Primary biliary cirrhosis strongly associated with low vitamin D

Created November 2014

Vitamin D in primary biliary cirrhosis, a plausible marker of advanced disease

Immunologic Research, November 2014

Nancy Agmon-Levin, Ron Kopilov, Carlo Selmi, Udi Nussinovitch, María Sánchez-Castañón, Marcos López-Hoyos, Howie Amital, Shaye Kivity, Eric M. Gershwin, Yehuda Shoenfeld

For those with very low vitamin D (< 10 ng) 1. ||PBC| 33% Controls|7%|| Autoimmune disease in 1 in 4,000 people 9X more women then men 500X more likely if first degree relative has had it Higher rate in those with Gluten intolerance Secondary biliary cirrhosis can happen after gallbladder surgery Reasons for PBC ==> low vitamin D appear to include 1. Bile is needed to process fats and perhaps fatty vitamins 1. A poorly functioning liver does not produce vitamin D as well Publisher wants $39.95 for the PDF

Vitamin D immune-modulating effects were extensively studied, and low levels have been linked with autoimmune diseases. The associations of vitamin D with autoimmune diseases of the liver, and particularly primary biliary cirrhosis (PBC), are yet to be defined. Hence, in this study, serum levels of vitamin D were determined in 79 patients with PBC and 70 age- and sex-matched controls by the LIAISON chemiluminescent immunoassays (DiaSorin—Italy). Clinical and serological parameters of patients were analyzed with respect to vitamin D status. Mean levels of vitamin D were significantly lower among patients with PBC compared with controls (16.8 ± 9 vs. 22.1 ± 9 ng/ml; p = 0.029), and

vitamin D deficiency (≤10 ng/ml) was documented in 33 % of patients with PBC versus 7 % of controls (p < 0.0001).

Vitamin D levels inversely correlated with advanced liver damage and the presence of concomitant autoimmune diseases.

In contrast, higher levels of vitamin D were observed among patients with PBC treated with ursodeoxycholic acid (UDCA).

In conclusion, low vitamin D levels are common among patients with PBC and correlate with advanced disease, lack of UDCA therapy and autoimmune comorbidity. This alludes to the plausible roles of vitamin D as a prognostic marker of PBC severity, and as a potential player in this disease pathogenesis. While further studies are awaited, monitoring vitamin D in patients with PBC and use of supplements may be advisable.

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Tags: Liver