Comparative Observational Analysis of Vitamin D Levels in NonCholestatic Chronic Liver Disease and Healthy Controls
Authors/Creators
- 1. Senior Resident, Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Bihar
- 2. Assistant Professor, Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Bihar
- 3. Associate Professor, Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Bihar
Description
Background: The definition of chronic liver disease (CLD) is the persistent, long-term destruction and regeneration of the liver; as the disease progresses, cirrhosis and hepatic fibrosis (scarring) often develop. It seems sense that vitamin D deficiency would be prevalent in people with chronic liver disease (CLD) since the liver is involved in the synthesis of bile salts, vitamin D absorption, and 25-hydroxylation of vitamin D. Methods: The present hospital based observational comparative analysis was conducted in the Department of Medicine of DMCH, Laheriasarai, Bihar among a total of 60 participants. The minimum sample size required in each group was at 95% confidence interval and 80% power to verify the expected difference of 58.6% in proportion of cases with vitamin D deficiency in non-cholestatic chronic liver disease group with age and sex matched control group (hospital staff and attendants of patients) (76.5% vs. 17.96%) was 30 in each group. Results: 30 study participants were cases and 30 study participants were controls. Out of the total study participants 23(38.3%) were female and 37(61.7%) patients were male and the male to female sex ratio was 1.6 : 1. The mean age of 30 cases in our study was 39.1±8.69 years and the mean age of 30 controls was 38.4±8.02 years and no significant difference was observed. Mean serum Vitamin D3 was lower in CLD cases (23.4 ± 6.44 ng / L) as compared to controls (43.8 ± 5.18ng/L). This difference was statistically significant with a p-value <0.001. In univariate analysis in patients with non-cholestatic CLD, significant (P<0.05) positive correlations were found between serum level of vitamin D and serum bilirubin, serum albumin, platelet count, & haemoglobin. Also, there were significant (P<0.05) negative correlations between vitamin D concentration and serum bilirubin, INR & MELD score. No significant correlation was seen between vitamin D and age, serum level of PTH, calcium, phosphate, ALT, AST, ALP, urea, or creatinine. Conclusion: Vitamin D inadequacy is very common in non-cholestatic CLD patients and correlates with the severity of the disease. Therefore, were commend that clinical guidelines for managing non-cholestatic CLD should include the assessment of vitamin D status in all patients. For vitamin D assessment and replacement in the management of patients with non-cholestatic CLD further studies are required.
Abstract (English)
Background: The definition of chronic liver disease (CLD) is the persistent, long-term destruction and regeneration of the liver; as the disease progresses, cirrhosis and hepatic fibrosis (scarring) often develop. It seems sense that vitamin D deficiency would be prevalent in people with chronic liver disease (CLD) since the liver is involved in the synthesis of bile salts, vitamin D absorption, and 25-hydroxylation of vitamin D. Methods: The present hospital based observational comparative analysis was conducted in the Department of Medicine of DMCH, Laheriasarai, Bihar among a total of 60 participants. The minimum sample size required in each group was at 95% confidence interval and 80% power to verify the expected difference of 58.6% in proportion of cases with vitamin D deficiency in non-cholestatic chronic liver disease group with age and sex matched control group (hospital staff and attendants of patients) (76.5% vs. 17.96%) was 30 in each group. Results: 30 study participants were cases and 30 study participants were controls. Out of the total study participants 23(38.3%) were female and 37(61.7%) patients were male and the male to female sex ratio was 1.6 : 1. The mean age of 30 cases in our study was 39.1±8.69 years and the mean age of 30 controls was 38.4±8.02 years and no significant difference was observed. Mean serum Vitamin D3 was lower in CLD cases (23.4 ± 6.44 ng / L) as compared to controls (43.8 ± 5.18ng/L). This difference was statistically significant with a p-value <0.001. In univariate analysis in patients with non-cholestatic CLD, significant (P<0.05) positive correlations were found between serum level of vitamin D and serum bilirubin, serum albumin, platelet count, & haemoglobin. Also, there were significant (P<0.05) negative correlations between vitamin D concentration and serum bilirubin, INR & MELD score. No significant correlation was seen between vitamin D and age, serum level of PTH, calcium, phosphate, ALT, AST, ALP, urea, or creatinine. Conclusion: Vitamin D inadequacy is very common in non-cholestatic CLD patients and correlates with the severity of the disease. Therefore, were commend that clinical guidelines for managing non-cholestatic CLD should include the assessment of vitamin D status in all patients. For vitamin D assessment and replacement in the management of patients with non-cholestatic CLD further studies are required.
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IJPCR,Vol16,Issue6,Article201.pdf
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Additional details
Dates
- Accepted
-
2024-03-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue6,Article201.pdf
- Development Status
- Active
References
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