Vitamin D in chronic liver disease

Abstract

Chronic liver disease (CLD) and several related extrahepatic manifestations such as hepatic osteodystrophy are associated with deficiency of vitamin D, which has therefore been suggested as therapeutic target. Vitamin D undergoes hepatic 25-hydroxylation, rendering the liver critical to the metabolic activation of this vitamin. Vitamin D deficiency is highly prevalent in CLD patients, and vitamin D levels are inversely related to the severity of CLD. Declining levels of carrier proteins such as albumin and vitamin D-binding protein might also be critical in CLD. Intervention studies report improvements of CLD following supplementation, and benefits to health outcomes in particular with respect to hepatitis C virus infection have recently been documented. Content: We discuss vitamin D sources, functions and metabolism with a focus on the inherent complications of analytical measurements, such as the interference of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D C-3 epimers. Global discrepancies in the definition of optimal serum 25-hydroxyvitamin D levels are covered, and the prevalence of vitamin D deficiency in CLD is reviewed. We also address the functional mechanisms underlying this deficiency, and refer to associations between genetic variation in vitamin D metabolism and CLD. Lastly, we consider the health implications of a vitamin D deficiency in CLD and consider therapeutic options. Summary: Herein, we focus on the epidemiological and functional relationships between vitamin D deficiency and CLD, followed by a discussion of the potential implications for therapeutic interventions.

Association of vitamin D binding protein polymorphisms with response to therapy in Egyptian chronic hepatitis C patients

“…Vitamin D levels in hepatitis C patients were significantly lower than controls and 25-hydroxyvitamin D insufficiency was more common in HCV patients. These findings confirm that patients with chronic liver disease have impaired 25-hydroxyvitamin D status compared to healthy controls [21].…”

A vitamin D protocol post‐liver transplantation

“…Relevant to liver disease is that hepatocellular and intrahepatic cholangiocarcinoma often develop in patients with cirrhosis and is inversely related to levels of VD (Stokes et al, 2013). VD has strong evidence that it promotes anti-apoptotic activity, as well as anti-inflammatory and anti-angiogenic properties that promote cell differentiation and inhibit cancer cell proliferation (Courbebaisse et al, 2014;Stokes et al, 2013).…”

Association between serum vitamin D and severity of liver fibrosis in chronic hepatitis C patients: a systematic meta-analysis

“…More and more evidence also shows that vitamin D status is very important for the liver disease severity in patients who are infected with chronic hepatitis C (Terrier et al, 2012;Kitson et al, 2013;Ladero et al, 2013;Lange et al, 2013 (VDBP). Because the half-life of serum 25(OH) D is long, the serum concentration of 25(OH) D is the most commonly used biomarker for vitamin D status (Wang et al, 2004;Stokes et al, 2013). Vitamin D plays an important role not only in maintenance of skeletal health, but also in the immune response, wound healing and many other important physiological functions (Cholongitas et al, 2012).…”