Kilani Yassine, Alsakarneh Saqr, Madi Mahmoud Y, Mosquera Daniel Alejandro Gonzalez, Ferreira Mariana Nunes, Jaber Fouad, Helzberg John, Duong Nikki, Syn Wing-Kin
Department of Medicine, NYC Health + Hospitals, Lincoln - Weill Cornell Medical College Affiliate, New York, New York, USA.
Department of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA.
Aliment Pharmacol Ther. 2025 Feb;61(4):682-692. doi: 10.1111/apt.18438. Epub 2024 Dec 11.
Vitamin D deficiency is linked to worse outcomes in patients with chronic liver diseases (CLD). However, data in patients with autoimmune hepatitis (AIH) remain limited.
We aimed to assess the impact of vitamin D deficiency on the outcomes of individuals with AIH.
This retrospective cohort study used the TriNetX research network to identify patients with AIH. Patients were matched using propensity score matching and stratified to sufficient vitamin D levels (e.g., 25 (OH) D3 ≥ 30 ng/mL), vitamin D insufficiency (25 (OH) D3: 20-29.9 ng/mL) and vitamin D deficiency (e.g., 25 (OH) D3 < 20 ng/mL). The primary outcome was the all-cause mortality among adult patients with AIH. Secondary outcomes included decompensated liver cirrhosis, acute hepatic failure, liver transplantation (LT), all-cause hospitalizations and all-cause critical care admissions.
A total of 1288 AIH patients with vitamin D deficiency were identified and propensity matched with 1288 patients with normal vitamin D levels. Patients with vitamin D deficiency had significantly increased odds for all-cause mortality compared to those with normal levels (adjusted odds ratio (aOR) = 3.2, 95%CI: 2.3-4.48). Patients with vitamin D deficiency were at increased odds of all-cause hospitalizations (aOR = 2.37, 95%CI: 1.97-2.84), critical care unit admissions (aOR = 2.8, 95%CI: 2.21-3.71), decompensated liver cirrhosis (aOR = 2.74, 95%CI: 2.13-3.54), acute hepatic failure (aOR = 3.11, 95%CI: 2.09-4.62) and LT (aOR = 3.47, 95%CI: 1.71-7.04), as compared to those with normal vitamin D levels.
This cohort study showed significantly increased odds for all-cause mortality in AIH patients with vitamin D deficiency. Vitamin D deficiency in patients with AIH was associated with increased likelihood of hospitalisation, decompensated liver cirrhosis, acute liver failure and LT.
维生素D缺乏与慢性肝病（CLD）患者的不良预后相关。然而，自身免疫性肝炎（AIH）患者的数据仍然有限。
我们旨在评估维生素D缺乏对AIH患者预后的影响。
这项回顾性队列研究使用TriNetX研究网络来识别AIH患者。通过倾向评分匹配对患者进行匹配，并分层为维生素D水平充足（例如，25（OH）D3≥30 ng/mL）、维生素D不足（25（OH）D3：20 - 29.9 ng/mL）和维生素D缺乏（例如，25（OH）D3 < 20 ng/mL）。主要结局是成年AIH患者的全因死亡率。次要结局包括失代偿期肝硬化、急性肝衰竭、肝移植（LT）、全因住院和全因重症监护入院。
共识别出1288例维生素D缺乏的AIH患者，并与1288例维生素D水平正常的患者进行倾向匹配。与维生素D水平正常的患者相比，维生素D缺乏的患者全因死亡率的几率显著增加（调整后的优势比（aOR） = 3.2，95%CI：2.3 - 4.48）。与维生素D水平正常的患者相比，维生素D缺乏的患者全因住院（aOR = 2.37，95%CI：1.97 - 2.84）、重症监护病房入院（aOR = 2.8，95%CI：2.21 - 3.71）、失代偿期肝硬化（aOR = 2.74，95%CI：2.13 - 3.54）、急性肝衰竭（aOR = 3.11，95%CI：2.09 - 4.62）和LT（aOR = 3.47，95%CI：1.71 - 7.04）的几率增加。
这项队列研究表明，维生素D缺乏的AIH患者全因死亡率的几率显著增加。AIH患者的维生素D缺乏与住院、失代偿期肝硬化、急性肝衰竭和LT的可能性增加相关。
