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Testing vitamin D levels in patients with cirrhosis.

Of 82 patients with cirrhosis, 54 (66%) had a low serum albumin level and 28 (34%) had a normal albumin level. Compared with patients with normal albumin levels, those with low albumin levels had lower levels of vitamin D-binding protein, total 25-hydroxyvitamin D (25[OH]D), and free 25(OH)D. The expected relationship between total or free 25(OH)D and parathyroid hormone levels was observed in patients with normal albumin levels but not in those with low albumin levels.

Comment: In previous columns in the Townsend Letter, I have questioned the reliability of serum 25(OH)D as an indicator of vitamin D status. The results of the present study suggest that neither total 25(OH)D nor free 25(OH)D is an accurate indicator of bioactive vitamin D status in patients with cirrhosis and low albumin levels.

Lai JC et al. Total 25(01-1) vitamin D, free 25(OH) vitamin D and markers of bone turnover in cirrhotics with and without synthetic dysfunction. Liver Int. 2015;35:2294-2300.

by Alan R. Gaby, MD

drgaby@earthlink.net

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Title Annotation:Literature Review & Commentary
Author:Gaby, Alan R.
Publication:Townsend Letter
Article Type:Brief article
Date:May 1, 2016
Words:180
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