Vitamin D Is Associated with Clinical Outcomes in Patients with Primary Biliary Cholangitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Clinical and Laboratory Evaluations
2.3. Diagnosis of Cirrhosis at Baselines or during Follow-Up
2.4. Incomplete Response to UDCA Therapy
2.5. Liver-Related Events
2.6. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Treatment Response to UDCA
3.3. Development of Cirrhosis
3.4. Liver-Related Mortality or Liver Transplantation
3.5. Response to VD Supplementation
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | All (n = 255) | <50 nmol/L (n = 64) | ≥50 nmol/L (n = 191) | p-Value |
---|---|---|---|---|
Age at diagnosis, years | 53 ± 12 | 52 ± 13 | 53 ± 12 | 0.73 |
Sex, male | 32 (13) | 9 (14) | 23 (12) | 0.67 |
BMI, kg/m2 | 27 ± 6 | 26 ± 6 | 27 ± 5 | 0.10 |
BMI ≥ 25 kg/m2 | 186 (73) | 42 (66) | 144 (75) | 0.14 |
Hypertension | 78 (31) | 20 (31) | 58 (30) | 0.88 |
Diabetes | 38 (15) | 16 (25) | 22 (12) | 0.01 |
Albumin (g/L) | 40 ± 5 | 38 ± 6 | 41 ± 4 | <0.001 |
Alkaline phosphatase (IU/L) | 209 ± 160 | 299 ± 209 | 179 ± 127 | <0.001 |
Bilirubin (µmol/L) | 14 ± 14 | 21 ± 23 | 12 ± 8 | 0.005 |
VD (nmol/L) | 77 ± 39 | 30 ± 13 | 93 ± 31 | <0.001 |
Hepatic encephalopathy | 19 (7) | 11 (17) | 8 (4) | 0.002 |
Ascites | 51 (20) | 24 (38) | 27 (14) | <0.001 |
Cirrhosis at diagnosis | 35 (14) | 18 (28) | 17 (9) | <0.001 |
UDCA-incomplete response | 70 (28) | 29 (45) | 41 (22) | <0.001 |
Development of cirrhosis | 80 (31) | 25 (54) | 55 (32) | 0.006 |
Liver-related events | 37 (15) | 19 (30) | 18 (9) | <0.001 |
Seasonal variation | ||||
Spring–summer | 122 (48) | 31 (48) | 91 (48) | 1.00 |
Fall–winter | 133 (52) | 33 (52) | 100 (52) | 1.00 |
Univariate | Multivariate Serum VD Level (nmol/L) | Multivariate (VD Deficiency) | ||||
---|---|---|---|---|---|---|
Characteristics | OR (95% CI) | p-Value | OR (95% CI) | p-Value | OR (95% CI) | p-Value |
Age at diagnosis, years | 0.97 (0.95–0.99) | 0.009 | 0.97 (0.95–0.99) | 0.01 | 0.97 (0.95–0.99) | 0.009 |
Sex, male | 0.57(0.23–1.46) | 0.24 | ||||
Hypertension | 0.65(0.35–1.22) | 0.18 | ||||
Diabetes | 0.79 (0.36–1.77) | 0.57 | ||||
Cirrhosis at diagnosis | 0.76 (0.33–1.75) | 0.51 | ||||
BMI ≥ 25 kg/m2 | 0.25 (0.14–0.45) | <0.001 | 0.24 (0.13–0.45) | <0.001 | 0.25 (0.13–0.46) | <0.001 |
Serum VD level, nmol/L | 0.99 (0.98–0.996) | 0.002 | 0.99 (0.98–0.997) | 0.01 | ||
VD deficiency | 3.03 (1.66–5.53) | <0.001 | 2.92 (1.53–5.56) | 0.001 |
Univariate | Multivariate Serum VD Level (nmol/L) | Multivariate (VD Deficiency) | ||||
---|---|---|---|---|---|---|
Characteristics | HR (95% CI) | p-Value | HR (95% CI) | p-Value | HR (95% CI) | p-Value |
Age at diagnosis, years | 1.03 (1.01–1.05) | 0.002 | 1.03 (1.01–1.05) | 0.004 | 1.03 (1.01–1.05) | 0.009 |
Sex, male | 2.02 (1.11–3.68) | 0.02 | 1.26 (0.67–2.39) | 0.48 | 1.48 (0.79–2.79) | 0.22 |
Hypertension | 1.34 (0.83–2.14) | 0.23 | ||||
Diabetes | 2.39 (1.33–4.32) | 0.004 | 2.21 (1.20–4.06) | 0.01 | 2.19 (1.19–4.04) | 0.01 |
UDCA-incomplete response | 1.99 (1.27–3.14) | 0.003 | 2.07 (1.29–3.34) | 0.003 | 2.02 (1.25–3.28) | 0.004 |
BMI ≥ 25 kg/m2 | 0.79 (0.49–1.28) | 0.34 | ||||
Serum VD level, nmol/L | 0.99 (0.98–0.99) | <0.001 | 0.99 (0.98–0.996) | 0.002 | ||
VD deficiency | 2.43 (1.51–3.92) | <0.001 | 1.93 (1.17–3.19) | 0.01 |
Univariate | Multivariate Serum VD Level (nmol/L) | Multivariate (VD Deficiency) | ||||
---|---|---|---|---|---|---|
Characteristics | HR (95% CI) | p-Value | HR (95% CI) | p-Value | HR (95% CI) | p-Value |
Age at diagnosis, years | 0.99 (0.97–1.02) | 0.69 | ||||
Sex, male | 1.71 (0.71–4.12) | 0.23 | ||||
Hypertension | 1.30 (0.65–2.60) | 0.47 | ||||
Diabetes | 2.79 (1.30–6.00) | 0.009 | 2.57 (1.15–5.70) | 0.02 | 2.64 (1.19–5.86) | 0.02 |
Cirrhosis at diagnosis | 6.04 (2.66–13.72) | <0.001 | 4.69 (1.89–11.63) | <0.001 | 5.32 (2.13–13.30) | <0.001 |
UDCA-incomplete response | 2.64 (1.37–5.10) | 0.004 | 1.95 (0.91–4.20) | 0.09 | 1.98 (0.93–4.23) | 0.08 |
BMI ≥ 25 kg/m2 | 0.56 (0.29–1.10) | 0.09 | 0.80 (0.36–1.75) | 0.57 | 0.75 (0.35–1.59) | 0.45 |
Serum VD level, nmol/L | 0.97 (0.96–0.98) | <0.001 | 0.98 (0.97–0.99) | <0.001 | ||
VD deficiency | 5.38 (2.76–10.47) | <0.001 | 3.33 (1.57–7.07) | 0.002 |
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Ebadi, M.; Ip, S.; Lytvyak, E.; Asghari, S.; Rider, E.; Mason, A.; Montano-Loza, A.J. Vitamin D Is Associated with Clinical Outcomes in Patients with Primary Biliary Cholangitis. Nutrients 2022, 14, 878. https://doi.org/10.3390/nu14040878
Ebadi M, Ip S, Lytvyak E, Asghari S, Rider E, Mason A, Montano-Loza AJ. Vitamin D Is Associated with Clinical Outcomes in Patients with Primary Biliary Cholangitis. Nutrients. 2022; 14(4):878. https://doi.org/10.3390/nu14040878
Chicago/Turabian StyleEbadi, Maryam, Stephen Ip, Ellina Lytvyak, Somayyeh Asghari, Elora Rider, Andrew Mason, and Aldo J. Montano-Loza. 2022. "Vitamin D Is Associated with Clinical Outcomes in Patients with Primary Biliary Cholangitis" Nutrients 14, no. 4: 878. https://doi.org/10.3390/nu14040878
APA StyleEbadi, M., Ip, S., Lytvyak, E., Asghari, S., Rider, E., Mason, A., & Montano-Loza, A. J. (2022). Vitamin D Is Associated with Clinical Outcomes in Patients with Primary Biliary Cholangitis. Nutrients, 14(4), 878. https://doi.org/10.3390/nu14040878