cholecalciferol and Liver-Cirrhosis--Alcoholic

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.. 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.. 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.. 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.

Topics: Bilirubin; Bone Diseases, Metabolic; Cholecalciferol; Dietary Supplements; Humans; International Normalized Ratio; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Osteoporosis; Prospective Studies; Serum Albumin; Severity of Illness Index; Treatment Outcome; Vitamin D; Vitamin D Deficiency

The goal of this study was to examine the effects of a single oral dose of 300,000 international units of either ergocalciferol (D₂) or cholecalciferol (D₃) on the plasma levels of 25-hydroxyvitamin D in patients with alcoholic liver cirrhosis.. Inclusion criteria for this study were diagnosis of alcoholic liver cirrhosis and plasma levels of 25-hydroxyvitamin D less than 25 nmol/l. At baseline, patients were divided into Child-Pugh groups A, B, or C and were given one oral dose of 300,000 international units of ergocalciferol (D₂ group, N=23) or cholecalciferol (D₃ group, N=13). Plasma concentrations of 25(OH) vitamin D and vitamin D-binding protein were measured on days 0, 7, 30, and 90.. On days 7 and 30, patients from the D₃ group had higher vitamin D levels than patients from the D₂ group (P<0.05). On day 7, vitamin D levels were found to correlate with Child-Pugh scores from patients in the D₃ group. For patients in the D₂ group, there was a positive correlation between vitamin D and vitamin D-binding protein as indicated by the area under the concentration versus time curves (Spearmen's ρ=0.64 P<0.001).. In patients with alcoholic liver cirrhosis, a single oral megadose of cholecalciferol was more effective than ergocalciferol in the treatment of vitamin D deficiency. Severe liver disease and low levels of vitamin D-binding protein were predictors for poor treatment outcomes.

Topics: Administration, Oral; Cholecalciferol; Drug Administration Schedule; Ergocalciferols; Female; Humans; Liver Cirrhosis, Alcoholic; Male; Prognosis; Severity of Illness Index; Treatment Outcome; Vitamin D; Vitamin D Deficiency; Vitamin D-Binding Protein

Vitamin D metabolism was investigated in 10 patients with cirrhosis. Mean plasma 25 hydroxycholecalciferol (25 OHD) centration in alcoholic cirrhosis was lower than in controls but the difference was not significant. In three patients restudied after the summer, plasma 25 OHD had risen. In contrast to the finding in normal subjects, the half-life of intravenously administered 3H cholecalciferol was short in cirrhotics and showed no correlation with plasma 25 OHD. Furthermore, the appearance of 3H 25 OHD from 3H cholecalciferol was reduced compared to the control group four hours after injection. Increased rate of metabolism of cholecalciferol and deficient production of 25 ohd contribute to vitamin D deficiency in liver disease.

Topics: Adult; Aged; Cholecalciferol; Female; Half-Life; Humans; Hydroxycholecalciferols; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Ultraviolet Rays; Vitamin D