High Prevalent Hypovitaminosis D Is Associated with Dysregulation of Calcium-parathyroid Hormone-vitamin D Axis in Patients with Chronic Liver Diseases

摘要

Background and Aims:Although hypovitaminosis D is common among patients with chronic liver disease (CLD),the data are inconsistent on its prevalence and its relationship with CLD.This study aimed to estimate the prevalence of hypovitaminosis D among patients with CLD and to determine the relationship between hypovitaminosis D and severity of liver dysfunction,and calcium (Ca),phosphate (PO4) and parathyroid hormone (PTH) levels in CLD.Methods:The study included 236 CLD patients attending the Department of Hepatology,Rajiv Gandhi Government General Hospital (Chennai,India).Serum levels of 25-hydroxyvitamin D (25 (OH)D),PTH,Ca,and PO4 were estimated.Severity of liver dysfunction was graded using the Child-Turcotte-Pugh (CTP)score.Results:The first report from our population showed that 162 of 236 (68.6％) CLD patients had hypovitaminosis D (25(OH)D levels of ＜30 ng/mL),with higher frequency (124/162) 76.5％ among CTP B,C patients.Significant negative correlation (r =-0.288,p =0.0001) between 25(OH)D and CTP scores was noted in hypovitaminosis D conditions.Level of 25(OH)D was correlated negatively with PTH (r =-0.537,p =0.0001),positively with Ca (r =0.657,p =0.0001),and positively with PO4 (r =0.477,p =0.0001) in sufficient vitamin D conditions.Conclusions:Hypovitaminosis D is associated with higher CTP scores and is strongly associated with dysregulation of the Ca-PTH-vitamin D axis in CLD.Timely measurement of vitamin D levels is essential,along with levels of PTH,Ca and PO4,to manage CLD patients.