ORIGINAL ARTICLE   

Minerva Medica 2018 October;109(5):352-7

DOI: 10.23736/S0026-4806.18.05723-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Vitamin D supplementation in patients with alcoholic liver cirrhosis: a prospective study

Željka SAVIĆ ¹, Vladimir VRAČARIĆ ¹, Nataša MILIĆ ², Dijana NIĆIFOROVIĆ ³, Dragomir DAMJANOV ¹, Rinaldo PELLICANO ⁴, Milica MEDIĆ-STOJANOSKA ⁵, Ludovico ABENAVOLI ⁶ ✉

¹ Clinic of Gastroenterology and Hepatology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; ² Department of Pharmacy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; ³ Clinic of Radiology, Clinical Center of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; ⁴ Unit of Gastroenterology, Molinette Hospital, Turin, Italy; ⁵ Clinic for Endocrinology, Diabetes, and Metabolic Diseases, Clinical Center of Vojvodina, University of Novi Sad, Novi Sad, Serbia; ⁶ Department of Health Sciences, Magna Græcia University, Catanzaro, Italy

BACKGROUND: The liver is involved in the metabolism of vitamin D. The prevalence of osteopenia in alcoholic liver disease (ALD) patients is 34-48%, and the prevalence of osteoporosis is 11-36%. Advanced liver disease is considered a risk factor for the development of osteoporosis. The aim of this study was to establish the relationship between vitamin D level and Child-Pugh score in patients with alcoholic liver cirrhosis (ALC), and to evaluate the effects of oral vitamin D supplementation.
METHODS: Seventy male ALC patients in the absence of active alcohol intake were enrolled and their clinical and laboratory data were recorded. A supplementation of cholecalciferol 1000 IU/day was administered. The vitamin D status was analyzed during the study, in patients stratified by Child-Pugh score.
RESULTS: The study was completed by fifty patients. At the enrollment, the mean level of vitamin D was 60.73±28.02, 50.53±39.52 and 26.71±12.81 nmol/L, respectively for Child-Pugh score class A, B and C. During vitamin D supplementation it was found in all the patients a significant increase of its levels during the first six months (P<0.05). However, in class C the improvement was consistent also after year (P<0.05). At the end of the study, two of seven patients initially in class C changed in class A, four from class C to B, and one remained in class C (P=0.012). Out of seventeen patients initially in class B, eleven changed to class A, and six remained in class B.
CONCLUSIONS: In patients with ALC, higher level of vitamin D level is related with lower Child-Pugh score. The supplementation of 1000 IU/day of vitamin D in these patients was optimal for a period of at least six months. A decrease in the Child-Pugh score was also found, with a redistribution of the patients in different classes.

KEY WORDS: Liver diseases - Cholecalciferol - Metabolism - Liver cirrhosis - Vitamin D