Dataset Information

Vitamin A levels reflect disease severity and portal hypertension in patients with cirrhosis.

ABSTRACT:

Background and aims

The liver plays a key role in the storage, metabolism and homeostasis of fat-soluble vitamins. We investigated the relation of Vitamin(Vit)A/D/E serum levels with severity of liver disease and portal hypertension (PHT).

Methods

VitA/D/E serum levels were assessed in 234 patients with advanced chronic liver disease (ACLD, i.e. hepatic venous pressure gradient [HVPG]???6 mmHg). Patients with hepatocellular carcinoma, pre-/post-hepatic PHT, TIPS or liver transplantation were excluded.

Results

Most patients were male (n?=?153; 65%) with a median age of 57.6 (49.7-64.5) years. Thirty-two (14%) patients had HVPG 6-9 mmHg, 66 (28%) 10-15 mmHg, and 136 (58%)???16 mmHg, respectively. VitD deficiency (25-OH-vitamin-D?<50 nmol/L) was found in 133 (57%) with higher prevalence in Child-Turcotte-Pugh (CTP)-C: 85% vs. B: 66% vs. A: 47% (p?1.05 µmol/L) VitA levels, while 58 (25%) had mild (0.70-1.04 µmol/L), 71 (30%) moderate (0.35-0.69 µmol/L), and 42(18%) severe(<0.35 µmol/L) VitA deficiency. VitA correlated with HVPG (Rho?=?-0.409), CTP score (Rho?=?-0.646), and serum bile acid levels (Rho?=?-0.531; all p?10 µmol/L; OR 3.62; 95%CI 1.61-8.14; p?=?0.002) were independently associated with VitA deficiency.

Conclusion

VitA and VitD but not VitE deficiencies are highly prevalent in ACLD. VitA deficiency strongly correlates with hepatic dysfunction, PHT and bile acid levels and is associated with decompensated ACLD.

Trial registration number

NCT03267615.

SUBMITTER: Simbrunner B

PROVIDER: S-EPMC7803875 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Vitamin A levels reflect disease severity and portal hypertension in patients with cirrhosis.

Simbrunner Benedikt B Semmler Georg G Stadlmann Alexander A Scheiner Bernhard B Schwabl Philipp P Paternostro Rafael R Bucsics Theresa T Bauer David D Eigenbauer Ernst E Pinter Matthias M Stättermayer Albert-Friedrich AF Quehenberger Peter P Marculescu Rodrig R Trauner Michael M Mandorfer Mattias M Reiberger Thomas T

Hepatology international 20201208 6

<h4>Background and aims</h4>The liver plays a key role in the storage, metabolism and homeostasis of fat-soluble vitamins. We investigated the relation of Vitamin(Vit)A/D/E serum levels with severity of liver disease and portal hypertension (PHT).<h4>Methods</h4>VitA/D/E serum levels were assessed in 234 patients with advanced chronic liver disease (ACLD, i.e. hepatic venous pressure gradient [HVPG] ≥ 6 mmHg). Patients with hepatocellular carcinoma, pre-/post-hepatic PHT, TIPS or liver transplan ...[more]

PMID: 33289910

Similar Datasets

Project description:BackgroundRecent data suggest that noninvasive liver fibrosis indexes could be useful for predicting esophageal varices (EV) in cirrhotic patients. However, thus far, the diagnostic efficacy of these indexes in predicting portal hypertension (PH) in cirrhotic patients has been poorly evaluated.AimsTo evaluate the diagnostic efficacy of noninvasive liver fibrosis indexes in the diagnosis of PH.MethodsA total of 238 cirrhotic patients underwent hepatic venous pressure gradient (HVPG) evaluation and relevant serum tests to analyze the variables associated with PH grade. Then, the diagnostic performances of seven fibrosis indexes, the aspartate aminotransferase (AST)-to-alanine aminotransferase (ALT) ratio (AAR), AST-to-platelet (PLT) ratio index (APRI), fibrosis index (FI), FIB-4, Forns index, King's score and the Lok index, were evaluated to determine their efficacy in predicting clinically significant PH (CSPH) and severe PH (SPH). In addition, the performances of these fibrosis indexes in different subgroups were investigated.ResultsThe results of a multivariate analysis of serum markers showed that AST values, platelet (PLT) count and albumin (ALB) were associated with PH grade. Among the seven-fibrosis indexes, King's score, APRI and the Lok index showed modest diagnostic accuracy in predicting CSPH and SPH, as indicated by AUC of 0.755 and 0.742, 0.740 and 0.742, and 0.722 and 0.717, respectively. In addition, combination of King's score (cutoff 23.47) and Lok index (cutoff 1.30) predicted presence of CSPH, with the highest PPV (95.38%) and +LR (5.49). A subgroup analysis indicated that the noninvasive screening model may be more applicable to patients with cirrhosis of viral etiology.ConclusionsSerum liver fibrosis indexes exhibited modest diagnostic accuracy for PH in cirrhotic patients. These indexes may not be able to replace HVPG measurements for the diagnosis of PH but may be used as a first-line screening method for CSPH in liver cirrhosis patients.

Dataset Information

Vitamin A levels reflect disease severity and portal hypertension in patients with cirrhosis.

Background and aims

Methods

Results

Conclusion

Trial registration number

Publications

Vitamin A levels reflect disease severity and portal hypertension in patients with cirrhosis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets