Vitamin D and depression in chronic liver disease

Aims: Patients with chronic liver disease (CLD) frequently exhibit vitamin D deficiency1. Vitamin D is purported to be implicated in depression, which is co-morbid with CLD. Serum 25-hydroxyvitamin D levels often correlate inversely with depression2, and vitamin D receptors (VDR) are confirmed to be involved in depression pathophysiology in the brain3. Behavioural impairment and increased anxiety are demonstrated in VDR knockout mice compared to controls4. Human studies show VDR gene variants to influence depression5. This study investigates the potential of vitamin D supplementation in ameliorating depressive symptoms in CLD and will explore for depression/genetic associations with variants affecting vitamin D metabolism and regulation. Methods: Currently 24 patients with CLD have been recruited (54% male, age 26–75). Patients are allocated to the intervention or control group when serum 25-hydroxyvitamin D levels are <30 ng/ml, and ≥30 ng/ml, respectively. The intervention group receives 20,000 IU 25-hydroxyvitamin D/week for six months. Patients are followed up at 3, 6 and 12 months to assess depression severity using the validated Beck Depression Inventory, and to measure serum 25-hydroxyvitamin D levels, which are determined by chemiluminescence immunoassay (Diasorin Liaison). Results: The majority of patients (79%) have serum 25-hydroxyvitamin D levels <30 ng/ml (mean 18.1±12.0 ng/ml). Of note, 30% (n=7) of CLD patients had depressive symptoms ranging from mild to moderate depression, of which six had vitamin D deficiency. Conclusions: A high proportion of CLD patients recruited in winter months display vitamin D deficiency, irrespective of depressive symptoms. Preliminary evidence indicates a potential inverse association between vitamin D deficiency and depression severity. The sample size is currently being increased to determine whether patients with depression have lower serum 25-hydroxyvitamin D levels compared to those without.

Literatur: 1. Arteh et al. Dig Dis Sci 2010 55:2624 2. Ganji et al. Int Arch Med 2010 3:29 3. Eyles et al. J Chem Neuroanat 2005 29:21 4. Kalueff et al. Neurosci Res 2006 54:254 5. Kuningas et al. Neurobiol Aging 2009 30:46

25-hydroxyvitamin D - vitamin D receptor