Variation of Hepatic Enzymes With Vitamin B12 and Vitamin D3 Levels in Cirrhotic Patients: 2013

Introduction: Our objective was to determine variation of hepatic enzymes Vitamin B12 and D3 levels in cirrhotic patients. Methods: This is a cross sectional study conducted in Abbasi Shaheed Hospital from November 2013 to May 2014. The sample size of the study is 250. 141 patients were male while 109 were female patients. Those who were diagnosed of Cirrhosis and previously infected with Hepatitis B and C virus were included.The analytical parameters determined were Vitamin B12, D3, ALT and GGT levels in blood. SPSS 19 was used. Results: Vitamin B12 levels were 1249.59±487.01pg/ml and 1422.28±627.75pg/ml in males and females respectively while Vitamin D3 levels were found to be 17.15±10.45 nmol/L in males and 14.80±14.24 nmol/L in females. Vitamin B12 levels were found to be positively correlated with the elevation of ALT and were negatively correlated with elevation of ALT, GGT and Alkaline Phosphatase. The ALT levels were 50.0±21.88 in males and 14.80±14.24 in females, Alkaline phosphatase to be 311.46±107.98 in males while female Alkaline phosphatase were 346.47±101.60. GGT levels to be 41.70±10.62 in males and 45.01±13.74 in females. Conclusion: The majority of subjects with CHC are vitamin D deficient ( < 50 nmol/L)27 with 25% having severe deficiency ( < 25 nmol/L) [28]. In those with chronic liver disease the prevalence of vitamin D insufficiency ( < 75 nmol/L) is almost universal, with vitamin D deficiency ( < 50 nmol/L) present in around two-thirds of subjects. Various studies suggest that vitamin D effects may play a significant role in the pathogenesis of chronic liver diseases.Even in the absence of cirrhosis, vitamin D deficiency is present in the majority of subjects. In those with cirrhosis, the prevalence of severe vitamin D deficiency ( < 25 nmol/L) increases with increasing severity of synthetic liver dysfunction.Another study also showed that vitamin D supplementation improves response to antiviral treatment for recurrent hepatitis C.Our findings suggest that cirrhotic patients admitted for complications presented with elevated plasma levels of vitamin B12 which were 1249.59±487.01pg/ ml in males and 1422.28±627.75pg/ml in females. The results also demonstrate a positive association between vitamin B12 and the hepatic enzymes where ALT is 50.0±21.88 pg/ml and 50.96±11.20 pg/ml, and GGT is 41.70±10.62 and 45.01±13.74 pg/ml in males and females respectively.Figure 1