ArticleTherapeutic advances in gastroenterology2025
Nonlinear associations of serum vitamin D levels with advanced liver disease and mortality: a US Cohort Study.
Article in Therapeutic advances in gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Vitamin D Signaling in Neurodegenerative Disorders: Mechanisms, Therapeutic Potential, and Clinical Implications.Nutrients · 2026Review
- Long-term Associations of Aspiration Pneumonia and All-Cause Mortality Following Percutaneous Endoscopic Gastrostomy : A US Multi-Institutional Retrospective Cohort Study.Journal of epidemiology and global health · 2026Article
- Disrupted Vitamin D Metabolism in Hepatocellular Carcinoma: Free and Bioavailable 25(OH)D as Novel Biomarkers of Hepatic Reserve and Clinical Risk.Molecules (Basel, Switzerland) · 2026Article
- Intersections of vitamin D deficiency, HIV and chronic liver diseases.HIV medicine · 2026Review
- Association of Glucagon-like Peptide-1 Receptor Agonists with Mortality and Aspiration Pneumonia in Patients with Type 2 Diabetes After Gastrostomy: A Target Trial Emulation Study.International journal of medical sciences · 2026Article
- Temporal trend of serum vitamin profiles and the association with non-alcoholic fatty liver disease.Frontiers in nutrition · 2026Article
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5 authors.
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Abstract
Background: Vitamin D deficiency is prevalent and linked to chronic diseases; its association with advanced liver disease progression requires clarification. Objectives: To investigate the association between vitamin D levels and risks of liver cirrhosis, hepatocellular carcinoma (HCC), and mortality, and assess risk changes after achieving sufficiency post-supplementation. Design: This was a retrospective cohort study. Methods: Utilized TriNetX US data (3,905,594 patients, 2000-2024). Adults with vitamin D deficiency (20.00-30.00 ng/mL) were compared with those with sufficient levels (30.01-80.00 ng/mL). Follow-up was initiated from the first vitamin D test or start of supplementation to minimize immortal time bias. Propensity score matching (1:1) balanced >20 baseline confounders. Results: After matching, 1,204,760 patients with vitamin D deficiency and 1,204,760 with sufficient vitamin D levels were included. Vitamin D deficiency was associated with an increased risk of liver cirrhosis (hazard ratio (HR), 1.30; 95% confidence interval (CI), 1.25-1.36), HCC (HR, 1.22; 95% CI, 1.08-1.37), and all-cause mortality (HR, 1.14; 95% CI, 1.13-1.16). Achieving sufficient vitamin D levels reduced the risk of all-cause mortality (HR, 0.93; 95% CI, 0.88-0.99) and aligned HCC outcomes (HR, 1.16; 95% CI, 0.68-2.00). However, it did not significantly reduce the risk of liver cirrhosis (HR, 2.05; 95% CI, 1.69-2.50). Dose-response analysis showed a U-shaped relationship for liver cirrhosis and HCC, with the lowest risks at 40-60 ng/mL. Conclusion: Serum vitamin D levels showed a nonlinear association with liver cirrhosis and HCC risk; deficiency independently increased the risks for cirrhosis, HCC, and mortality. Supplementation achieving sufficiency reduced mortality and normalized HCC risk but not cirrhosis risk, potentially reflecting limitations in reversing established disease. The lowest liver disease risk was associated with vitamin D levels of 40-60 ng/mL in this cohort, although causality and the clinical benefit of targeting this specific range require confirmation.
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