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Low Serum Vitamin D Levels Are Associated with Severe Histological Features and Poor Response to Therapy in Patients with Autoimmune Hepatitis

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Abstract

Background and Aim

25-Hydroxyvitamin D [25(OH)D] has an important role in fibrosis progression and inflammatory response in patients with various etiologies of chronic liver disease. However, its influence on autoimmune hepatitis (AIH) has not been investigated. We evaluated the association of serum 25(OH)D levels with clinical, biochemical and histological features and response to therapy in AIH.

Materials and methods

Serum 25(OH)D levels were quantified in 68 therapy naïve AIH patients and 34 healthy controls.

Results

Mean serum 25(OH)D levels were significantly lower in AIH compared to healthy controls (16.8 ± 9.2 vs. 35.7 ± 13.6, p < 0.0001). Low levels of 25(OH)D (<30 µg/L) were independently associated with advance fibrosis and severe interface hepatitis in AIH patients [p = 0.014; odds ratio (OR) 0.12, 95 % confidence interval (CI) 0.02–0.65 and p = 0.020; OR 0.17, 95 % CI 0.04–0.76, respectively]. Severe 25(OH)D deficiency (<10 µg/L) was associated with advance fibrosis, severe interface hepatitis, low platelet counts and sampling time in a univariate analysis. Only interface hepatitis and fibrosis scores were independently associated with 25(OH)D deficiency in a multiple regression analysis (p = 0.005; OR 0.12, 95 % CI 0.03–0.53 and p = 0.022; OR 0.15, 95 % CI 0.03–0.75, respectively). Mean serum 25(OH)D levels were lower in non-responders compared to responders (9.2 ± 4.8 vs. 17.1 ± 9.4, p = 0.015), and 25(OH)D deficiency was more commonly observed in non-responders than the responders (80 vs. 43 %, p = 0.036).

Conclusions

Low 25(OH)D levels are associated with advance fibrosis and severe inflammation in AIH. Our study suggests that vitamin D may be a potential biomarker that predicts response to therapy and histological features in AIH.

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Authors and Affiliations

  1. Department of Gastroenterology, Hacettepe University, Ankara, Turkey

    Cumali Efe, Taylan Kav & Murat Torgutalp

  2. Department of Pathology, Hacettepe University, Ankara, Turkey

    Cisel Aydin

  3. Department of Gastroenterology, Gazi University, Ankara, Turkey

    Mustafa Cengiz & Seren Ozenirler

  4. Department of Endocrinology and Metabolism, Numune Research and Education Hospital, Ankara, Turkey

    Narin Nasıroglu Imga

  5. Department of Gastroenterology, Numune Research and Education Hospital, Ankara, Turkey

    Tugrul Purnak & Ersan Ozaslan

  6. Division of Transplantation Immunology and Mucosal Biology, Institute of Liver Studies, King’s College London School of Medicine, London, UK

    Daniel S. Smyk & Dimitrios P. Bogdanos

  7. Department of Biochemistry, Numune Research and Education Hospital, Ankara, Turkey

    Turan Turhan

  8. Eceabat Sokak 21/12 Cebeci, Ankara, Turkey

    Cumali Efe

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  1. Cumali Efe
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  2. Taylan Kav
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  3. Cisel Aydin
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  4. Mustafa Cengiz
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  7. Daniel S. Smyk
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  8. Murat Torgutalp
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  9. Turan Turhan
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  10. Seren Ozenirler
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  11. Ersan Ozaslan
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  12. Dimitrios P. Bogdanos
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Correspondence to Cumali Efe.

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Efe, C., Kav, T., Aydin, C. et al. Low Serum Vitamin D Levels Are Associated with Severe Histological Features and Poor Response to Therapy in Patients with Autoimmune Hepatitis. Dig Dis Sci 59, 3035–3042 (2014). https://doi.org/10.1007/s10620-014-3267-3

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  • DOI: https://doi.org/10.1007/s10620-014-3267-3

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