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Disturbances of parathyroid hormone–vitamin D axis in non-cholestatic chronic liver disease: a cross-sectional study

Hepatology International volume 4, pages 634–640 (2010)Cite this article

Abstract

Purpose

Liver has an important role in metabolism of vitamin D. This study aimed to evaluate the patterns of vitamin D–parathyroid hormone (PTH) disturbance and correlate it in patients with non-cholestatic chronic liver disease (CLD).

Methods

A total of 40 healthy controls and 90 consecutive patients with evidence of non-cholestatic CLD due to hepatitis C (n = 28), hepatitis B (n = 26), autoimmune hepatitis (n = 19), and cryptogenic causes (n = 17) were enrolled. Cirrhosis was evident in 51 patients. Serum concentrations of 25-hydroxy vitamin D, PTH, calcium, phosphate, and liver enzymes were measured. Child–Pugh classification was determined in cirrhotic patients.

Results

Vitamin D deficiency (<50 nmol/l) was found in 46 (51.1%) patients and vitamin D insufficiency (50–80 nmol/l) in 15 (16.7%) patients. Secondary hyperparathyroidism (serum PTH > 6.8 pmol/l) was present in 6 (6.7%) patients. The prevalence of vitamin D deficiency was significantly higher in cirrhotic versus noncirrhotic patients (76.5 vs. 17.9%; P < 0.001), whereas there was no significant difference in serum calcium, phosphate, and PTH levels. Child–Pugh class B and C patients had significantly lower vitamin D level compared with class A patients (P < 0.001), whereas there was no significant difference in serum calcium, phosphate, and PTH levels. No significant correlation was seen between vitamin D and PTH, calcium or phosphate levels. Lower serum level of vitamin D was associated with coagulopathy, hyperbilirubinemia, hypoalbuminemia, anemia, and thrombocytopenia.

Conclusions

Vitamin D inadequacy and the severity of liver dysfunction move in parallel in patients with non-cholestatic CLD. Vitamin D assessment and replacement should be considered in the management of patients with non-cholestatic CLD.

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Authors and Affiliations

  1. Department of Gastroenterology, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Arash Miroliaee, Mohsen Nasiri-Toosi, Omid Khalilzadeh & Mehdi Mazloumi

  2. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Omid Khalilzadeh, Alireza Esteghamati & Mehdi Mazloumi

  3. Department of Pathology, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Alireza Abdollahi

Authors
  1. Arash Miroliaee
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  2. Mohsen Nasiri-Toosi
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  3. Omid Khalilzadeh
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  4. Alireza Esteghamati
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  6. Mehdi Mazloumi
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Correspondence to Omid Khalilzadeh.

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Miroliaee, A., Nasiri-Toosi, M., Khalilzadeh, O. et al. Disturbances of parathyroid hormone–vitamin D axis in non-cholestatic chronic liver disease: a cross-sectional study. Hepatol Int 4, 634–640 (2010). https://doi.org/10.1007/s12072-010-9194-2

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  • DOI: https://doi.org/10.1007/s12072-010-9194-2

Keywords

  • Vitamin D
  • Liver
  • Cirrhosis
  • Parathyroid hormone
  • Child–Pugh score
  • MELD