Impact of Chronic Liver Disease on Serum Vitamin D and Calcium Levels: A Comparative Study

Abstract

Background:  Chronic liver disease (CLD) is associated with various metabolic disturbances, including abnormalities in vitamin D and calcium homeostasis. The impairment of liver in CLD can lead to significant deficiencies. This study evaluates the serum levels of vitamin D and calcium in CLD patients and their association with disease severity.  Methods: This observational cross-sectional study was carried out from November 2012 to November 2013 at the Department of Gastroenterology, in BSMMU, Dhaka, with a sample size of 60 participants in each group. Data were entered into statistical software (SPSS version 22) for analysis, with categorical variables analyzed using the Chi-square test and a p-value of <0.05 considered statistically significant.  Result: The study assessed 30 CLD patients and 30 healthy individuals, revealing that 70% had decompensated cirrhosis (CTP B/C), with hepatitis B as the leading cause (43.3%). CLD patients had significantly lower serum albumin, calcium, and platelet counts (p<0.05), with 63.3% showing vitamin D deficiency (p=0.007) and 83.3% having low calcium levels (p<0.001). Vitamin D levels declined with worsening liver disease (p=0.009), while calcium levels were lower in advanced CTP classes but not statistically significant (p=0.276).  Conclusion: This study showed a high prevalence of vitamin D deficiency in patients with advanced chronic liver disease. Vitamin D levels inversely correlate with the Child-Turcotte-Pugh classes. Serum calcium level is also found to be low in these patients.