University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia.
University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia; Department for Clinical Nutrition, Institute of Oncology, Zaloška cesta 2, 1000 Ljubljana, Slovenia.
Clin Nutr ESPEN. 2021 Apr;42:258-261. doi: 10.1016/j.clnesp.2021.01.026. Epub 2021 Mar 5.
BACKGROUND & AIMS: Vitamin D deficiency is an important complication of chronic intestinal failure (CIF). Liver steatosis is a known late complication of long-term home parenteral nutrition (HPN) therapy in patients with CIF, which can progress to intestinal failure-associated liver disease (IFALD). The aim of this study was to determine the prevalence of vitamin D deficiency among Slovene HPN patients and determine any potential correlation between serum vitamin D levels and liver steatosis associated with IFALD in adult patients with CIF on HPN therapy.
Adult patients, diagnosed with CIF, receiving long term HPN therapy, were included in a cross-sectional study. Vitamin D status was determined by measuring serum levels of 25-hydroxyvitamin D. The presence of liver steatosis was diagnosed using 3 T S MRI scanner. The association between serum vitamin D levels and liver steatosis was calculated using univariate logistic regression.
We included 63 adult patients with CIF on HPN therapy in the study. The median duration of HPN therapy was 70 weeks. The average serum concentration of 25-hydroxyvitamin D was 41.3 nmol/l. Insufficient vitamin D levels were found in 45 (73%) patients. Liver steatosis was present in 18 (28.6%) patients. No statistically significant association between serum vitamin D levels and liver steatosis in the study population was found.
The results of this study have shown a high prevalence of vitamin D deficiency in adult patients with CIF on HPN. We failed to demonstrate an association between serum vitamin D levels and the prevalence of liver steatosis.
维生素 D 缺乏是慢性肠衰竭（CIF）的重要并发症。肝脂肪变性是 CIF 患者长期家庭肠外营养（HPN）治疗的已知晚期并发症，可进展为肠衰竭相关肝病（IFALD）。本研究旨在确定斯洛文尼亚 HPN 患者维生素 D 缺乏的患病率，并确定 CIF 接受 HPN 治疗的成年患者中与 IFALD 相关的肝脂肪变性与血清维生素 D 水平之间的任何潜在相关性。
纳入接受长期 HPN 治疗的成年 CIF 患者进行横断面研究。通过测量血清 25-羟维生素 D 水平来确定维生素 D 状态。使用 3T MRI 扫描仪诊断肝脂肪变性的存在。使用单变量逻辑回归计算血清维生素 D 水平与肝脂肪变性之间的关联。
我们纳入了 63 名接受 HPN 治疗的成年 CIF 患者进行研究。HPN 治疗的中位时间为 70 周。平均血清 25-羟维生素 D 浓度为 41.3nmol/l。45 名（73%）患者存在维生素 D 水平不足。18 名（28.6%）患者存在肝脂肪变性。在研究人群中，未发现血清维生素 D 水平与肝脂肪变性之间存在统计学显著相关性。
本研究结果表明，接受 HPN 的成年 CIF 患者维生素 D 缺乏的患病率很高。我们未能证明血清维生素 D 水平与肝脂肪变性的患病率之间存在关联。
