Associations of Serum Vitamin D with Sarcopenia in Patients with Chronic Liver Disease: A Population-Based Cross-Sectional Study.

Abstract

The association between vitamin D and sarcopenia in patients with chronic liver disease (CLD) has yet to be conclusively established, particularly in Western populations. We investigated the association between serum 25(OH)D levels and sarcopenia in adult CLD patients in the USA. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey III. Weighted logistic regression was used to determine the association between sarcopenia and serum 25(OH)D in participants with CLD. CLD was defined as chronic hepatitis B or C, non-alcoholic fatty liver disease, alcohol-related liver disease, and other liver diseases. A serum 25(OH)D level of less than 75 nmol/L was defined as vitamin D insufficiency. This study included 1402 participants with CLD. The serum 25(OH)D concentration was significantly lower in the sarcopenia group (45.3 nmol/l) compared to the non-sarcopenia group (50.6 nmol/l). The prevalence of vitamin D insufficiency was as high as 91.3% in participants with CLD, and the proportion of vitamin D insufficiency was higher in those with sarcopenia. In the full multivariate model, each 10-nmol/L increase in 25(OH)D concentration was significantly associated with a decreased risk of sarcopenia (OR 0.89; 95%CI 0.79-0.99). Conversely, participants with insufficient vitamin D levels had a significantly increased risk of sarcopenia (OR, 2.07; 95% CI 1.08-4.00). Subgroup analyses suggested a sex difference in the association between vitamin D levels and sarcopenia, with a significant association only observed in females. Restricted cubic spline curves indicated a linear inverse association between serum 25(OH)D concentration and risk of sarcopenia in all participants and in females. Low serum 25(OH)D levels were significantly associated with an increased risk of sarcopenia in individuals with CLD, with the observed gender differences in this association warranting further validation in future studies.