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An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis.
Ann Hepatol 2018; 17(6):920-932AH

Abstract

Malnutrition is prevalent in cirrhosis. Vitamin and mineral deficiencies, including vitamin D, vitamin A, and zinc, are common and have been shown to correlate with survival. Our aim was to review the mechanisms of vitamin D, vitamin A, and zinc deficiencies in cirrhosis and the clinical assessment of affected patients, their outcomes based on the current literature, and management. This is a narrative review including the relevant literature for cirrhosis and vitamin D, vitamin A, and zinc deficiencies. Vitamin D deficiency has important effects in cirrhosis, regardless of the cause of chronic liver disease.These effects include associations with fibrosis and outcomes such as infections, hepatocellular carcinoma, and mortality. Vitamin A deficiency is associated with liver disease progression to cirrhosis and clinical decompensation, including occurrence of ascites or hepatic encephalopathy. Zinc deficiency can lead to hepatic encephalopathy and impaired immune function. Such deficiencies correlate with patient survival and disease severity. Caution should be applied when replacing vitamin D, vitamin A, and zinc to avoid toxicity. Identification and appropriate treatment of vitamin and mineral deficiencies in cirrhosis may reduce specific nutritional and cirrhosis-related adverse events. Routine monitoring of vitamin A, vitamin D and zinc levels in cirrhosis should be considered.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30600288

Citation

Koop, Andree H., et al. "An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis." Annals of Hepatology, vol. 17, no. 6, 2018, pp. 920-932.
Koop AH, Mousa OY, Pham LE, et al. An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis. Ann Hepatol. 2018;17(6):920-932.
Koop, A. H., Mousa, O. Y., Pham, L. E., Corral-Hurtado, J. E., Pungpapong, S., & Keaveny, A. P. (2018). An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis. Annals of Hepatology, 17(6), pp. 920-932. doi:10.5604/01.3001.0012.7192.
Koop AH, et al. An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis. Ann Hepatol. 2018 Oct 16;17(6):920-932. PubMed PMID: 30600288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis. AU - Koop,Andree H, AU - Mousa,Omar Y, AU - Pham,Ly Elaine, AU - Corral-Hurtado,Juan E, AU - Pungpapong,Surakit, AU - Keaveny,Andrew P, PY - 2019/1/3/entrez PY - 2019/1/3/pubmed PY - 2019/4/23/medline KW - Cirrhosis KW - Vitamin A deficiency KW - Vitamin D deficiency KW - Zinc deficiency SP - 920 EP - 932 JF - Annals of hepatology JO - Ann Hepatol VL - 17 IS - 6 N2 - Malnutrition is prevalent in cirrhosis. Vitamin and mineral deficiencies, including vitamin D, vitamin A, and zinc, are common and have been shown to correlate with survival. Our aim was to review the mechanisms of vitamin D, vitamin A, and zinc deficiencies in cirrhosis and the clinical assessment of affected patients, their outcomes based on the current literature, and management. This is a narrative review including the relevant literature for cirrhosis and vitamin D, vitamin A, and zinc deficiencies. Vitamin D deficiency has important effects in cirrhosis, regardless of the cause of chronic liver disease.These effects include associations with fibrosis and outcomes such as infections, hepatocellular carcinoma, and mortality. Vitamin A deficiency is associated with liver disease progression to cirrhosis and clinical decompensation, including occurrence of ascites or hepatic encephalopathy. Zinc deficiency can lead to hepatic encephalopathy and impaired immune function. Such deficiencies correlate with patient survival and disease severity. Caution should be applied when replacing vitamin D, vitamin A, and zinc to avoid toxicity. Identification and appropriate treatment of vitamin and mineral deficiencies in cirrhosis may reduce specific nutritional and cirrhosis-related adverse events. Routine monitoring of vitamin A, vitamin D and zinc levels in cirrhosis should be considered. SN - 1665-2681 UR - https://www.unboundmedicine.com/medline/citation/30600288/An_Argument_for_Vitamin_D_A_and_Zinc_Monitoring_in_Cirrhosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/01.3001.0012.7192 DB - PRIME DP - Unbound Medicine ER -