Vitamin D deficiency in patients with chronic intestinal failure on home parenteral nutrition.

Abstract

Vitamin D deficiency is an important complication of chronic intestinal failure (CIF). Liver steatosis is a known late complication of long-term home parenteral nutrition (HPN) therapy in patients with CIF, which can progress to intestinal failure-associated liver disease (IFALD). The aim of this study was to determine the prevalence of vitamin D deficiency among Slovene HPN patients and determine any potential correlation between serum vitamin D levels and liver steatosis associated with IFALD in adult patients with CIF on HPN therapy. Adult patients, diagnosed with CIF, receiving long term HPN therapy, were included in a cross-sectional study. Vitamin D status was determined by measuring serum levels of 25-hydroxyvitamin D. The presence of liver steatosis was diagnosed using 3TS MRI scanner. The association between serum vitamin D levels and liver steatosis was calculated using univariate logistic regression. We included 63 adult patients with CIF on HPN therapy in the study. The median duration of HPN therapy was 70 weeks. The average serum concentration of 25-hydroxyvitamin D was 41.3nmol/l. Insufficient vitamin D levels were found in 45 (73%) patients. Liver steatosis was present in 18 (28.6%) patients. No statistically significant association between serum vitamin D levels and liver steatosis in the study population was found. The results of this study have shown a high prevalence of vitamin D deficiency in adult patients with CIF on HPN. We failed to demonstrate an association between serum vitamin D levels and the prevalence of liver steatosis.