title: Low serum vitamin D levels are associated with severe histological features and poor response to therapy in patients with autoimmune hepatitis.
abstract: OBJECTIVE
  25-Hydroxyvitamin D [25(OH)D] has an important role in fibrosis progression and inflammatory response in patients with various etiologies of chronic liver disease. However, its influence on autoimmune hepatitis (AIH) has not been investigated. We evaluated the association of serum 25(OH)D levels with clinical, biochemical and histological features and response to therapy in AIH.
  
  
  METHODS
  Serum 25(OH)D levels were quantified in 68 therapy naïve AIH patients and 34 healthy controls.
  
  
  RESULTS
  Mean serum 25(OH)D levels were significantly lower in AIH compared to healthy controls (16.8 ± 9.2 vs. 35.7 ± 13.6, p < 0.0001). Low levels of 25(OH)D (<30 µg/L) were independently associated with advance fibrosis and severe interface hepatitis in AIH patients [p = 0.014; odds ratio (OR) 0.12, 95% confidence interval (CI) 0.02-0.65 and p = 0.020; OR 0.17, 95% CI 0.04-0.76, respectively]. Severe 25(OH)D deficiency (<10 µg/L) was associated with advance fibrosis, severe interface hepatitis, low platelet counts and sampling time in a univariate analysis. Only interface hepatitis and fibrosis scores were independently associated with 25(OH)D deficiency in a multiple regression analysis (p = 0.005; OR 0.12, 95% CI 0.03-0.53 and p = 0.022; OR 0.15, 95% CI 0.03-0.75, respectively). Mean serum 25(OH)D levels were lower in non-responders compared to responders (9.2 ± 4.8 vs. 17.1 ± 9.4, p = 0.015), and 25(OH)D deficiency was more commonly observed in non-responders than the responders (80 vs. 43%, p = 0.036).
  
  
  CONCLUSIONS
  Low 25(OH)D levels are associated with advance fibrosis and severe inflammation in AIH. Our study suggests that vitamin D may be a potential biomarker that predicts response to therapy and histological features in AIH.
authors.affiliation: Department of Gastroenterology, Hacettepe University, Ankara, Turkey, drcumi21@hotmail.com.
authors.forename: Cumali
authors.initials: C
authors.lastname: Efe
authors.forename: Taylan
authors.initials: T
authors.lastname: Kav
authors.forename: Cisel
authors.initials: C
authors.lastname: Aydin
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cengiz
authors.forename: Narin Nasıroglu
authors.initials: NN
authors.lastname: Imga
authors.forename: Tugrul
authors.initials: T
authors.lastname: Purnak
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Smyk
authors.forename: Murat
authors.initials: M
authors.lastname: Torgutalp
authors.forename: Turan
authors.initials: T
authors.lastname: Turhan
authors.forename: Seren
authors.initials: S
authors.lastname: Ozenirler
authors.forename: Ersan
authors.initials: E
authors.lastname: Ozaslan
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Bogdanos
mesh_terms: D000328:Adult; D002112:Calcifediol / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D019693:Hepatitis, Autoimmune / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013256:Steroids / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood*
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids; D002112:Calcifediol