Vitamin D Deficiency and Chronic Liver Disease: Investigating Predictive Factors and Their Implications for Patient Care in Pakistan.

BACKGROUND

Chronic liver disease (CLD) and its end-stage manifestation, cirrhosis, present significant global health challenges, contributing to substantial morbidity and mortality. Despite its impact on various organ systems, the musculoskeletal effects of CLD, particularly vitamin D deficiency remain underexplored. This study aimed to identify significant predictors of vitamin D deficiency among CLD patients.

METHODS

Overall, 177 CLD patients of either gender, aged 18 yr and above were included using the non-probability consecutive sampling technique. This cross-sectional study was conducted at the medical units of Isra University Hospital, Hyderabad, from Jan to Jun 2023. Various markers of hepatic function including bilirubin, albumin, and International normalised ratio (INR), were analyzed, along with a complete blood count and each patient was assigned a Child-Turcotte-Pugh (CTP) score. The relationship of vitamin D with different variables was assessed through Chi-Square tests. Pearson correlation and regression analyses were carried out to identify predictors of vitamin D deficiency.

RESULTS

Mean age of patients was 51.76±5.77 yr and the majority were male (68.4%). Vitamin D deficiency was present in 28.24%, particularly among those with cirrhosis. Vitamin D levels correlated negatively with disease severity, as indicated by CTP (<0.05) and Model for End-Stage Liver Disease (MELD) (<0.05) scores, and positively with albumin levels (<0.05). Increasing age, male gender, and higher CTP and MELD scores were significant predictors (<0.05) of vitamin D deficiency.

CONCLUSION

Vitamin D levels correlate with hepatic dysfunction and are negatively associated with disease progression. Significant predictors of vitamin D deficiency identified include increasing age, male gender, and higher MELD and CTP Score.