1 Hepatology Unit, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
2 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
Vitamin D deficiency is common in patients with chronic liver disease, including chronic hepatitis C (CHC). However, the interplay between serum 25-hydroxy-vitamin-D (25-OH-D) and health-related-quality-of-life (HRQoL) in CHC subjects has never been investigated. The study aimed to analyze the relationship between vitamin D deficiency and HRQoL in CHC patients. One-hundred-fifty-five consecutive CHC patients completed the Health-Survey-Short-Form-36 (SF-36) and their serum 25-OH-D levels were evaluated. Vitamin D deficiency was defined as a 25-OH-D level lower than 20 ng/mL. We identified 53 patients (34.2%) with vitamin D deficiency, who showed a mean 25-OH-D serum level of 12.5 ± 3.7 ng/mL. Vitamin D deficient patients had significantly higher liver stiffness values compared to those with normal levels (20.8 ± 14 vs 14.9 ± 9.7 KPa, p=0.003). In a multivariate linear regression analysis, vitamin D deficiency was independently associated with a lower SF-36 physical-component summary score (p=0.034) and SF-36 mental-component summary score (p=0.042) after controlling for age, gender and liver stiffness. Specifically, vitamin D deficiency was associated with 3 out of 4 physical domains of the SF-36 [physical-function (p=0.016), role-physical (p=0.016) and general-health (p=0.002)] and 3 out of 4 mental domains [vitality (p=0.020), role-emotional (p=0.005) and mental-health (p=0.025)]. In conclusion, the present study provides novel evidence demonstrating that vitamin D deficiency can contribute to a decreased physical and mental HRQoL in CHC patients. Given that serum vitamin D levels are easy to evaluate and deficiency treatment is simple and inexpensive, clinicians should be aware of the potential multiple benefits of vitamin D supplementation in CHC patients.