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Changes in vitamin D binding protein and vitamin D concentrations associated with liver transplantation
Author(s) -
Reese Peter P.,
Bloom Roy D.,
Feldman Harold I.,
Huverserian Ari,
Thomasson Arwin,
Shults Justine,
Hamano Takayuki,
Goral Simin,
Shaked Abraham,
Olthoff Kimberly,
Rickels Michael R.,
Bleicher Melissa,
Leonard Mary B.
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02638.x
Subject(s) - vitamin , chemistry , transplantation , food science , biochemistry , medicine
Background Vitamin D deficiency is associated with fractures, infections and death. Liver disease impairs vitamin D and vitamin D binding protein ( DBP ) metabolism. Aims We aimed to determine the impact of liver transplantation on vitamin D , particularly on DBP and free vitamin D concentrations. Methods Serum 25( OH )D, 1,25( OH ) 2 D and DBP concentrations were measured in 202 adults before liver transplantation and 3 months later in 155. Free vitamin D concentrations were estimated from these values. Risk factors for 25( OH )D deficiency (<20 ng/ml) and low 1,25( OH ) 2 D (<20 pg/ml) were examined with logistic regression, and changes in concentrations following transplantation with linear regression. Results Pretransplant, 84% were 25( OH )D deficient, 13% had 25( OH )D concentrations <2.5 ng/ml, and 77% had low 1,25( OH ) 2 D. Model for end‐stage liver disease score ≥20 ( P < 0.005) and hypoalbuminemia ( P < 0.005) were associated with low 25( OH )D and 1,25( OH ) 2 D concentrations. Following transplantation, 25( OH )D concentrations increased a median of 17.8 ng/ml ( P < 0.001). Albumin increased from a median of 2.7 to 3.8 g/dl ( P < 0.001) and DBP from 8.6 to 23.8 mg/dl ( P < 0.001). Changes in total 25( OH )D were positively and independently associated with changes in DBP ( P < 0.05) and albumin ( P < 0.001). Free 25( OH )D concentrations rose from 6.0 to 9.7 pg/ml ( P < 0.001). In contrast, total 1,25( OH ) 2 Dconcentrations rose only by 4.3 pg/ml ( P < 0.001) and free 1,25( OH ) 2 D concentrations declined ( P < 0.001). Conclusions Serum total and free 25( OH )D and DBP concentrations rose substantially following transplantation, while 1,25( OH ) 2 D concentrations showed modest changes and free 1,25( OH ) 2 D decreased. Studies of the effects of vitamin D status on diverse transplant complications are needed.