Relationship between serum vitamin D level and sarcopenia in chronic liver disease

Although the association of vitamin D with primary sarcopenia has been extensively investigated, its relationship with secondary sarcopenia in patients with liver disease remains unclear. This study aimed to identify factors associated with sarcopenia in patients with chronic liver disease with a focus on serum vitamin D levels.

The study included 204 patients with chronic liver disease. Independent factors significantly associated with sarcopenia were determined using multiple logistic regression analysis. The sarcopenia diagnosis was based on the sarcopenia criteria proposed by the Japan Society of Hepatology. Serum 25-hydroxyvitamin D₃ (25[OH]D₃ ) levels to represent serum vitamin D levels were measured using double-antibody radioimmunoassay, and vitamin D deficiency was defined as a serum 25(OH)D₃ level of ≤20 ng/mL.

The prevalence of sarcopenia in the cirrhotic patients (28/76, 36.8%) was significantly higher than that in the non-cirrhotic patients (18/128, 14.1%; P = 2.48 × 10^-4 ). Sarcopenia was diagnosed in 44 (27.5%) of the 160 patients with vitamin D deficiency, and two (4.5%) of the 44 patients without vitamin D deficiency (P = 4.90 × 10^-3 ). On multivariate analysis, advanced age (odds ratio 1.11; P = 2.10 × 10^-4 ), low body mass index (odds ratio 1.42; p = 2.08 × 10^-5 ), and low serum 25(OH)D₃ level (odds ratio 1.13; p = 1.20 × 10^-2 ) were significant, independent factors associated with sarcopenia. Serum 25(OH)D₃ was positively correlated with grip strength and skeletal muscle mass index.

Sarcopenia complicated by chronic liver disease was associated with advanced age, low body mass index, and low serum 25(OH)D₃ level.