An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis

Andree H. Koop, Omar Y. Mousa, Ly Elaine Pham, Juan E. Corral-Hurtado, Surakit Pungpapong, Andrew P. Keaveny

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Malnutrition is prevalent in cirrhosis. Vitamin and mineral deficiencies, including vitamin D, vitamin A, and zinc, are common and have been shown to correlate with survival. Our aim was to review the mechanisms of vitamin D, vitamin A, and zinc deficiencies in cirrhosis and the clinical assessment of affected patients, their outcomes based on the current literature, and management. This is a narrative review including the relevant literature for cirrhosis and vitamin D, vitamin A, and zinc deficiencies. Vitamin D deficiency has important effects in cirrhosis, regardless of the cause of chronic liver disease.These effects include associations with fibrosis and outcomes such as infections, hepatocellular carcinoma, and mortality. Vitamin A deficiency is associated with liver disease progression to cirrhosis and clinical decompensation, including occurrence of ascites or hepatic encephalopathy. Zinc deficiency can lead to hepatic encephalopathy and impaired immune function. Such deficiencies correlate with patient survival and disease severity. Caution should be applied when replacing vitamin D, vitamin A, and zinc to avoid toxicity. Identification and appropriate treatment of vitamin and mineral deficiencies in cirrhosis may reduce specific nutritional and cirrhosis-related adverse events. Routine monitoring of vitamin A, vitamin D and zinc levels in cirrhosis should be considered.

Original languageEnglish (US)
Pages (from-to)920-932
Number of pages13
JournalAnnals of Hepatology
Volume17
Issue number6
DOIs
StatePublished - Oct 16 2018

    Fingerprint

Keywords

  • Cirrhosis
  • Vitamin A deficiency
  • Vitamin D deficiency
  • Zinc deficiency

ASJC Scopus subject areas

  • Hepatology

Cite this

Koop, A. H., Mousa, O. Y., Pham, L. E., Corral-Hurtado, J. E., Pungpapong, S., & Keaveny, A. P. (2018). An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis. Annals of Hepatology, 17(6), 920-932. https://doi.org/10.5604/01.3001.0012.7192