Jamil Zubia, Arif Sharmin, Khan Anum, Durrani Asghar Aurangzeb, Yaqoob Nayyar
Department of Medicine, Foundation University Medical College, Islamabad, Pakistan.
Department of Medicine, Fauji Foundation Hospital, Rawalpindi, Pakistan.
J Clin Transl Hepatol. 2018 Jun 28;6(2):135-140. doi: 10.14218/JCTH.2017.00055. Epub 2018 Feb 1.
Skeletal manifestation in liver diseases represents the minimally scrutinized part of the disease spectrum. Vitamin D deficiency has a central role in developing hepatic osteodystrophy in patients with chronic liver disease. This study aimed to investigate vitamin D levels and their relationship with disease advancement in these patients. Vitamin D levels were checked in 125 chronic liver disease patients. The patients were classified in three stages according to Child-Pugh score: A, B and C. The relationship of vitamin D levels with Child-Pugh score and other variables in the study was assessed by the contingency coefficient. Correlation and logistic regression analyses were also carried out to find additional predictors of low vitamin D levels. Among the patients, 88% had either insufficient or deficient stores of vitamin D, while only 12% had sufficient vitamin D levels ( >0.05). Vitamin D levels were notably related to Child-Pugh class (contingency coefficient = 0.5, <0.05). On univariate and multinomial regression analyses, age, female sex, MELD and Child-Pugh class were predictors of low vitamin D levels. Age, model of end-stage liver disease score and Child-Pugh score were negatively correlated to vitamin D levels ( <0.05). Vitamin D deficiency is notably related to age, female sex and model of end-stage liver disease score, in addition to Child-Pugh class of liver cirrhosis. Vitamin D levels should be routinely checked in patients with advanced liver cirrhosis (Child-Pugh class B and C) and this deficiency must be addressed in a timely manner to improve general well-being of cirrhotic patients.
肝脏疾病中的骨骼表现是疾病谱中最少受到关注的部分。维生素D缺乏在慢性肝病患者肝性骨营养不良的发生中起核心作用。本研究旨在调查这些患者的维生素D水平及其与疾病进展的关系。对125例慢性肝病患者进行了维生素D水平检测。根据Child-Pugh评分将患者分为三个阶段：A、B和C。通过列联系数评估维生素D水平与Child-Pugh评分及研究中的其他变量之间的关系。还进行了相关性和逻辑回归分析，以寻找维生素D水平低的其他预测因素。在这些患者中，88%的患者维生素D储备不足或缺乏，而只有12%的患者维生素D水平充足（>0.05）。维生素D水平与Child-Pugh分级显著相关（列联系数=0.5，<0.05）。在单因素和多因素回归分析中，年龄、女性、终末期肝病模型（MELD）评分和Child-Pugh分级是维生素D水平低的预测因素。年龄、终末期肝病模型评分和Child-Pugh评分与维生素D水平呈负相关（<0.05）。除了肝硬化的Child-Pugh分级外，维生素D缺乏还与年龄、女性及终末期肝病模型评分显著相关。对于晚期肝硬化（Child-Pugh分级B和C）患者，应常规检查维生素D水平，必须及时解决这种缺乏情况，以改善肝硬化患者的总体健康状况。
