Relationships between blood levels of fat soluble vitamins and disease etiology and severity in adults awaiting liver transplantation

Abbott-Johnson, Winsome, Kerlin, Paul, Clague, Alan, Johnson, Helen and Cuneo, Ross (2011) Relationships between blood levels of fat soluble vitamins and disease etiology and severity in adults awaiting liver transplantation. Journal of Gastroenterology and Hepatology, 26 9: 1402-1410. doi:10.1111/j.1440-1746.2011.06746.x


Author Abbott-Johnson, Winsome
Kerlin, Paul
Clague, Alan
Johnson, Helen
Cuneo, Ross
Title Relationships between blood levels of fat soluble vitamins and disease etiology and severity in adults awaiting liver transplantation
Journal name Journal of Gastroenterology and Hepatology   Check publisher's open access policy
ISSN 0815-9319
1440-1746
Publication date 2011-09
Sub-type Article (original research)
DOI 10.1111/j.1440-1746.2011.06746.x
Volume 26
Issue 9
Start page 1402
End page 1410
Total pages 9
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing
Collection year 2012
Language eng
Formatted abstract
Background and Aims:
Although malnutrition is common in liver disease, there are limited data on fat soluble vitamins in various diseases. The aims of this study were to: (i) determine fat soluble vitamin levels in patients assessed for liver transplantation; (ii) compare levels between different disease etiologies (hepatocellular and cholestatic) and between subgroups of hepatocellular disease; and (iii) assess the multivariate contribution to vitamin levels of etiology and various indicators of disease severity.

Methods:
This was a cross-sectional study of 107 inpatients awaiting liver transplantation, mean age 47years. Biochemical parameters included plasma retinol, 25-hydroxycholecalciferol, and vitamin E. Biochemical (albumin, bilirubin and zinc) and clinical indicators (Child-Pugh and Model of End Stage Liver Disease [MELD] scores) of disease severity were determined.

Results:

Deficiencies of retinol (<1.0μmol/L), 25-hydroxycholecalciferol (<50nmol/L) and vitamin E (<11μmol/L) were present in 75%, 66% and 3%, respectively, of patients. Concentrations of retinol and vitamin E were lower in hepatocellular than cholestatic disease but 25-hydroxycholecalciferol concentrations were similar. Child-Pugh score was higher in hepatocellular than cholestatic disease. Concentrations of retinol were lower in alcoholic liver disease (ALD) than hepatitis and Child-Pugh score was higher in ALD. For the whole group, levels of retinol, 25-hydroxycholecalciferol and vitamin E were negatively related to Child-Pugh score, MELD score and bilirubin, and positively related to albumin. When Child-Pugh scores were controlled for, retinol was lower in the hepatocellular group.

Conclusions:

There was a high prevalence of fat soluble vitamin deficiencies with vitamin levels being related to disease severity. Retinol was lower in the hepatocellular group.
Keyword Cholestatic
Liver diseases
Liver transplantation
Vitamin A
Vitamin D
Vitamin E
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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