Vitamin D status, liver enzymes, and incident liver disease and mortality: a general population study

Abstract

Vitamin D deficiency is common among patients with liver diseases. Both cholestatic and non-cholestatic liver diseases can cause vitamin D deficiency. Whether vitamin D status can also affect liver function is poorly understood. To investigate the association between vitamin D status, liver enzymes, and incident liver disease, we included a total of 2,649 individuals from the Monica10 study conducted in 1993-1994. Vitamin D status as assessed by serum 25-hydroxyvitamin, serum alanine transaminase (ALT), aspartate transaminase (AST), and gamma glutamyl transferase (GGT) were measured at baseline. Information on fatal and non-fatal liver disease was obtained from the Danish National Patient Register and The Danish Registry of Causes of Death, respectively. Median follow-up time was 16.5 years, and there were 62 incident cases of fatal and non-fatal liver disease. Multivariable Cox regression analyses with age as underlying time axis and delayed entry showed a statistically significant inverse association between vitamin D status and incident liver disease with a hazard ratio = 0.88 (95 % confidence interval 0.79-0.99) per 10 nmol/l higher vitamin D status at baseline (adjusted for gender, season, alcohol consumption, smoking, physical activity, dietary habits, education, body mass index, and ALT). The risk of having a high level of ALT, AST, or GGT tended to be higher for lower vitamin D levels, although not statistically significant. In this general population study, vitamin D status was inversely associated with incident liver disease. Further studies are needed to determine whether patients in risk of developing impaired liver function should be screened for vitamin D deficiency for preventive purposes.

Does vitamin D improve liver enzymes, oxidative stress, and inflammatory biomarkers in adults with non-alcoholic fatty liver disease? A randomized clinical trial

“…The results of some cross-sectional studies revealed a significant association between serum levels of 25(OH)D 3 and hepatic enzymes [13,51]. In a recent population study (n = 2,649) after adjusting for confounding variables, the risk of having a high level of hepatic enzymes was higher for lower levels of vitamin D, although not statistically significant [52].…”

Lower 25-hydroxyvitamin D3 levels and increased risk of liver diseases: is there a causal link?

“…It cannot be, therefore, excluded that vitamin D deficiency might exert differential adverse effects on different types of liver diseases. Moreover, whether lower baseline 25(OH)D levels simply reflected early pre-existing (undiagnosed) liver disease or instead actively contributed to the pathogenesis of chronic liver disease cannot be determined from the results of this study [3].…”

“…To our knowledge, the paper published by Skaaby et al [3] on this issue of the journal is one of the first prospective studies to demonstrate that lower levels of serum 25(OH)D are significantly associated with a higher incidence of fatal and non-fatal liver diseases (as combined endpoint) in a population-based sample of 2,649 middle-aged Danish individuals, who were followed for a median follow-up period of 16.5 years. Diagnosis of incident liver diseases was based on the Danish National Patient Register.…”

“…Indeed, the presence of nuclear vitamin D receptors in several cell types, including cardiomyocytes, neurons, immune cells, and hepatocytes, has stimulated considerable scientific interest in understanding the putative pleiotropic properties of vitamin D that may regulate hundreds of different genes and play an important role in regulating cell proliferation, differentiation, and apoptosis in many normal and cancer cells and also have anti-inflammatory and immuno-modulatory effects [1,2]. Evolving data indicate that vitamin D deficiency/insufficiency may be playing a role in the pathophysiology of cardiovascular disease as well as several other acute and chronic diseases, including common cancers, autoimmune diseases, osteoarthritis, mental disorders, infectious diseases, metabolic syndrome, and diabetes mellitus [1,2].To our knowledge, the paper published by Skaaby et al [3] on this issue of the journal is one of the first prospective studies to demonstrate that lower levels of serum 25(OH)D are significantly associated with a higher incidence of fatal and non-fatal liver diseases (as combined endpoint) in a population-based sample of 2,649 middle-aged Danish individuals, who were followed for a median follow-up period of 16.5 years. Diagnosis of incident liver diseases was based on the Danish National Patient Register.…”

Levels of Interleukin-17 and Vitamin D and Their Correlation in Viral Hepatitis Patients

“…[7] The existing evidence on the beneficial and harmful effects of vitamin D supplementation in individuals with chronic liver diseases is not sufficient and contrasting. [8] One meta-analysis research of observational and interventional studies in persons with HCV infection reported a positive relation between sustained virological response and high levels vitamin D. [9] On the other hand, one study reported association between vitamin D levels and chronic liver disease progression.…”