Abnormal vitamin D metabolism in patients with cirrhosis

To assess the role of hepatic function and alcohol on vitamin D metabolism, serum 25-hydroxyvitamin D (25-OHD) levels were measured in 20 healthy nonalcoholic control subjects, 31 inactive cirrhotics whose alcoholism was in remission, 8 alcoholic cirrhotics, and 15 alcoholics with normal liver function. Cirrhosis, but not alcoholism, was associated with low serum 25-OHD levels. The aminopyrine breath test (ABT) was performed because aminopyrine, like vitamin D₃, is metabolized by hepatic microsomes; the ABT correlated highly (r-0.74,P<0.01) with serum 25-OHD in the inactive cirrhotics. After an intravenous injection of 120 g vitamin D₃, serum 25-OHD rose significantly within 24 hr in 6 healthy controls and 2 patients with celiac disease but not in 6 inactive cirrhotics. The data suggest impaired 25-hydroxylation of vitamin-D impaired in patients with cirrhosis, related predominantly to the degree of hepatic dysfunction.This work was supported in part by Grant AM 17303 from the National Institutes of Health.