Association of 25‐hydroxyvitamin D levels with liver dysfunction and mortality in chronic liver disease

Abstract

Previous studies suggest that chronic liver disease may be related to vitamin D deficiency. It is, however, not known whether 25(OH)D levels are associated with incident hepatic decompensation and mortality in chronic liver failure. We aimed to evaluate whether 25(OH)D serum levels are associated with Child-Pugh (CP) score, model for end-stage liver disease (MELD) score, occurrence of hepatic decompensation, and survival in patients with cirrhosis. We enrolled 75 consecutive cirrhotic patients admitted to our outpatient liver clinic (32% females; age: 58± 11years; aetiology alcohol in 61%). At baseline, 25(OH)D was determined and the degree of liver dysfunction was estimated by CP and MELD score. Thereafter patients were followed-up with respect to hepatic decompensation and mortality. 25(OH)D levels averaged 16.0±9.2ng/ml and were inversely correlated with MELD score (r=-0.34, P=0.003) and CP score (r=-0.21, P=0.080). Thirty-seven patients developed hepatic decompensation and 24 patients died during a median follow-up of 3.6years. Age- and gender-adjusted relative risk (with 95% confidence interval) was 6.37 (1.75-23.2; P=0.005) for hepatic decompensation and 4.31 (1.38-13.5; P=0.012) for mortality within the first vs the third 25(OH)D tertile but these associations were largely attenuated towards non-significant trends after additional adjustments for CP or MELD score. Our findings show a significant association of 25(OH)D with the degree of liver dysfunction and suggest that low 25(OH)D levels may predict hepatic decompensation and mortality in patients with chronic liver failure.