Article Text

PDF
PTH-053 Vitamin D and other micronutrient status in patients with ald and other liver diseases
  1. C Raychaudhuri1,
  2. A Al-Joudeh1,
  3. M Srinivas1,
  4. B Ellis2,
  5. K D Bardhan1,
  6. P J Willemse1,
  7. P Basumani1,
  8. B Höroldt1
  1. 1Department of Gastroenterology, Rotherham General Hospital, Rotherham, UK
  2. 2Department of Clinical Chemistry, Rotherham General Hospital, Rotherham, UK

Abstract

Introduction Vitamin D deficiency is associated with non-specific symptoms, carries long-term risk to bone health, and certain groups are at higher risk (alcohol excess, old age, Asians). The prevalence among patients attending hepatology clinics is unclear; this prompted our pilot study.

Methods Measurements: vitamin D, calcium profile, LFT, FBC available for all; vitamin B12, folate, ferritin/iron studies available for 256 patients. Use of OTC supplements was checked and those on vitamin (other than oral thiamine or Vitamin B complex) preparations were excluded. Frequencies were compared by Fisher exact test.

Results 288 patients were included (170 male, median (range) age: 54.81 (17–92), 155 Caucasian). 113 had alcoholic liver disease (112 Caucasians), 175 other liver diseases (non-ALD: 29 autoimmune liver disease, 52 fatty liver, 65 viral liver hepatitis, 29 other). 37 patients had liver cirrhosis (29 ALD, 8 non-ALD). (a) Overall median vitamin D level was 37 nmol/l and was lower in ALD vs non-ALD patients: 30 vs 47 nmol/l. (b) Median vitamin D level in south-east Asian was 23 nmol/l, deficiency was significantly more common (50 vs 30%, p=0.02); these patients were excluded from subsequent analysis. (c) Vitamin D deficiency was significantly more common in ALD patients (33 vs 13%, p=0.001). (d) In ALD cirrhosis was not significantly associated with vitamin D deficiency (p=0.08). (e) In ALD, there was trend towards increased vitamin D deficiency in females (p=0.06), in patients over 60 years (p=0.053) and towards worsening vitamin D deficiency in spring compared to autumn (p=0.07). (f) In non-ALD, vitamin D deficiency was significantly more common in patients >60 years (p=0.02); but not in women (p=1.0). Seasonal variation was not significant for deficiency (p=0.07), but for combined deficiency/insufficiency (p=0.004). (g) In non-ALD cirrhosis, vitamin D deficiency was more common but this did not reach statistically significance (33 vs 12%, p=0.09). (h) Folate (10%) and iron deficiency (14%) were more common in ALD (non-ALD both 4%) but vitamin B12 deficiency was not (8.8 vs 8.2%).

Conclusion Vitamin D is common in ALD, it's prevalence in other liver diseases is around 12%, higher than other micronutrient deficiencies. It is increased in older subjects and South-East Asians and seasonal variation is less then expected. It should be screened for in all ALD patients and in non-ALD in those at increased risk (older age, South-East Asian and cirrhosis).

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.