AIM To assess the vitamin D(VD) deficiency as a prognostic factor and effect of replenishment of VD on mortality in decompensated cirrhosis. METHODS Patients with decompensated liver cirrhosis were screened for serum ...AIM To assess the vitamin D(VD) deficiency as a prognostic factor and effect of replenishment of VD on mortality in decompensated cirrhosis. METHODS Patients with decompensated liver cirrhosis were screened for serum VD levels. A total of 101 VD deficient patients(< 20 ng/mL) were randomly enrolled in two groups: Treatment group(n = 51) and control group(n = 50). Treatment group received VD treatment in the form of intramuscular cholecalciferol 300000 IU as loading dose and 800 IU/d oral as maintenance dose along with 1000 mg oral calcium supplementation. The VD level, clinical parameters and survival of both the groups were compared for 6-mo.RESULTS Prevalence of vitamin D deficiency(VDD) in decompensated CLD was 84.31%. The mean(SD) age of the patients in the treatment group(M:F: 40:11) and control group(M:F: 37:13) were 46.2(± 14.93) years and 43.28(± 12.53) years, respectively. Baseline mean(CI) VD(ng/mL) in control group and treatment group were 9.15(8.35-9.94) and 9.65(8.63-10.7), respectively. Mean(CI) serum VD level(ng/mL) at 6-mo in control group and treatment group were 9.02(6.88-11.17) and 29(23-35), respectively. Over the period of time the VD, calcium and phosphorus level was improved in treatment group compared to control group. There was nonsignificant trend seen in greater survival(69% vs 64%; P > 0.05) and longer survival(155 d vs 141 d; P > 0.05) in treatment group compared to control group. VD level had no significant association with mortality(P > 0.05). In multivariate analysis, treatment with VD supplement was found significantly(P < 0.05; adjusted hazard ratio: 0.48) associated with survival of the patients over 6-mo. CONCLUSION VD deficiency is very common in patients of decompensated CLD. Replenishment of VD may improve survival in patients with decompensated liver cirrhosis.展开更多
文摘AIM To assess the vitamin D(VD) deficiency as a prognostic factor and effect of replenishment of VD on mortality in decompensated cirrhosis. METHODS Patients with decompensated liver cirrhosis were screened for serum VD levels. A total of 101 VD deficient patients(< 20 ng/mL) were randomly enrolled in two groups: Treatment group(n = 51) and control group(n = 50). Treatment group received VD treatment in the form of intramuscular cholecalciferol 300000 IU as loading dose and 800 IU/d oral as maintenance dose along with 1000 mg oral calcium supplementation. The VD level, clinical parameters and survival of both the groups were compared for 6-mo.RESULTS Prevalence of vitamin D deficiency(VDD) in decompensated CLD was 84.31%. The mean(SD) age of the patients in the treatment group(M:F: 40:11) and control group(M:F: 37:13) were 46.2(± 14.93) years and 43.28(± 12.53) years, respectively. Baseline mean(CI) VD(ng/mL) in control group and treatment group were 9.15(8.35-9.94) and 9.65(8.63-10.7), respectively. Mean(CI) serum VD level(ng/mL) at 6-mo in control group and treatment group were 9.02(6.88-11.17) and 29(23-35), respectively. Over the period of time the VD, calcium and phosphorus level was improved in treatment group compared to control group. There was nonsignificant trend seen in greater survival(69% vs 64%; P > 0.05) and longer survival(155 d vs 141 d; P > 0.05) in treatment group compared to control group. VD level had no significant association with mortality(P > 0.05). In multivariate analysis, treatment with VD supplement was found significantly(P < 0.05; adjusted hazard ratio: 0.48) associated with survival of the patients over 6-mo. CONCLUSION VD deficiency is very common in patients of decompensated CLD. Replenishment of VD may improve survival in patients with decompensated liver cirrhosis.
