Severe Vitamin D Deficiency Is Strongly Associated with Liver Dysfunction and Disease Severity in Hepatitis B Virus Related Cirrhosis and Liver Failure Patients.

Vitamin D deficiency is common in chronic liver diseases, it may increase the severity of the diseases. However, studies on the potential role of vitamin D in hepatitis B virus (HBV) related end stage liver disease are still limited. This study was performed to assess the prevalence of vitamin D deficiency in patients with different stages of chronic HBV infection and explore whether vitamin D deficiency can be established as an index of severity and prognosticator of disease progression. Serum 25(OH)D3 levels were measured in a cohort of 363 patients with chronic HBV infection. Biochemical parameters, the alpha fetoprotein level, HBV DNA load, hepatitis B surface antigen level, and hepatitis B early antigen level were tested. The mean 25(OH)D3 level was significantly lower in patients with chronic HBV-related liver disease than in healthy controls. Overall, 74.9% of patients had 25(OH)D3 deficiency. The 25(OH)D3 level was significantly positively correlated with the albumin level. In total, 77.6% (121/156) of patients with cirrhosis had vitamin D deficiency. The 25(OH)D3 level significantly decreased as the Child-Pugh classification increased in severity. The 25(OH)D3 level was negatively correlated with the model for end-stage liver disease (MELD) score and low 25(OH)D3 concentrations were significantly associated with high MELD score and mortality in patients with liver failure. Vitamin D deficiency is prevalent in patients with chronic HBV infection. Severe vitamin D deficiency is strongly related to liver dysfunction and disease severity in the cirrhosis and liver failure patients.