Differential Impact of Serum 25-Hydroxyvitamin D3 Levels on the Prognosis of Patients with Liver Cirrhosis According to MELD and Child-Pugh Scores.

Autor:	Kim TH; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Yun SG; Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea., Choi J; Department of Biostatistics, Korea University College of Medicine, Seoul, Korea., Goh HG; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Lee HA; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Yim SY; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Choi SJ; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Lee YS; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Yoon EL; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Jung YK; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Seo YS; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Kim JH; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Yim HJ; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Yeon JE; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Byun KS; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Um SH; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. umsh@korea.ac.kr.
Jazyk:	angličtina
Zdroj:	Journal of Korean medical science [J Korean Med Sci] 2020 May 18; Vol. 35 (19), pp. e129. Date of Electronic Publication: 2020 May 18.
DOI:	10.3346/jkms.2020.35.e129
Abstrakt:	Background: Prognosis of patients with diverse chronic diseases is reportedly associated with 25-hydroxyvitamin D levels. In this study, we investigated the potential role of 25-hydroxyvitamin D3 (25[OH]D3) levels in improving the predictive power of conventional prognostic models for patients with liver cirrhosis. Methods: We investigated clinical findings, including serum 25(OH)D3 levels at admission, of 155 patients with cirrhosis who were followed up for a median of 16.9 months. Results: Median 25(OH)D3 levels were significantly different among patients exhibiting Child-Pugh grades A, B, and C. Mortality, including urgent transplantation, was significantly associated with 25(OH)D3 levels in univariate analysis. Severe vitamin-D deficiency (serum 25[OH]D3 level < 5.0 ng/mL) was significantly related to increased mortality, even after adjusting for Child-Pugh and Model for End-stage Liver Disease (MELD) scores. In particular, the presence of severe vitamin D deficiency clearly defined a subgroup with significantly poorer survival among patients with Child-Pugh scores of 5-10 or MELD scores ≤ 20. A new combination model of MELD score and severe vitamin D deficiency showed significantly more accurate predictive power for short- and long-term mortality than MELD scores alone. Additionally, serum 25(OH)D3 levels and new model scores were significantly associated with the development of spontaneous bacterial peritonitis, overt encephalopathy, and acute kidney injury. Conclusion: Serum 25(OH)D3 level is an independent prognostic factor for patients with liver cirrhosis and has a differential impact on disease outcomes according to MELD and Child-Pugh scores. Competing Interests: The authors have no potential conflicts of interest to disclose. (© 2020 The Korean Academy of Medical Sciences.)
Databáze:	MEDLINE
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