The effect of a single oral megadose of vitamin D provided as either ergocalciferol (D₂) or cholecalciferol (D₃) in alcoholic liver cirrhosis.
OBJECTIVE
The goal of this study was to examine the effects of a single oral dose of 300,000 international units of either ergocalciferol (D₂) or cholecalciferol (D₃) on the plasma levels of 25-hydroxyvitamin D in patients with alcoholic liver cirrhosis.


METHODS
Inclusion criteria for this study were diagnosis of alcoholic liver cirrhosis and plasma levels of 25-hydroxyvitamin D less than 25 nmol/l. At baseline, patients were divided into Child-Pugh groups A, B, or C and were given one oral dose of 300,000 international units of ergocalciferol (D₂ group, N=23) or cholecalciferol (D₃ group, N=13). Plasma concentrations of 25(OH) vitamin D and vitamin D-binding protein were measured on days 0, 7, 30, and 90.


RESULTS
On days 7 and 30, patients from the D₃ group had higher vitamin D levels than patients from the D₂ group (P<0.05). On day 7, vitamin D levels were found to correlate with Child-Pugh scores from patients in the D₃ group. For patients in the D₂ group, there was a positive correlation between vitamin D and vitamin D-binding protein as indicated by the area under the concentration versus time curves (Spearmen's ρ=0.64 P<0.001).


CONCLUSIONS
In patients with alcoholic liver cirrhosis, a single oral megadose of cholecalciferol was more effective than ergocalciferol in the treatment of vitamin D deficiency. Severe liver disease and low levels of vitamin D-binding protein were predictors for poor treatment outcomes.
Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, Aarhus, Denmark. Mikkel.Malham@gmail.com
Mikkel
M
Malham
Søren
S
Peter Jørgensen
Anna L
AL
Lauridsen
Peter
P
Ott
Henning
H
Glerup
Jens F
JF
Dahlerup
D000284:Administration, Oral; D002762:Cholecalciferol / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004872:Ergocalciferols / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000150:complications*; D008297:Male; D011379:Prognosis; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D014809:Vitamin D-Binding Protein / Q000097:blood
D004872:Ergocalciferols; D014809:Vitamin D-Binding Protein; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D