Hepatic encephalopathy (HE) is a frequently encountered complication of chronic liver disease (CLD). The manifestation is thought to be due to alteration in absorption of nutrients with associated altered metabolism with deterioration in synthetic function of liver. Several factors are known to precipitate HE. Recent studies have demonstrated the role of 25 hydroxyvitamin D (25OHD) in development of HE. Although uncertain as a causative factor, studies have shown significant lower levels of 25OHD with worsening HE. This study was therefore undertaken with the aim to access the 25OHD levels in patients of CLD and the relationship with the degree of severity of HE.
Material: A cross-sectional hospital based observational study for a period of one year (1st June 2020 to 31st May 2021) was carried out with a total of 88 subjects of either sex above 12 years of age after application of inclusion criteria and exclusion criteria.
Observation: The results showed significant difference in serum albumin levels (p= 0.003) in patient groups of with and without overt HE. The mean levels of serum 25OHD was significantly lower in the overt HE group than the covert HE group (24.11 ± 6.46 ng/ml vs 11.72 ± 4.84 ng/ml, p< 0.001). The study showed the mean levels of serum 25OHD among patients with grade 1 HE is 24.11 ± 6.46 ng/ml, in patients with grade 2 HE is 13.61 ± 4.73 ng/ ml, followed by 8.41 ± 2.84 ng/ml and 8.00 ± 2.66 ng/ml in grade 3 and grade 4 HE respectively, p<0.001. There was a statistically significant negative correlation between serum 25OHD levels and HE (person's correlation coefficient r = -0.731, p <0.001).
Conclusion: Serum 25OHD levels were significantly lower in patients with overt HE. Serum levels of 25OHD showed a negative correlation with the degree of severity of HE.
© Journal of the Association of Physicians of India 2011.