title: Effects of Vitamin D Supplementation on Serum 25-Hydroxyvitamin D Concentrations in Cirrhotic Patients: A Randomized Controlled Trial.
abstract: BACKGROUND
  The liver is crucial for 25-hydroxyvitamin D (25(OH)D) metabolism, and vitamin D deficiency is highly prevalent in patients with cirrhosis and predicts adverse outcomes. We aimed to evaluate whether vitamin D supplementation in patients with cirrhosis is effective in increasing 25(OH)D serum concentrations. Secondary outcome measures included liver function tests (aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyltransferase (GGT), and alkaline phosphatase (AP)), albumin, International Normalized Ratio (INR), bilirubin, the liver fibrosis marker hyaluronic acid, and parameters of mineral metabolism including parathyroid hormone (PTH).
  
  
  METHODS
  This is a double-center, double-blind, placebo-controlled study conducted from December 2013 to May 2014 at the Medical University of Graz, and the hospital Hoergas-Enzenbach, Austria. We enrolled 36 consecutive patients with cirrhosis and 25(OH)D concentrations below 30 ng/mL. Study participants were randomly allocated to receive either 2800 International Units of vitamin D3 per day as oily drops (n = 18) or placebo (n = 18) for 8 weeks.
  
  
  RESULTS
  Thirty-three study participants (mean (SD) age: 60 (9) years; 21% females; 25(OH)D: 15.6 (7.4) ng/mL) completed the trial. The mean treatment effect (95% CI) for 25(OH)D was 15.2 (8.0 to 22.4) ng/mL (p < 0.001). There was no significant effect on any secondary outcome.
  
  
  CONCLUSIONS
  In this randomized controlled trial, vitamin D supplementation increases 25(OH)D serum concentrations, even in cirrhotic patients.
authors.affiliation: Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. stefan.pilz@chello.at.
authors.forename: Stefan
authors.initials: S
authors.lastname: Pilz
authors.affiliation: Department of Internal Medicine, Landeskrankenhaus Hoergas-Enzenbach, Hörgas 30, 8112 Gratwein-Straßengel, Austria. Csilla.Putz-Bankuti@lkh-hoergas.at.|Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. Csilla.Putz-Bankuti@lkh-hoergas.at.
authors.forename: Csilla
authors.initials: C
authors.lastname: Putz-Bankuti
authors.affiliation: Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. martin.gaksch@gmail.com.
authors.forename: Martin
authors.initials: M
authors.lastname: Gaksch
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. walter.spindelboeck@medunigraz.at.
authors.forename: Walter
authors.initials: W
authors.lastname: Spindelboeck
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. marius.haselberger@stud.medunigraz.at.
authors.forename: Marius
authors.initials: M
authors.lastname: Haselberger
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. flo_rainer@hotmail.com.
authors.forename: Florian
authors.initials: F
authors.lastname: Rainer
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. andreas.posch@medunigraz.at.
authors.forename: Andreas
authors.initials: A
authors.lastname: Posch
authors.affiliation: Department of Internal Medicine, Landeskrankenhaus Hoergas-Enzenbach, Hörgas 30, 8112 Gratwein-Straßengel, Austria. philipp.kreuzer@klinikum-graz.at.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kreuzer
authors.affiliation: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. tatjana.stojakovic@medunigraz.at.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Stojakovic
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. vanessa.stadlbauer@medunigraz.at.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Stadlbauer
authors.affiliation: Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. barbara.obermayer@medunigraz.at.
authors.forename: Barbara
authors.initials: B
authors.lastname: Obermayer-Pietsch
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. rudolf.stauber@medunigraz.at.
authors.forename: Rudolf E
authors.initials: RE
authors.lastname: Stauber
mesh_terms: D000368:Aged; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: RCT; intervention; liver; supplementation; vitamin D