Serum 25-hydroxyvitamin D deficiency and hepatic encephalopathy in chronic liver disease

Table 1 Population characteristics

	Total cohort (n)	Overt HE1 (n)	No HE1 (n)
Demographics	165	88	77
Gender
Male	119	68	51
Female	46	20	26
Mean age (years ± SD)	53 ± 8	52 ± 7	54 ± 8
Primary indication for liver transplantation
Viral hepatitis	91	52	39
Alcoholic cirrhosis	23	18	5
Cholestatic disease (PBC, PSC, autoimmune)	30	10	20
Non-alcoholic steatohepatitis	7	6	1
Other	14	2	12
Ethnicity
Caucasian	130	75	55
Asian	22	6	16
Middle Eastern	8	4	4
Other	5	3	2
Clinical characteristics
CTP score mean ± SD	9 ± 2.5	11 ± 1.7a	7 ± 2a
CTP stage
A	41	0a	41a
B	47	22	25
C	77	66a	11a
Ascites
None	51	7a	44a
Medically controlled	54	36a	18a
Poorly controlled	60	45a	15a
BMI (kg/m2 ± SD)	27.4 ± 5.2	28.7 ± 5.4a	25.7 ± 4.2a
Nutritional status	104	65	39
SGA: A (well nourished)	12	9	3
SGA: B (moderately malnourished)	65	40	25
SGA: C (severely malnourished)	27	16	11
Biochemical characteristics
25-OHD (vitamin D) (nmol/L) mean ± SD	36 ± 15	30 ± 13a	42 ± 16a
MELD score mean ± SD	17.1 ± 6.8	19.9 ± 6. 5a	13.9 ± 5.7a
Bilirubin (μmol/L) mean ± SD	114 ± 152	141 ± 167a	83 ± 128a
Creatinine (μmol/L) mean ± SD	84 ± 50	85 ± 35a	83 ± 63
Albumin (g/L) mean ± SD	33 ± 6	31 ± 5a	35 ± 6a
INR mean ± SD	1.6 ± 0.5	1.8 ± 0.6a	1.3 ± 0.3a
Sodium (mmol/L) mean ± SD	136 ± 5	135 ± 5a	138 ± 4a
Zinc (μmol/L) mean ± SD	8 ± 4	8 ± 3a	10 ± 5a

^aP < 0.05.

¹Unless otherwise indicated there is no significant difference between HE and no HE. 25-OHD: 25-hydroxyvitamin D; HE: Hepatic encephalopathy; CTP: Child Turcotte Pugh; BMI: Body mass index; SGA: Subjective nutritional assessment; MELD: Model for end stage liver disease; INR: International normalized ratio.

Table 2 25-hydroxyvitamin D categories in patients assessed for liver transplantation

	25-OHD (nmol/L)	Total number	Overt HE1 (n = 88)	No overt HE1 (n = 77)
Sufficient	> 75	2	0	2
Insufficient	50-75	27	6	21
Mildly deficient	25-50	87	46	41
Moderately deficient	12.5-25	42	30a	12a
Severely deficient	< 12.5	7	6	1

^aP < 0.05.

¹Unless otherwise indicated there were no significant differences between the overt HE and no-overt HE groups. 25-OHD: 25-hydroxyvitamin D; HE: Hepatic encephalopathy.

Table 3 Univariate 25-hydroxyvitamin D correlations with physical and biochemical markers determined by Spearman correlation

	Spearman r	P value	Significance
Age	0.1110	0.16	ns
Total bilirubin	-0.3493	< 0.0001	f
Albumin	0.3153	< 0.0001	f
ALP	0.0203	0.80	ns
GGT	0.2055	0.0081	b
ALT	0.0246	0.75	ns
AST	-0.1741	0.0253	a
Creatinine	-0.0687	0.38	ns
Na+	0.2666	0.0005	e
Zn+	0.2790	0.0004	e
RBP	0.2913	0.0002	e
Transferrin	0.3568	< 0.0001	f
INR	-0.4232	< 0.0001	f
Ca2+	0.2370	0.0022	b
Ca2+ corrected	-0.1531	0.08	ns
PTH	-0.1824	0.0205	a
BMI	-0.2244	0.0055	b

^aP < 0.05;

^bP < 0.01;

^eP < 0.001;

^fP < 0.0001. ns: Not significant; ALP: Alkalinephosphatase; GGT: Glutamyl transpeptidase; ALT: Alanine transaminase; AST: Aspartate transaminase; RBP: Retinol binding protein; INR: International normalized ratio; PTH: Parathyroid hormone; BMI: Body mass index.