Oral vitamin D replacement is effective in chronic liver disease.
OBJECTIVE
End-stage chronic liver disease is associated with vitamin D deficiency but the prevalence across a broad-spectrum of liver disease is unknown. This study prospectively examines prevalence of vitamin D deficiency and response to replacement in chronic liver disease.


METHODS
One hundred and fifty-eight outpatients with chronic liver disease were enrolled. Serum 25-hydroxyvitamin D (25[OH]D) levels were classified as: severely deficient less than 25 nmol/l, deficient 25-54 nmol/l or replete greater than 54 nmol/l. Sixty-five of 158 (41%) had cirrhosis.


RESULTS
25[OH]D was suboptimal in 101/158 (64%), including severe deficiency in 24 patients (15%). Vitamin D deficiency occurred in liver disease of all aetiologies, including patients with only mild liver disease. 25[OH]D increased by 60.0% (19.11 ± 13.20 nmol/l) in patients with deficiency after vitamin D replacement and decreased by 25.2% (-18.33 ± 12.02 nmol/l) in non-treated initially replete patients over a median of 4 months.


CONCLUSIONS
Vitamin D deficiency improves with oral vitamin D supplementation and levels fall without supplementation. Chronic liver disease patients are at very high risk of vitamin D deficiency regardless of etiology or severity.
Rode
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Department of Gastroenterology, Royal Melbourne Hospital, Grattan St, Parkville, VIC, 3050, Melbourne, Australia. arode@iinet.net.au
Fourlanos
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S
Nicoll
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D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence; D011446:Prospective Studies; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology
D014807:Vitamin D; C104450:25-hydroxyvitamin D