title: Vitamin D supplementation reduces depressive symptoms in patients with chronic liver disease.
abstract: Vitamin D deficiency and depression frequently occur in patients with chronic liver diseases (CLD). Depression has recently been inversely associated with vitamin D in a meta-analysis, and vitamin D receptor is expressed in brain. This pilot study investigates whether vitamin D replacement ameliorates depressive symptoms in CLD patients and consists of a cross-sectional and an interventional analysis.
  
  
  
  Overall, 111 patients with CLD were included in the cross-sectional analysis. The Beck Depression Inventory II (BDI-II) was used to assess depression. Chemiluminescence immunoassay and LC-MS/MS quantified serum 25-hydroxyvitamin D levels. For the interventional analysis, 77 patients with inadequate vitamin D concentrations received 20,000 IU vitamin D per week for six months. The final follow-up was carried out six months post supplementation.
  
  
  
  In the cross-sectional analysis, 81% of patients (median age 55 years, 47% women) had inadequate baseline vitamin D levels (<30 ng/ml), and 31% presented with depressive symptoms (BDI-II score ≥14). Depression severity correlated inversely with vitamin D level in depressed patients (β = -0.483, P = 0.004). Depression scores improved significantly from baseline in depressed patients after three and six months (P = 0.003 and P = 0.004, respectively) of supplementation, with vitamin D levels increasing to normal (P < 0.0001). Subgroup analyses revealed this anti-depressant effect of vitamin D to occur predominantly in women. The final follow-up showed increases in median BDI-II scores in the setting of decreased vitamin D levels.
  
  
  
  Vitamin D levels correlated with BDI-II scores, and vitamin D replacement significantly improved depressive symptoms in women with CLD. Adjuvant vitamin D may be considered in these patients.
  
  
  
  DRKS00007782 German Clinical Trials Registry (DRKS).
authors.affiliation: Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Electronic address: caroline.stokes@uks.eu.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Stokes
authors.affiliation: Department of Medicine II, Saarland University Medical Center, Homburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Grünhage
authors.affiliation: Department of Psychiatry and Psychotherapy, Saarland University Medical Center, Homburg, Germany.
authors.forename: Crystal
authors.initials: C
authors.lastname: Baus
authors.affiliation: Institute of Bioanalytical Chemistry, Saarland University, Saarbrücken, Germany.
authors.forename: Dietrich A
authors.initials: DA
authors.lastname: Volmer
authors.affiliation: Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Campus Homburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wagenpfeil
authors.affiliation: Department of Psychiatry and Psychotherapy, Saarland University Medical Center, Homburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Riemenschneider
authors.affiliation: Department of Medicine II, Saarland University Medical Center, Homburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Lammert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000188:drug therapy*; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008107:Liver Diseases / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D053719:Tandem Mass Spectrometry; D014807:Vitamin D / Q000008:administration & dosage* / Q000097:blood; D014808:Vitamin D Deficiency / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D014807:Vitamin D
keywords: 25-Hydroxyvitamin D; Beck Depression Inventory; Cirrhosis; Mood; Supplementation; Women