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

被引：15

作者：

Simbrunner, Benedikt ^{[1
,2
,3
,4
,5
]}

Semmler, Georg ^{[1
,2
]}

Stadlmann, Alexander ^{[1
,2
,6
]}

Scheiner, Bernhard ^{[1
,2
]}

Schwabl, Philipp ^{[1
,2
,5
]}

Paternostro, Rafael ^{[1
,2
]}

Bucsics, Theresa ^{[1
,2
]}

Bauer, David ^{[1
,2
]}

Eigenbauer, Ernst ^{[7
]}

Pinter, Matthias ^{[1
]}

Stattermayer, Albert-Friedrich ^{[1
]}

Quehenberger, Peter ^{[8
]}

Marculescu, Rodrig ^{[8
]}

Trauner, Michael ^{[1
]}

Mandorfer, Mattias ^{[1
,2
]}

Reiberger, Thomas ^{[1
,2
,3
,4
,5
]}

机构：

[1] Med Univ Vienna, Div Gastroenterol & Hepatol, Dept Internal Med 3, Wahringer Gurtel 18-20, A-1090 Vienna, Austria

[2] Med Univ Vienna, Vienna Hepat Hemodynam Lab, Vienna, Austria

[3] Ludwig Boltzmann Inst Rare & Undiagnosed Dis, Vienna, Austria

[4] Austrian Acad Sci, CeMM Res Ctr Mol Med, Vienna, Austria

[5] Med Univ Vienna, Christian Doppler Lab Portal Hypertens & Liver Fi, Vienna, Austria

[6] Klinikum Hietzing, Vienna, Austria

[7] Med Univ Vienna, IT4Sci, Vienna, Austria

[8] Med Univ Vienna, Dept Lab Med, Vienna, Austria

来源：

HEPATOLOGY INTERNATIONAL | 2020年 / 14卷 / 06期

关键词：

ACLD; Cirrhosis; Hepatic venous pressure gradient; Hepatic decompensation; PRIMARY BILIARY-CIRRHOSIS; NONALCOHOLIC STEATOHEPATITIS; LIVER-DISEASE; SERUM; ASSOCIATION; ACID; DEFICIENCY;

D O I：

10.1007/s12072-020-10112-3

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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 < 0.001). VitD levels displayed significant but weak correlations with hepatic dysfunction and PHT. VitE levels were normal in 227 (97%) patients and displayed no relevant association with hepatic dysfunction or PHT. Only 63 (27%) patients had normal (>1.05 mu mol/L) VitA levels, while 58 (25%) had mild (0.70-1.04 mu mol/L), 71 (30%) moderate (0.35-0.69 mu mol/L), and 42(18%) severe(<0.35 mu mol/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 < 0.001). The prevalence of decompensated ACLD (dACLD) continuously increased with severity of VitA deficiency (no: 40% vs. mild: 51% vs. moderate: 67% vs. severe: 91% had dACLD; p < 0.001). CTP score (per point; OR 2.46; 95%CI 1.80-3.37; p <0.001), age (per year; OR 0.95; 95%CI 0.92-0.98; p = 0.001) and elevated bile acid levels(>10 mu mol/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.

引用

页码：1093 / 1103

页数：11

共 37 条

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