Tags

Type your tag names separated by a space and hit enter

Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease.
Clin Gastroenterol Hepatol. 2007 Apr; 5(4):513-20.CG

Abstract

BACKGROUND & AIMS

The liver plays a central role in vitamin D metabolism. Our aim was to determine the prevalence and type of vitamin D-parathyroid hormone (PTH) disturbance in ambulatory patients with noncholestatic chronic liver disease (CLD) and its relationship with disease severity and liver function.

METHODS

We studied 100 consecutive outpatients (63 men, 37 women; mean age, 49.0 +/- 12.1 [SD] y) with noncholestatic CLD caused by alcohol (n = 40), hepatitis C (n = 38), hepatitis B (n = 12), autoimmune hepatitis (n = 4), hemochromatosis (n = 4), and nonalcoholic steatohepatitis (n = 2); 51 patients had cirrhosis. Serum concentrations of 25-hydroxyvitamin D (25[OH]D), PTH, calcium, phosphate, magnesium, creatinine, and liver function tests were determined.

RESULTS

Serum 25(OH)D levels were inadequate in 91 patients: vitamin D deficiency (<50 nmol/L) was found in 68 patients and vitamin D insufficiency (50-80 nmol/L) was found in 23 patients. Secondary hyperparathyroidism (serum PTH, >6.8 pmol/L) was present in 16 patients. The prevalence of vitamin D deficiency was significantly higher in cirrhotic vs noncirrhotic patients (86.3% vs 49.0%; P = .0001). In Child-Pugh class C patients, 25(OH)D levels were significantly lower than in class A patients (22.7 +/- 10.0 nmol/L vs 45.8 +/- 16.8 nmol/L; P < .001). Serum 25(OH)D independently correlated with international normalized ratio (negatively; P = .018) and serum albumin (positively; P = .007). Serum 25(OH)D levels of less than 25 nmol/L predicted coagulopathy, hyperbilirubinemia, hypoalbuminemia, increased alkaline phosphatase, and anemia and thrombocytopenia.

CONCLUSIONS

Vitamin D inadequacy is common in noncholestatic CLD and correlates with disease severity, but secondary hyperparathyroidism is relatively infrequent. Management of CLD should include assessment of vitamin D status in all patients and replacement when necessary.

Authors+Show Affiliations

Department of Gastroenterology, Canberra Hospital, ACT, Australia. leonfisher@optusnet.com.auNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17222588

Citation

Fisher, Leon, and Alexander Fisher. "Vitamin D and Parathyroid Hormone in Outpatients With Noncholestatic Chronic Liver Disease." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 5, no. 4, 2007, pp. 513-20.
Fisher L, Fisher A. Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease. Clin Gastroenterol Hepatol. 2007;5(4):513-20.
Fisher, L., & Fisher, A. (2007). Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 5(4), 513-20.
Fisher L, Fisher A. Vitamin D and Parathyroid Hormone in Outpatients With Noncholestatic Chronic Liver Disease. Clin Gastroenterol Hepatol. 2007;5(4):513-20. PubMed PMID: 17222588.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease. AU - Fisher,Leon, AU - Fisher,Alexander, Y1 - 2007/01/10/ PY - 2007/1/16/pubmed PY - 2007/5/11/medline PY - 2007/1/16/entrez SP - 513 EP - 20 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 5 IS - 4 N2 - BACKGROUND & AIMS: The liver plays a central role in vitamin D metabolism. Our aim was to determine the prevalence and type of vitamin D-parathyroid hormone (PTH) disturbance in ambulatory patients with noncholestatic chronic liver disease (CLD) and its relationship with disease severity and liver function. METHODS: We studied 100 consecutive outpatients (63 men, 37 women; mean age, 49.0 +/- 12.1 [SD] y) with noncholestatic CLD caused by alcohol (n = 40), hepatitis C (n = 38), hepatitis B (n = 12), autoimmune hepatitis (n = 4), hemochromatosis (n = 4), and nonalcoholic steatohepatitis (n = 2); 51 patients had cirrhosis. Serum concentrations of 25-hydroxyvitamin D (25[OH]D), PTH, calcium, phosphate, magnesium, creatinine, and liver function tests were determined. RESULTS: Serum 25(OH)D levels were inadequate in 91 patients: vitamin D deficiency (<50 nmol/L) was found in 68 patients and vitamin D insufficiency (50-80 nmol/L) was found in 23 patients. Secondary hyperparathyroidism (serum PTH, >6.8 pmol/L) was present in 16 patients. The prevalence of vitamin D deficiency was significantly higher in cirrhotic vs noncirrhotic patients (86.3% vs 49.0%; P = .0001). In Child-Pugh class C patients, 25(OH)D levels were significantly lower than in class A patients (22.7 +/- 10.0 nmol/L vs 45.8 +/- 16.8 nmol/L; P < .001). Serum 25(OH)D independently correlated with international normalized ratio (negatively; P = .018) and serum albumin (positively; P = .007). Serum 25(OH)D levels of less than 25 nmol/L predicted coagulopathy, hyperbilirubinemia, hypoalbuminemia, increased alkaline phosphatase, and anemia and thrombocytopenia. CONCLUSIONS: Vitamin D inadequacy is common in noncholestatic CLD and correlates with disease severity, but secondary hyperparathyroidism is relatively infrequent. Management of CLD should include assessment of vitamin D status in all patients and replacement when necessary. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/17222588/Vitamin_D_and_parathyroid_hormone_in_outpatients_with_noncholestatic_chronic_liver_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(06)01053-6 DB - PRIME DP - Unbound Medicine ER -