Division of Gastroenterology & Liver Unit, Department of Medicine, University of Alberta Hospital, Edmonton, AB T6G 2X8, Canada.
Department of Clinical Nutrition, Faculty of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 14176-13151, Iran.
Nutrients. 2022 Feb 19;14(4):878. doi: 10.3390/nu14040878.
Vitamin D (VD) deficiency has been associated with clinical outcomes in patients with chronic liver disease. This study aims to identify the prevalence of VD deficiency in patients with primary biliary cholangitis (PBC) and its association with treatment response to ursodeoxycholic acid (UDCA), cirrhosis development, and liver-related events (mortality and liver transplantation). Two hundred and fifty-five patients with PBC diagnosis were evaluated. Patients with VD levels below 50 nmol/L were defined as deficient. Treatment response to UDCA was defined according to the Toronto criteria. Independent risk factors were identified using binary logistic and Cox regression analysis. The mean level of serum VD was 77 ± 39 nmol/L, and 64 patients (25%) were VD deficient. Incomplete response to UDCA was more prevalent in VD-deficient patients compared to their counterparts (45% vs. 22%; < 0.001). The risk of cirrhosis development (hazard ratio (HR) 1.93; 95% confidence interval (CI) 1.17-3.19, = 0.01) and liver-related mortality or need for liver transplantation (HR 3.33, 95% CI, 1.57-7.07, = 0.002) was higher in VD-deficient patients after adjusting for confounders. Vitamin D deficiency is frequent in patients with PBC and is associated with incomplete response to UDCA, cirrhosis development, and liver-related mortality or need for liver transplantation.
维生素 D（VD）缺乏与慢性肝病患者的临床结局有关。本研究旨在确定原发性胆汁性胆管炎（PBC）患者中 VD 缺乏的患病率及其与熊去氧胆酸（UDCA）治疗反应、肝硬化发展和与肝脏相关的事件（死亡率和肝移植）的关系。评估了 255 名 PBC 诊断患者。将 VD 水平低于 50 nmol/L 的患者定义为缺乏。根据多伦多标准定义 UDCA 治疗反应。使用二项逻辑回归和 Cox 回归分析确定独立的危险因素。血清 VD 的平均水平为 77 ± 39 nmol/L，64 名患者（25%）VD 缺乏。与对照组相比，VD 缺乏的患者对 UDCA 的不完全反应更为常见（45%比 22%；< 0.001）。在调整混杂因素后，VD 缺乏患者的肝硬化发展（风险比（HR）1.93；95%置信区间（CI）1.17-3.19，= 0.01）和与肝脏相关的死亡率或需要肝移植（HR 3.33，95%CI，1.57-7.07，= 0.002）的风险更高。
