Effect of Vitamin D Supplementation on Vitamin D Level and Bone Mineral Density in Patients With Cirrhosis: A Randomized Clinical Trial.

Abstract

INTRODUCTION:

In patients with cirrhosis, highly prevalent vitamin D deficiency and low bone mineral density (BMD) increase the burden of disease, and role of vitamin D supplementation is not clear. So, our aim was to determine the effect of vitamin D supplementation on vitamin D level and BMD in patients with cirrhosis.

METHODS:

Patients with cirrhosis (18-60 years) of any etiology were enrolled. We measured serum 25(OH)D, parathyroid hormone, thyroid-stimulating hormone, free T4, bone-specific alkaline phosphatase, insulin-like growth factor (IGF)-1, and health-related quality of life at entry and at 1 year; however, serum calcium was measured at 3-month interval. BMD was measured by dual-energy x-ray absorptiometry at lumbar spine and left hip neck at entry and after 1 year. Statistical analysis was performed according to intention-to-treat analysis.

RESULTS:

Of 390 screened patients with cirrhosis, 164 participants (82 in each group) were randomized. There was significant increase in 25(OH)D levels in intervention group after 1 year (33.7 [24.3-45.7] ng/mL vs 23.1 [17-28.2] ng/mL; P < 0.001) when compared with placebo. The mean difference in BMD at lumbar spine and left hip neck was not significantly changed after 1 year of intervention with vitamin D between both groups. There was no significant change in both the groups in levels of calcium, thyroid-stimulating hormone, parathyroid hormone, free T4, IGF-1, and bone-specific alkaline phosphatase and quality of life.

DISCUSSION:

Supplementation with vitamin D for 1 year improves vitamin D levels but did not result in improvement in BMD at lumbar spine and left hip neck in patients with cirrhosis.

• Authors: Indu Grover, Deepak Gunjan, Namrata Singh, Jaya Benjamin, Lakshmy Ramakrishnan, Ravindra M Pandey, Hem C Sati, Anoop Saraya
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 116 Issue 10 Pg. 2098-2104 (10 01 2021) ISSN: 1572-0241 [Electronic] United States
• PMID: 33927126 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 by The American College of Gastroenterology.

Chemical References

• Bone Density Conservation Agents
• Vitamin D

Topics

• Absorptiometry, Photon
• Adult
• Bone Density
• Bone Density Conservation Agents (therapeutic use)
• Cohort Studies
• Dietary Supplements
• Female
• Humans
• Liver Cirrhosis (blood, complications)
• Male
• Middle Aged
• Quality of Life
• Vitamin D (blood, therapeutic use)
• Vitamin D Deficiency (prevention & control)