Z Gastroenterol 2011; 49 - P1_23
DOI: 10.1055/s-0030-1269473

Serum 25-hydroxy-vitamin D3 in chronic liver disease: a transient elastography- based study

K Hochrath 1, M Krawczyk 2, B Obermayer-Pietsch 3, M Trauner 3, F Lammert 2, F Grünhage 4
  • 1Abteilung für Innere Medizin II, Saarland, Homburg
  • 2Department of Internal Medicine II, Saarland University Hospital, Homburg, Germany, Homburg
  • 3Department of Internal Medicine, Graz, Austria
  • 4Medizinische Klinik II, Universitätsklinikum des Saarlandes, Homburg/Saar

Background: Low serum 25-hydroxy-vitamin D3 (vit. D) levels have been associated with advanced liver fibrosis and unfavorable outcome of chronic viral hepatitis C (HCV) treatment. Lately, transient elastography (TE) has gained wide acceptance as a non-invasive tool to assess liver fibrosis. Here we investigate serum vit. D levels in relation to TE values in patients with different types of chronic liver diseases (CLD).

Methods: We determined the serum vit. D concentration in 787 patients with CLDs of mixed etiologies. The HCV group included patients with viral replication (n=491), therapy non-responders (n=133) and patients after successful treatment (n=55). Liver stiffness was quantified by TE (Fibroscan). Patients were stratified to a mild fibrosis (TE<6kPa) or severe fibrosis (TE>18kPa) group. In 206 individuals who underwent liver biopsy fibrosis was staged according to the Desmet score.

Results: The majority of patients (n=490, 62%) had vit. D serum concentrations <30ng/ml. The levels were significantly (p<0.05) lower in patients with alcoholic or cryptogenic liver diseases than in patients with HCV, PBC or AIH. Negative correlations between vit. D levels and both liver stiffness values and histological fibrosis stages (both p<0.001) were detected. Patients with fibrosis stages F1 and F2 (n=99) displayed significantly (p<0.01) higher vit. D levels (33.2±1.7ng/ml) than patients with severe fibrosis and cirrhosis (18.5±1.3ng/ml). TE stratification in patients with mild (n=137) and severe fibrosis (n=284) demonstrated significantly (p<0.001) lower vit. D levels in the latter group. No differences in vitamin D levels according to treatment response in HCV patients were detected.

Conclusions: Vitamin D serum levels correlate negatively with TE independently of CLD etiology, possibly reflecting impaired hydroxylation capacity or profibrogenic risk conferred by vitamin D deficiency. Low vit. D levels in cryptogenic liver diseases deserve further work-up.