Vitamin D2026-07

Vitamin D supplementation is associated with reduced risk of hepatobiliary malignancy in patients with primary sclerosing cholangitis.

Cooper Katherine M, Mulligan Connor, Pratt Henry E, Mitsialis Vanessa et al. — Hepatology communications

Summary

A study investigated the link between vitamin D supplements and the risk of certain cancers in people with a rare liver disease called primary sclerosing cholangitis (PSC). Researchers found that patients with PSC who took vitamin D supplements had a significantly lower chance of developing cancers of the liver and bile ducts compared to those who did not. This suggests a potential protective role for vitamin D in this specific patient group.

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Key points

This study focused on patients with primary sclerosing cholangitis (PSC), a chronic liver disease.
It examined whether vitamin D supplementation affected their risk of developing liver and bile duct cancers.
Patients taking vitamin D supplements showed a significantly reduced risk of these specific cancers.
The findings suggest a potential protective effect of vitamin D in this vulnerable group.

What the study looked at

This study aimed to understand if taking vitamin D supplements could reduce the risk of developing liver and bile duct cancers in individuals diagnosed with primary sclerosing cholangitis (PSC), a chronic liver disease. Researchers analyzed data from 160 PSC patients enrolled in a specialized registry over a decade. They compared patients who reported taking vitamin D supplements with those who did not, tracking who developed liver and bile duct cancers during a median follow-up of seven years. Advanced statistical methods were used to account for other factors that might influence cancer risk. The study found a strong association: patients with PSC who took vitamin D supplements had a significantly lower risk of developing liver and bile duct cancers. For example, the 5-year cumulative incidence of these cancers was much lower in the supplemented group (1.1%) compared to the non-supplemented group (11.5%). This association held true regardless of baseline vitamin D levels.

Dietary takeaway

While this study suggests a potential benefit of vitamin D supplementation for a specific group of patients with a chronic liver condition, it's important to remember that these findings are not definitive for the general population. For most people, maintaining adequate vitamin D levels through a balanced diet including fatty fish, fortified foods, and safe sun exposure is generally recommended. Always consult a healthcare provider before starting any new supplement regimen, as more research is needed to confirm these findings and understand their broader implications.

Abstract

BACKGROUND: Vitamin D deficiency has been implicated in cancer risk across several organ systems, but its role in hepatobiliary malignancy (HBM) remains unclear. We evaluated whether vitamin D supplementation (VDS) was associated with a lower risk of HBM specifically in patients with primary sclerosing cholangitis (PSC). METHODS: Patients enrolled in the PSC registry at our quaternary care and liver transplant (LT) center from 2010 to 2020 were analyzed. The primary exposure was VDS, modeled as a time-dependent variable. The primary outcome was HBM. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics, and Cox proportional hazards models were employed to estimate marginal hazard ratios (HRs). Cumulative incidence functionsfor HBM were estimated using a competing risks analysis treating death, and LT was as competing events. RESULTS: A total of 160 patients (mean age 42 years; 66% male) were included, of whom 76 (47.5%) reported baseline VDS. Over a median follow-up of 7 years, 15 patients developed HBM, corresponding to an incidence rate of 12.3 per 1000 person-years. VDS was associated with a significantly lower risk of HBM in both conventional (HR 0.16, 95% CI 0.05-0.57) and IPTW (HR 0.15, 95% CI 0.03-0.41) analyses. This association was consistent across baseline vitamin D strata, including <30 ng/mL (HR 0.12, 95% CI 0.02-0.79) and ≥30 ng/mL (HR 0.18, 95% CI 0.05-0.65). Accounting for competing risks, the 5-year cumulative incidence of HBM was 1.1% among patients receiving VDS versus 11.5% without VDS (p<0.01). DISCUSSION: VDS was associated with a significantly lower risk of HBM in this longitudinally followed cohort of patients with PSC. These findings support the consideration of VDS in all patients with PSC and underscore the need for mechanistic and interventional studies to further evaluate this association.

View on PubMed →DOI: 10.1097/HC9.0000000000000929