Kronik karaciğer hastalıklarında 25(OH) Vitamin D düzeylerinin incelenmesi / Investigation of 25 (OH) Vitamin D levels in chronic liverdiseases

Abstract

Introduction: The liver is one of the major organs involved in metabolism of vitamin D. Recent studies have demostrated a very high prevalence of vitamin D deficiency and insufficiency in patients with cirrhosis. We aimed to evaluated serum 25-hydroxy vitamin D (25 (OH) D ) levels in patients with cirrhosis and to examine the relationship between 25 (OH) D and severity, complications and etiology of cirrhosis. Material and methods: Serum levels of 25 (OH)D3 were evaluated in 118 cirrhosis patients, retrospectively. A normal level of vitamin D was defined as a 25 (OH) D concentration greater than 30 ng/ml, vitamin D insufficiency was defined as a 25 (OH) D concentration of 20 to 30 ng/ml and vitamin D deffiency was defined as a 25 (OH) D level less than 20 ng/ml. Patients already taking vitamin D supplementation in the last six months were excluded. The disease severity was determined by Child and Model For End-Stage Liver Disease (MELD) scores. The complications of cirrhosis were recorded. The biochemical parameters were included in the analyzes. Results: The mean age of the patients was 58.7 ± 11.8 years. The etiology of cirrhosis was crytogenic in 53.4%, hepatitis B in 28.8%, hepatitis C in 8.5%, alcohol in 7.6%, and drugs in 1.7%. There was no correlation between 25 (OH) D levels and etiology of cirrhosis. Vitamin D deficiency was present in 93.2% (n = 110), vitamin D deficiency was present in 5.1% (n = 6), Vitamin D levels were normal in only 1.7% of patients (n = 2). Vitamin D levels were positively correlated with triglyceride (p=0.006), albumin (p=0.003) and total cholesterol levels vii (p=0.035), and negatively correlated with Child (p=0.008) and MELD scores (p=0.045), prothrombin time (PT) (p=0.003) and International Normalized Ratio (INR) (p=0.011) levels. Moreover, complications of cirrhosis did not affect serum vitamin D levels. Conclusion Most patients of cirrhosis, irrespecitve of etiology, have vitamin D deficiency. The vitamin D levels further decreases as the severity of cirrhosis progresses. Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology and complictions. Key words: Vitamin D, Cirrhosis, Disease Severity, Child, MELD