Study of vitamin D levels and its correlation with child PUGH score in patients of chronic liver disease

Abstract

Background: Vitamin D has anti fibrotic effect and anti-inflammatory effect other than the effects on calcium and skeletal metabolism. This anti-inflammatory and anti-fibrotic property of vitamin D is implicated in the causation, disease progression of chronic liver disease. Chronic Liver Disease (CLD) is defined as the process of long-term progressive destruction and regeneration of the liver, and with advancing disease, hepatic fibrosis (scarring) and cirrhosis. The Child-Pugh (CP) score is a widely used scoring system to predict the 1-year survival rate among cirrhotic patients. Materials and Method: This prospective cross-sectional study entitled “was conducted after clearance from Board of Studies and Ethical committee in the Department of Medicine, Muzaffarnagar medical college, Muzaffarnagar (U.P.) during the period 2018-20. The study population has been calculated by using G-power software with 80% of the power and 5% of the significance level. The total sample size was determined to be 100 patients, aged 18-60 years of age. Results: The mean age of the study population was 41.83±10.36 (18-59) years. There were 67 (67.0%) males and 33 (33.0%) females among study population. Vitamin D level was found to be Deficient (≤ 20 ng/ml) among 32 (32.0%), Insufficient (20-30 ng/ml) among 26 (26.0%) and Optimum (> 30 ng/ml) among 42 (42.0%) subjects. The mean Vitamin D level was significantly more among Child Pugh Class A compared to class B which was significantly more than class C. Conclusion: It also observed that the severity of cirrhosis as assessed by Child Pugh Score was inversely proportional with Vitamin D level. As the disease advances, the levels become more deficient. Vitamin D levels should be routinely checked in all patients suffering from advanced CLD, so that adequate replacement by vitamin D supplements can be initiated as a therapeutic adjunct in managing such patients. We found that in patients with liver cirrhosis, vitamin D deficiency was associated with poor survival. Therefore, randomized controlled trials aiming to confirm this association and demonstrate the potential role of vitamin D supplementation in improving survival rates are needed.