology

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OBJECTIVES:Low levels of vitamin D are associated with a higher mortality in cirrhotic patients, but the role of this deficiency is still unknown. The purpose of this study was to assess the levels of vitamin D in cirrhotic patients with and without bacterial infection.METHODS:25-hydroxy (25-OH) vitamin D was assessed by immunoassay in 88 patients hospitalized in our hepatology unit.RESULTS:The causes of cirrhosis were mainly alcohol (70%), hepatitis C (10%), or both (9%). Infections (n=38) mainly included bacteriemia (21%), urinary tract infections (24%), and spontaneous bacterial peritonitis (29%). A severe deficiency in vitamin D (<10 ng/ml) was observed in 56.8% of patients. Infections were more frequent in patients with a severe deficiency compared with the others (54 vs. 29%, P=0.02). A severe deficiency in vitamin D was a predictive factor of infection (odds ratio=5.44 (1.35–21.97), P=0.017) independently of the Child–Pugh score (odds ratio=2.09 (1.47–2.97) P=0.00004) and the C-reactive protein level (odds ratio=1.03 (1.002–1.052), P=0.03) in a logistic regression also including the alanine amino transferase (not significant). By a Cox regression analysis, only the presence of an infection was significantly associated with mortality (relative risk=3.24 (1.20–8.76), P=0.02) in a model also associating the Child–Pugh score (not significant) and the presence of a severe deficiency in vitamin D (not significant).CONCLUSIONS:Low levels of 25-OH vitamin D were independently associated with bacterial infections in cirrhotic patients. The impact of 25-OH vitamin D supplementation on the infection rate and death of cirrhotic patients should be assessed in randomized trials.

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Oral vitamin D replacement is effective in chronic liver disease

Cited by 56 publications

References 10 publications

D-livering the message: The importance of vitamin D status in chronic liver disease

D-livering the message: The importance of vitamin D status in chronic liver disease

Relationship between 25-Hydroxyvitamin D Levels and Liver Fibrosis as Assessed by Transient Elastography in Patients with Chronic Liver Disease

Low Levels of 25-Hydroxy Vitamin D are Independently Associated with the Risk of Bacterial Infection in Cirrhotic Patients

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