Understanding Vitamin D Deficiency in Chronic Liver Diseases Exploring the Influence of Demographic, Clinical and Etiological Factors

Abstract

Background: Vitamin D deficiency is a common issue in patients with chronic liver disease (CLD) and has been linked to various complications. Despite its significance, the relationship between vitamin D levels and different factors such as age, disease severity, and underlying causes of CLD remains underexplored, particularly in the Bangladeshi population. Aim: This study aimed to assess the prevalence of vitamin D deficiency in CLD patients and explore how demographic, clinical, and etiological factors influence vitamin D status. Methods: This cross-sectional study was conducted at the Department of Hepatology and Medicine, Rajshahi Medical College Hospital, Bangladesh. A total of 181 patients diagnosed with CLD were selected using purposive sampling. Data collection involved structured interviews, clinical assessments, and laboratory tests, including serum 25-hydroxyvitamin D [25(OH)D] measurement using an enzyme-linked fluorescence assay (ELFA). Statistical analysis was performed using SPSS version 24.0, with Chi-square test used to examine associations between vitamin D levels and various factors. Results: Vitamin D deficiency was highly prevalent, affecting 81.2% of CLD patients, while 10.5% had insufficient levels, and only 8.3% had sufficient vitamin D levels. Age was significantly linked to vitamin D deficiency (p = 0.002), with older patients being more affected, while gender showed no significant association (p = 0.993). Disease severity played a crucial role, as patients with ascites (p = 0.001) and hepatic encephalopathy (p = 0.038) had notably lower vitamin D levels. Among the underlying causes of CLD, hepatitis B virus (HBV) (p = 0.031) and non-alcoholic fatty liver disease (NAFLD) (p = 0.045) were significantly associated with vitamin D deficiency, whereas hepatitis C virus (HCV) and cryptogenic liver disease also showed high deficiency rates, though without statistical significance. Conclusion: Older age, severe liver disease complications such as ascites and hepatic encephalopathy, and specific etiologies like HBV and NAFLD are strongly associated with vitamin D deficiency among patients with CLD.