title: Factors associated with 25-hydroxyvitamin D levels in patients with liver cirrhosis.
abstract: BACKGROUND
  Lower 25-hydroxyvitamin D [25(OH)D] levels have been observed in cirrhotic patients and have been related to disease severity. However, most previous studies included patients with very advanced disease, lacking an adequate control for other variables that could interfere with vitamin D levels. We sought to investigate the prevalence of hypovitaminosis D and the factors related to its occurrence.
  
  
  METHODS
  This cross-sectional study included 133 cirrhotic patients and 30 healthy controls. Bivariate and multivariate analyses were performed to determine factors associated with 25(OH)D levels below the lower tertile. Thirty patients who had been recently hospitalized were compared in two time points.
  
  
  RESULTS
  Mean 25(OH)D levels were 32.34 ± 11.38 in controls and 27.03 ± 6.22 ng/mL in patients (P = 0.018). 25(OH)D levels were < 30 ng/mL in 69.9% and < 20 ng/mL in 14.3% of the sample. Levels of 25(OH)D below the lower tertile (< 24 ng/mL) were independently associated with higher triceps skinfold and non-Caucasian race. Parathyroid hormone above the reference value (65 pg/mL) was found in 24.6% of patients without association with 25(OH)D or severity of liver disease. Significantly lower levels of 25(OH)D were found at the time of acute decompensation of cirrhosis.
  
  
  CONCLUSIONS
  In conclusion, hypovitaminosis D was prevalent in cirrhotics and it was associated with adiposity and non-Caucasian race in stable patients with relatively well preserved liver function. However, significantly lower levels were observed during admission for acute decompensation suggesting an impact of systemic inflammation or liver dysfunction on 25(OH)D levels.
authors.affiliation: Division of Gastroenterology, Federal University of Santa Catarina.
authors.forename: Mariana
authors.initials: M
authors.lastname: Costa Silva
authors.affiliation: Division of Gastroenterology, Federal University of Santa Catarina.
authors.forename: Telma
authors.initials: T
authors.lastname: Erotides Silva
authors.affiliation: Nutrition and Dietetic Service, Hospital Universitário Polydoro Ernani de São Thiago.
authors.forename: Maria Luiza Aires
authors.initials: ML
authors.lastname: de Alentar
authors.affiliation: Nutrition and Dietetic Service, Hospital Universitário Polydoro Ernani de São Thiago.
authors.forename: Mara Sérgia Pacheco
authors.initials: MS
authors.lastname: Honório Coelho
authors.affiliation: Department of Clinical Analysis, Federal University of Santa Catarina.
authors.forename: Letícia Muraro
authors.initials: LM
authors.lastname: Wildner
authors.affiliation: Department of Clinical Analysis, Federal University of Santa Catarina.
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Bazzo
authors.affiliation: Post-Graduate Program in Nutrition, Federal University of Santa Catarina.
authors.forename: David Alejandro
authors.initials: DA
authors.lastname: González-Chica
authors.affiliation: Division of Gastroenterology, Federal University of Santa Catarina.
authors.forename: Esther Buzaglo
authors.initials: EB
authors.lastname: Dantas-Corrêa
authors.affiliation: Division of Gastroenterology, Federal University of Santa Catarina.
authors.forename: Janaína Luz
authors.initials: JL
authors.lastname: Narciso-Schiavon
authors.affiliation: Division of Gastroenterology, Federal University of Santa Catarina.
authors.forename: Leonardo de Lucca
authors.initials: Lde L
authors.lastname: Schiavon
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*; D044465:White People / Q000706:statistics & numerical data
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D