Autoimmune Hepatitis and Vitamin D Deficiency: A Nationwide Perspective.

Autor: Kilani Y; Department of Medicine, NYC Health + Hospitals, Lincoln - Weill Cornell Medical College Affiliate, New York, New York, USA., Alsakarneh S; Department of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA., Madi MY; Division of Gastroenterology & Hepatology, Department of Medicine, Saint Louis University, St. Louis, Missouri, USA., Mosquera DAG; Department of Medicine, NYC Health + Hospitals, Lincoln - Weill Cornell Medical College Affiliate, New York, New York, USA., Ferreira MN; Department of Medicine, NYC Health + Hospitals, Lincoln - Weill Cornell Medical College Affiliate, New York, New York, USA., Jaber F; Department of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA., Helzberg J; Department of Gastroenterology & Hepatology, University of Missouri-Kansas City, Missouri, USA., Duong N; Department of Gastroenterology and Hepatology, Stanford University, Stanford, Palo Alto, USA., Syn WK; Division of Gastroenterology & Hepatology, Department of Medicine, Saint Louis University, St. Louis, Missouri, USA.; Department of Physiology, Faculty of Medicine and Nursing, University of Basque Country UPV/EHU, Vizcaya, Spain.
Jazyk: angličtina
Zdroj: Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2024 Dec 11. Date of Electronic Publication: 2024 Dec 11.
DOI: 10.1111/apt.18438
Abstrakt: Background: Vitamin D deficiency is linked to worse outcomes in patients with chronic liver diseases (CLD). However, data in patients with autoimmune hepatitis (AIH) remain limited.
Aims: We aimed to assess the impact of vitamin D deficiency on the outcomes of individuals with AIH.
Methods: This retrospective cohort study used the TriNetX research network to identify patients with AIH. Patients were matched using propensity score matching and stratified to sufficient vitamin D levels (e.g., 25 (OH) D3 ≥ 30 ng/mL), vitamin D insufficiency (25 (OH) D3: 20-29.9 ng/mL) and vitamin D deficiency (e.g., 25 (OH) D3 < 20 ng/mL). The primary outcome was the all-cause mortality among adult patients with AIH. Secondary outcomes included decompensated liver cirrhosis, acute hepatic failure, liver transplantation (LT), all-cause hospitalizations and all-cause critical care admissions.
Results: A total of 1288 AIH patients with vitamin D deficiency were identified and propensity matched with 1288 patients with normal vitamin D levels. Patients with vitamin D deficiency had significantly increased odds for all-cause mortality compared to those with normal levels (adjusted odds ratio (aOR) = 3.2, 95%CI: 2.3-4.48). Patients with vitamin D deficiency were at increased odds of all-cause hospitalizations (aOR = 2.37, 95%CI: 1.97-2.84), critical care unit admissions (aOR = 2.8, 95%CI: 2.21-3.71), decompensated liver cirrhosis (aOR = 2.74, 95%CI: 2.13-3.54), acute hepatic failure (aOR = 3.11, 95%CI: 2.09-4.62) and LT (aOR = 3.47, 95%CI: 1.71-7.04), as compared to those with normal vitamin D levels.
Conclusion: This cohort study showed significantly increased odds for all-cause mortality in AIH patients with vitamin D deficiency. Vitamin D deficiency in patients with AIH was associated with increased likelihood of hospitalisation, decompensated liver cirrhosis, acute liver failure and LT.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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