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Chronic hepatic disease and vitamin D : Lisbon universitary hospital reality

Published in 2017 by Catarina João Monteiro Ferreira
This paper is available in a repository.
This paper is available in a repository.

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Preprint: policy unknown
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Postprint: policy unknown
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Abstract

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016 ; Introdução: Estudos anteriores sugerem que a Doenca Hepatica Cronica (DHC) pode estar relacionada com a deficiencia de vitamina D, independentemente da etiologia. Baixos niveis de 25(OH)D podem estar inversamente relacionados com a gravidade da doenca. Objectivos: 1) avaliar a prevalencia da deficiencia de vitamina D na DHC; 2) analisar a relacao entre os niveis de 25(OH)D e etiologia da DHC, classificaçao de Child-Pugh (CP) e classifica cao Model for End-stage Liver Disease (MELD). M etodos: inclu dos 85 doentes cirr oticos internados na Unidade de Hepatologia. Avaliacao de 25(OH)D: d e ce 20ng/ml, insuficiente 21-29ng/ml; gravidade da doen ca avaliada por CP e MELD. Resultados: maioria do sexo masculino (57%), m edia de idades 59 15 anos, 45% hepatite cronica viral. Valores m edios de 25(OH)D: 17.1 5.3 ng/ml; 79% tinha d e ce de vitamina D e 17% tinha ni veis insuficientes. Nao foram encontradas diferen cas entre n iveis de 25(OH)D e cirrose de etiologia viral (17.2 8.1 ng/ml) e nao viral (16.7 5.7 ng/ml; P=0.838). Classe CP A tem n veis mais elevados de vitamina D (20.2 9.2 ng/ml) em compara cao com as classes B e C (16.2 6.3 ng/ml) (p=0.03); doentes com 20 pontos no MELD t^em niveis mais reduzidos de vitamina D (12.5 3.5 ng/ml) que o grupo com 11-20 pontos no MELD (18.6 8.2 ng/ml) (P=0.02). Conclusoes: Existe uma elevada prevalencia de deficiencia de vitamina D na DHC. Niveis mais baixos de vitamina D estao inversamente relacionados com gravidade da doenca, mas nao com etiologia da DHC. ; Background: Previous studies suggest that Chronic Liver Disease (CLD) may be related to vitamin D de ciency, regardless of aetiology. Low 25(OH)D levels may be inversely related with disease severity. Aims: 1) to evaluate the prevalence of vitamin D de ciency in CLD; 2) to analyse whether 25(OH)D levels are associated with disease aetiology, Child- Pugh (CP) score and Model for End-stage Liver Disease (MELD) score. Methods: 85 cirrhotic patients admitted to our inpatient Liver Unit were enrolled. 25(OH)D measured: de ciency 20ng/ml, insu ciency 21- 29ng/ml; disease severity was estimated by CP and MELD. Results: a majority of patients were males (57%) and the mean age was 59 15 years; the aetiology of 45% of patients was chronic viral hepatitis. The average levels of 25(OH)D was 17.1 5.3 ng/ml and vitamin D de ciency was observed in 79% of patients and insu ciency in 17%. No signi cant di erence was found in 25(OH)D levels between chronic viral cirrhosis (17.2 8.1 ng/ml) and non-viral cirrhosis (16.7 5.7 ng/ml; P=0.838). CP stage A (20.2 9.2 ng/ml) had higher vitamin D levels than CP stages B plus C (16.2 6.3 ng/ml)(p=0.03); patients with MELD 20 (12.5 3.5) had lower levels of vitamin D than MELD 11-20 (18.6 8.2)(P=0.02). Conclusions: There is a high prevalence of vitamin D deficiency in CLD patients. Lower concentrations are inversely associated with disease severity, but it is not associated with CLD aetiology.