The following is a summary of “Daily Vitamin D Supplementation Improves Vitamin D Deficiency in Patients With Chronic Liver Disease,” published in the June 2023 issue of Pediatrics by Rocha, et al.
For a study, researchers sought to evaluate the response to oral cholecalciferol (OC) treatment at a dosage of 6,000 IU in children with chronic liver disease (CLD) and 25(OH)D deficiency.
The historical cohort included non-transplanted CLD patients below 18 years old. The patients’ serum 25(OH)D levels, liver function, bone metabolism, Child-Pugh classification, and anthropometric measurements were analyzed. Patients with 25(OH)D deficiency (defined as 25(OH)D < 20 ng/mL) who received 6,000 IU/day of OC were evaluated pre-and post-intervention. Responders were defined as patients with 25(OH)D > 20 ng/mL after at least 60 days of treatment. Clinical and laboratory data were compared between patients with and without 25(OH)D deficiency and between responders and nonresponders.
A total of 96 patients were included in the study, with 57.2% diagnosed with biliary atresia. The prevalence of 25(OH)D deficiency was 67.7% (65/96). Patients with 25(OH)D deficiency were younger (P < 0.001). They had higher Child-Pugh scores (P < 0.001), total bilirubin (TB) levels (P < 0.001), gamma-glutamyl transferase levels (P < 0.001), alkaline phosphatase levels (P = 0.002), and lower phosphorus levels (P = 0.009) compared to patients without 25(OH)D deficiency. The median duration of treatment was 126 days (ranging from 70 to 307 days). At the end of the treatment, there was a significant increase in median 25(OH)D levels (P < 0.001) and a decrease in median parathyroid hormone (PTH) levels (P = 0.023). Nine patients (29%) achieved normal 25(OH)D levels, and they had lower Child-Pugh scores (P = 0.001), lower TB levels (P = 0.001), and higher phosphorus levels (P = 0.003) after treatment.
Although there was an increase in 25(OH)D levels and a decrease in PTH levels, a dosage of 6,000 IU/day of OC was insufficient to restore 25(OH)D deficiency in most patients in the study.