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patients with cirrhosis, regardless of liver failure. Vitamin D deficiency is frequent in these patients and has been related to frailty and sarcopenia, but the impact of its supplementation on frailty in cirrhosis is unknown. The aim was to evaluate the effect of vitamin D supplementation on frailty in patients with decompensated cirrhosis and vitamin D deficiency or insufficiency. Methods: We included patients with cirrhosis who had vitamin D deficiency or insufficiency following their hospitalization for acute decompensation. Vitamin D was supplemented according to current recommendations, as were other micronutrients if necessary. Patients were followed for one year to evaluate changes at 6 and 12 months in frailty (Fried frailty index), health-related quality of life (SF-36, CLDQ) and mood (HADS). Body composition was assessed by DXA at baseline and at 12 months. Results: We included 39 patients, 27 of whom reached the 6-month follow-up. Serum vitamin D increased at 6 and 12 months (p &lt; 0.001 compared to baseline). Fried frailty index improved at the 6-month visit (p = 0.004), and handgrip strength improved at 6 (p = 0.001) and 12 (p = 0.002) months, similarly in women and men. At 12 months, we observed an increase in body mass index, right arm lean mass and total fat mass. Conclusions: A multifactorial nutritional intervention, especially vitamin D supplementation after discharge in decompensated, vitamin D-deficient patients with cirrhosis, was associated with an improvement in frailty, muscular strength and lean muscle mass. However, the increase in fat mass strengthens the recommendation for diet, exercise and weight supervision.<\/jats:p>","DOI":"10.3390\/medsci13010030","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T04:18:32Z","timestamp":1741839512000},"page":"30","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Treatment of Vitamin D Deficiency in Decompensated Patients with Cirrhosis Is Associated with Improvement in Frailty"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2259-0289","authenticated-orcid":false,"given":"Raquel","family":"D\u00edaz-Ru\u00edz","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Facultad de Medicina, Universidad Complutense de Madrid, CIBERehd, 28007 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM), 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0235-1395","authenticated-orcid":false,"given":"Maria","family":"Poca","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Aut\u00f2noma de Barcelona, CIBERehd, 08025 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9084-8555","authenticated-orcid":false,"given":"Eva","family":"Rom\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Aut\u00f2noma de Barcelona, CIBERehd, 08025 Barcelona, Spain"},{"name":"University Nursing School EUI-Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Aut\u00f2noma de Barcelona, 08025 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9988-7163","authenticated-orcid":false,"given":"Berta","family":"Cuy\u00e0s","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau (IR Sant Pau), Universitat Aut\u00f2noma de Barcelona, CIBERehd, 08025 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Ba\u00f1ares","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM), 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela","family":"Morales","sequence":"additional","affiliation":[{"name":"Unidad de Nutrici\u00f3n Cl\u00ednica y Diet\u00e9tica, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-9052","authenticated-orcid":false,"given":"Elvira","family":"Hern\u00e1ndez Mart\u00ednez-Esparza","sequence":"additional","affiliation":[{"name":"University Nursing School EUI-Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Aut\u00f2noma de Barcelona, 08025 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Panadero","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM), 28007 Madrid, Spain"},{"name":"Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Velasco","sequence":"additional","affiliation":[{"name":"Unidad de Nutrici\u00f3n Cl\u00ednica y Diet\u00e9tica, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8484-6051","authenticated-orcid":false,"given":"Marta","family":"Rapado-Castro","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM), 28007 Madrid, Spain"},{"name":"Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, 28007 Madrid, Spain"},{"name":"Department of Psychiatry, The University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0263-3728","authenticated-orcid":false,"given":"Irene","family":"Bret\u00f3n","sequence":"additional","affiliation":[{"name":"Unidad de Nutrici\u00f3n Cl\u00ednica y Diet\u00e9tica, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-8437","authenticated-orcid":false,"given":"Rafael","family":"Ba\u00f1ares","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Facultad de Medicina, Universidad Complutense de Madrid, CIBERehd, 28007 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM), 28007 Madrid, 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Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S147","DOI":"10.1016\/j.jhep.2021.01.025","article-title":"Sarcopenia and frailty in decompensated cirrhosis","volume":"75","author":"Tandon","year":"2021","journal-title":"J. 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