Vitamin D Deficiency and Chronic Liver Disease: Investigating Predictive Factors and Their Implications for Patient Care in  Pakistan

Kumayl Abbas  Meghji; Tariq Feroz  Memon; Abdul  Raqeeb; Muhammad  Fahad Pathan; Usaid  Raqeeb; Tariq Zafar  Shaikh

doi:10.18502/ijph.v54i5.18640

Kumayl Abbas Meghji Department of Physiology, Isra University, Hyderabad, Pakistan
Tariq Feroz Memon Department of Community Medicine and Public Health Sciences, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Abdul Raqeeb Department of Internal Medicine, Hafar Al-Batin Central Hospital, Ministry of Health, Hafar Al Batin, Saudi Arabia
Muhammad Fahad Pathan Department of Family Medicine, Islington House Medical Centre, Liverpool, United Kingdom
Usaid Raqeeb Department of Emergency, Ascension Bay Medical Care Hospital, Panama City, Florida, United States
Tariq Zafar Shaikh Department of Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan

DOI: https://doi.org/10.18502/ijph.v54i5.18640

Keywords: Chronic liver disease; Liver cirrhosis; Vitamin D; Vitamin D deficiency

Abstract

Background: Chronic liver disease (CLD) and its end-stage manifestation, cirrhosis, present significant global health challenges, contributing to substantial morbidity and mortality. Despite its impact on various organ systems, the musculoskeletal effects of CLD, particularly vitamin D deficiency remain underexplored. This study aimed to identify significant predictors of vitamin D deficiency among CLD patients.

Methods: Overall, 177 CLD patients of either gender, aged 18 yr and above were included using the non-probability consecutive sampling technique. This cross-sectional study was conducted at the medical units of Isra University Hospital, Hyderabad, from Jan to Jun 2023. Various markers of hepatic function including bilirubin, albumin, and International normalised ratio (INR), were analyzed, along with a complete blood count and each patient was assigned a Child-Turcotte-Pugh (CTP) score. The relationship of vitamin D with different variables was assessed through Chi-Square tests. Pearson correlation and regression analyses were carried out to identify predictors of vitamin D deficiency.

Results: Mean age of patients was 51.76±5.77 yr and the majority were male (68.4%). Vitamin D deficiency was present in 28.24%, particularly among those with cirrhosis. Vitamin D levels correlated negatively with disease severity, as indicated by CTP (P<0.05) and Model for End-Stage Liver Disease (MELD) (P<0.05) scores, and positively with albumin levels (P<0.05). Increasing age, male gender, and higher CTP and MELD scores were significant predictors (P<0.05) of vitamin D deficiency.

Conclusion: Vitamin D levels correlate with hepatic dysfunction and are negatively associated with disease progression. Significant predictors of vitamin D deficiency identified include increasing age, male gender, and higher MELD and CTP Score.