vitamin-d-2 and Liver-Cirrhosis--Alcoholic

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

In 2 similar groups of alcoholic cirrhotics with definite hepatic failure, the results of the oral administration of 25-hydroxycholecalciferol and of vitamin d2 on calcemia and urinary calcium excretion were studied. 25-hydroxycholecalciferol definitely increases calcemia and urinary calcium excretion, this action being superior to that of vitamin D2. This action which occurs, at least in part, by an increase in intestinal calcium absorption, deomonstrated the true nature of the "hepatic block" of vitamin D2 in alcoholic cirrhosis and the value of the administration of 25-hydroxycholecalciferol.

Topics: Calcium; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Intestinal Absorption; Liver Cirrhosis, Alcoholic; Male; Middle Aged

In order to evaluate the influence of chronic alcoholism on vitamin D metabolism, plasma 25-hydroxycholecalciferol (25-OHD) concentrations were measured during winter-time in alcoholic patients with cirrhosis (n = 9) or steatosis (n = 5) and in nonalcoholic patients with cirrhosis (n = 8) or without liver disease (n = 10). Low levels of 25-OHD were found in 91% of the whole population studied. After oral administration of vitamin D 2600000 units, the increase in 25-OHD observed was less pronounced in patients with cirrhosis, but was similar in alcoholic and non-alcoholic patients. The study indicates that chronic alcoholism is not responsible for the 25-OHD deficiency.

Topics: Alcoholism; Calcifediol; Ergocalciferols; Fatty Liver, Alcoholic; Humans; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Liver Diseases, Alcoholic; Vitamin D

Twenty of 32 patients with either chronic cholestatic or hepatocellular liver disease had bone pain or recent fractures. On bone biopsy five patients had normal bone, 15 had osteomalacia, five had osteoporosis, and seven had a combination of osteomalacia and osteoporosis. In the presence of osteoporosis, osteomalacia was minimal or absent. There was no biochemical, radiological, or histological evidence of excess parathyroid activity. No significant correlations were demonstrated between the plasma and urinary biochemical findings and the presence of either osteoporosis or osteomalacia and bone biopsy was essential for correct diagnosis. There was no statistical relationship between low serum 25-hydroxy vitamin D values and the presence of osteomalacia. Bone disease was not prevented by regular intramuscular vitamin D2, although biochemical changes were improved. Drugs such as corticosteroids and cholestyramine may be important aetiological factors in hepatic osteodystrophy.

Topics: Adult; Bone and Bones; Cholestasis; Chronic Disease; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Osteomalacia; Osteoporosis; Parathyroid Glands

Topics: Adult; Aged; Bone and Bones; Calcium; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Hydroxylation; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Parathyroid Hormone; Phosphorus