Severe 25‐hydroxyvitamin D deficiency identifies a poor prognosis in patients with hepatocellular carcinoma – a prospective cohort study. Issue 10 (29th March 2014)

• Record Type: Journal Article
• Authors: Finkelmeier, F.; Kronenberger, B.; Köberle, V.; Bojunga, J.; Zeuzem, S.; Trojan, J.; Piiper, A.; Waidmann, O.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 39:Issue 10(2014)
• Page Start: 1204
• Page End: 1212
• Publication Date: 2014-03-29
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12731
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt12731-abs-0001"> <title>Summary</title> <sec id="apt12731-sec-0001" sec-type="section"> <title>Background</title> <p>Vitamin D is involved in many biological processes. The role of vitamin D in patients with hepatocellular carcinoma (HCC) remains inconclusive, although there is evolving evidence that vitamin D may modulate cancer development and progression.</p> </sec> <sec id="apt12731-sec-0002" sec-type="section"> <title>Aim</title> <p>To evaluate serum vitamin D as prognostic parameter in HCC, we performed a prospective cohort study.</p> </sec> <sec id="apt12731-sec-0003" sec-type="section"> <title>Methods</title> <p>HCC patients were prospectively recruited and 25‐hydroxyvitamin D3 (25(OH)D<sub>3</sub>) levels were determined. 25(OH)D<sub>3</sub> levels were compared to stages of cirrhosis and HCC stages with nonparametric Kruskal–Wallis tests and Spearman correlations in 200 HCC patients. The association of the 25(OH)D<sub>3</sub> levels and overall survival (OS) was assessed in uni‐ and multivariate Cox regression models.</p> </sec> <sec id="apt12731-sec-0004" sec-type="section"> <title>Results</title> <p>Two‐hundred patients with HCC were included. The mean follow‐up time was 322 ± 342 days with a range of 1–1508 days. Nineteen patients underwent liver transplantation and 60 patients died within the observation time. The mean serum 25(OH)D<sub>3</sub> concentration was 17 ± 13 ng/mL with a range of 1–72 ng/mL. 25(OH)D<sub>3</sub> serum levels negatively correlated with the stage of cirrhosis as well as with stages of HCC. Patients with severe 25(OH)D<sub>3</sub> deficiency had the highest mortality risk (hazard ratio 2.225, 95% confidence interval 1.331–3.719, <italic>P </italic>=<italic> </italic>0.002). Furthermore, very low 25(OH)D<sub>3</sub> levels were associated with mortality independently from the MELD score and high alpha‐Fetoprotein levels (>400 ng/mL) in a multivariate Cox regression model.</p> </sec> <sec id="apt12731-sec-0005" sec-type="section"> <title>Conclusions</title> <p>We conclude that 25(OH)D<sub>3</sub> deficiency is associated with advanced stages of hepatocellular carcinoma and it is a prognostic indicator for a poor outcome.</p> </sec> </abstract>