Vitamin D2026-05

Treatment of Hypovitaminosis D Is Associated with Improvement in Anemia of Inflammation in Patients with Decompensated Cirrhosis.

Diaz-Ruiz Raquel, Poca Maria, Roman Eva, Cuyàs Berta et al. — Medical sciences (Basel, Switzerland)

Summary

Patients with severe liver disease (decompensated cirrhosis) often suffer from both low vitamin D and a type of anemia called anemia of inflammation. This study found that providing vitamin D supplements, alongside other necessary nutrients, for three months significantly improved hemoglobin levels and reduced markers of inflammation in these patients. This suggests that treating vitamin D deficiency could be a valuable strategy to help manage anemia in individuals with decompensated cirrhosis by reducing overall body inflammation.

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Abstract

: Anemia of inflammation (AI) is a prevalent condition linked to systemic inflammation in several chronic diseases, including chronic liver diseases. Hypovitaminosis D is frequently identified in patients with chronic diseases, and its pathogenic role in anemia is currently under investigation. The aim of this study was to prospectively investigate changes in hemoglobin concentration and inflammatory markers in vitamin D-deficient/-insufficient patients with decompensated cirrhosis after initiating vitamin D supplementation, in addition to the supplementation of other micronutrients if needed. : Patients with cirrhosis discharged from decompensation were assessed at baseline and 3 months after vitamin D supplementation. Laboratory parameters of red cell series, nutrition, and micronutrients were assessed in both visits, together with markers of systemic inflammation. : Thirty-nine patients were included in the study, of whom 33 completed the 3-month evaluation and were analyzed [age: 62.7 ± 10.7 years; gender: n = 29 (87.9%) males; Charlson index: 5.9 ± 1.6; Model for End-Stage Liver Disease (MELD): 12.4 ± 4.5; baseline hemoglobin (Hb): 11.7 ± 1.8 g/dL (anemia n = 24 (72.7%)); mean 25-hydroxyvitamin D (25OHD) plasma level: 15.5 ± 8.6 µg/L]. A significant increase in plasma 25OHD (40.1 ± 17.8, < 0.001) and in Hb (12.4 ± 2.0, = 0.01) was observed at 3 months with a decrease in the prevalence of anemia (n = 17, = 0.015) and of Interleukin 6 in plasma levels [IL-6, 10.7 (5.8-23.3) vs. 6.5 (4.1-11.8), = 0.016]. A greater rise in hemoglobin was correlated with higher plasma IL-6 concentration at baseline. Milder anemia and indexes of hypoferremia at baseline, along with optimal renal function and plasma levels of 25OHD at 3 months, were linked to resolution of anemia. : Treating vitamin D deficiency together with other micronutrient deficits is associated with inflammation amelioration and improvement in anemia in patients with cirrhosis following discharge from acute decompensation. This paper supports the potential role of vitamin D in the management of anemia in patients with decompensated cirrhosis by modulating systemic inflammation.

View on PubMed →DOI: 10.3390/medsci14020267