Z Gastroenterol 2020; 58(01): e20
DOI: 10.1055/s-0039-3402154
Poster Visit Session II Clinical Hepatology, Surgery, LTX: Friday, February 14, 2020, 2:40 pm – 3:25 pm, Lecture Hall P1
Georg Thieme Verlag KG Stuttgart · New York

Vitamin A deficiency is associated with disease severity in patients with liver cirrhosis

M Nagel
1   University Hospital Mainz, First Department of internal medicine, Mainz, Germany
2   University Hospital Mainz, Cirrhose Centrum Mainz, Mainz, Germany
,
C Labenz
1   University Hospital Mainz, First Department of internal medicine, Mainz, Germany
2   University Hospital Mainz, Cirrhose Centrum Mainz, Mainz, Germany
,
M Nguyen-Tat
1   University Hospital Mainz, First Department of internal medicine, Mainz, Germany
2   University Hospital Mainz, Cirrhose Centrum Mainz, Mainz, Germany
3   Hospital Osnabrück, Department of Internal Medicine II, Osnabrück, Germany
,
N Cabezas Wallscheid
4   Max Planck Institute (MPI) of Immunobiology and Epigenetics, Freiburg, Germany
,
C Czauderna
1   University Hospital Mainz, First Department of internal medicine, Mainz, Germany
2   University Hospital Mainz, Cirrhose Centrum Mainz, Mainz, Germany
,
J Schattenberg
1   University Hospital Mainz, First Department of internal medicine, Mainz, Germany
2   University Hospital Mainz, Cirrhose Centrum Mainz, Mainz, Germany
,
MA Wörns
1   University Hospital Mainz, First Department of internal medicine, Mainz, Germany
2   University Hospital Mainz, Cirrhose Centrum Mainz, Mainz, Germany
,
PR Galle
1   University Hospital Mainz, First Department of internal medicine, Mainz, Germany
2   University Hospital Mainz, Cirrhose Centrum Mainz, Mainz, Germany
,
J Marquardt
1   University Hospital Mainz, First Department of internal medicine, Mainz, Germany
2   University Hospital Mainz, Cirrhose Centrum Mainz, Mainz, Germany
5   University Medical Center of the Johannes Gutenberg-University Mainz, Lichtenberg Research Group for Molecular Hepatocarcinogenesis, Mainz, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
03 January 2020 (online)

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Background:

Malnutrition and subsequent development of cachexia is frequently observed in patients with liver cirrhosis. Subsequent induction of oxidative stress within the liver is associated with increased morbidity and mortality. Malnutrition-induced deficiency of the anti-oxidative vitamin A may, thus, be a modifiable factor and contribute to the progression of chronic liver diseases.

Methods:

From March 2018 to May 2019, vitamin A status of 161 patients with liver cirrhosis were prospectively assessed at our outpatient and inpatients liver unit at the University Medical Center Mainz. Clinical and laboratory parameters were recorded and associated with vitamin A levels.

Results:

Vitamin A deficiency was found in 67% of cirrhotic patients. Vitamin A deficiency showed an inverse correlation with labMELD values (R =-0.6, p value = 0.001) and direct correlation with parameters of the liver function (albumin, R = 0.8, p value =< 0.001; bilirubin R =-0,04, p value =< 0.001; INR, R =-0,6, p value =< 0.0001). Likewise, patients with a history of hepatic encephalopathy (p value = 0.05) or signs of decompensation (p value = 0.03) showed a significant reduction in vitamin A deficiency. CRP as a marker for inflammation and infection also correlates significantly with serum vitamin A levels (R =-0.37, p value =< 0.0001).

Conclusion:

Majority of cirrhotic patients suffer from vitamin A deficiency. Herein, the liver synthesis correlates significantly with the extent of vitamin A deficiency. Vitamin A deficiency is particularly pronounced in patients with ascites and hepatic encephalopathy.