{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:48:47Z","timestamp":1790707727382,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T00:00:00Z","timestamp":1543363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007827","name":"American College of Gastroenterology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007827","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vitamin D deficiency has been implicated in the outcome of chronic liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the frequency of severe vitamin D deficiency in autoimmune hepatitis (AIH), assess its association with treatment non\u2010response, and evaluate the relationship between vitamin D status and liver\u2010related mortality and need for transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred and nine patients were evaluated by liver tissue examination at presentation. Serum vitamin D levels were determined, and serum levels &lt;25\u00a0nmol\/L (10\u00a0ng\/mL) were considered severely deficient. Treatment non\u2010response was defined as non\u2010normalised aspartate aminotransferase\/alanine aminotransferase and immunoglobulin G levels during conventional immunosuppressive therapy. Univariate and multivariate analyses were performed using binary logistic regression and Cox proportional hazards model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean vitamin D level was 60\u00a0\u00b1\u00a038\u00a0nmol\/L (range, 3\u2010263\u00a0nmol\/L), and 42 patients (20%) had severe vitamin D deficiency. Treatment non\u2010response was more common in patients with severe vitamin D deficiency than in patients without (59% vs 41%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04). Severe vitamin D deficiency was also independently associated with a higher risk of developing cirrhosis (HR 3.40; 95% CI 1.30\u20108.87, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) and liver\u2010related mortality or requirement for liver transplantation (LT; HR 5.26, 95% CI, 1.54\u201018.0, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008). Patients with persistent severe deficiency following vitamin D supplementation continued to have poor outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Severe vitamin D deficiency is associated with treatment non\u2010response, progression to cirrhosis, and liver\u2010related death or need for LT. Severe vitamin D deficiency is a prognostic biomarker in AIH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15029","type":"journal-article","created":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T17:12:30Z","timestamp":1543425150000},"page":"173-182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Severe vitamin D deficiency is a prognostic biomarker in autoimmune hepatitis"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6148-1002","authenticated-orcid":false,"given":"Maryam","family":"Ebadi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology &amp; Liver Unit University of Alberta Hospital Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9088-8848","authenticated-orcid":false,"given":"Rahima A.","family":"Bhanji","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Liver Unit University of Alberta Hospital Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera C.","family":"Mazurak","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition University of Alberta Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellina","family":"Lytvyak","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Liver Unit University of Alberta Hospital Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0470-9522","authenticated-orcid":false,"given":"Andrew","family":"Mason","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Liver Unit University of Alberta Hospital Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5024-3065","authenticated-orcid":false,"given":"Albert J.","family":"Czaja","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic College of Medicine and Science Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2511-7980","authenticated-orcid":false,"given":"Aldo J.","family":"Montano\u2010Loza","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; 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