{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:58:57Z","timestamp":1789556337615,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,22]],"date-time":"2023-01-22T00:00:00Z","timestamp":1674345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Food and Health Innovation Initiative (Vitamin Fund), University of Alberta","award":["RES0046510"],"award-info":[{"award-number":["RES0046510"]}]},{"name":"Food and Health Innovation Initiative (Vitamin Fund), University of Alberta","award":["HGY-164788"],"award-info":[{"award-number":["HGY-164788"]}]},{"name":"Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism, and Diabetes (INMD) Fellowship\u2013Hepatology","award":["RES0046510"],"award-info":[{"award-number":["RES0046510"]}]},{"name":"Canadian Institutes of Health Research (CIHR) Institute of Nutrition, Metabolism, and Diabetes (INMD) Fellowship\u2013Hepatology","award":["HGY-164788"],"award-info":[{"award-number":["HGY-164788"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Vitamin D deficiency has been linked with adverse events in various liver diseases. The present study aimed to recognize the association between severe vitamin D deficiency and disease progression, hepatobiliary malignancies, liver-related mortality, and the need for liver transplantation in primary sclerosing cholangitis (PSC). Patients with a diagnosis of PSC (n = 354), followed by the autoimmune liver disease clinic at the University of Alberta, were included. Patients with vitamin D levels &lt; 25 nmol\/L were defined as severely deficient. Univariate and multivariate analyses were conducted using the Cox proportional hazards regression models. The mean vitamin D level was 59 \u00b1 2 nmol\/L, and 63 patients (18%) had a severe vitamin D deficiency. Patients with a severe vitamin D deficiency were 2.5 times more likely to experience hepatobiliary malignancies (HR 2.55, 95% CI, 1.02\u20136.40, p = 0.046). A severe vitamin D deficiency at diagnosis (HR 1.82, 95% CI, 1.05\u20133.15, p = 0.03) and persistent deficiencies over time (HR 2.26, 95% CI, 1.17\u20134.37, p = 0.02) were independently associated with a higher risk of poor clinical liver outcomes. A severe vitamin D deficiency at diagnosis and persistent deficiency at longitudinal assessments were associated with liver-related mortality or the need for liver transplantation.<\/jats:p>","DOI":"10.3390\/nu15030576","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T04:19:22Z","timestamp":1674447562000},"page":"576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Prognostic Significance of Severe Vitamin D Deficiency in Patients with Primary Sclerosing Cholangitis"],"prefix":"10.3390","volume":"15","author":[{"given":"Maryam","family":"Ebadi","sequence":"first","affiliation":[{"name":"Liver Unit, Division of Gastroenterology, University of Alberta Hospital, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elora","family":"Rider","sequence":"additional","affiliation":[{"name":"Liver Unit, Division of Gastroenterology, University of Alberta Hospital, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Tsai","sequence":"additional","affiliation":[{"name":"Liver Unit, Division of Gastroenterology, University of Alberta Hospital, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Wang","sequence":"additional","affiliation":[{"name":"Liver Unit, Division of Gastroenterology, University of Alberta Hospital, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5651-9010","authenticated-orcid":false,"given":"Ellina","family":"Lytvyak","sequence":"additional","affiliation":[{"name":"Liver Unit, Division of Gastroenterology, University of Alberta Hospital, Edmonton, AB T6G 2X8, 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":"Liver Unit, Division of Gastroenterology, University of Alberta Hospital, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2511-7980","authenticated-orcid":false,"given":"Aldo J.","family":"Montano-Loza","sequence":"additional","affiliation":[{"name":"Liver Unit, Division of Gastroenterology, University of Alberta Hospital, Edmonton, AB T6G 2X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/hep.23294","article-title":"American Association for the Study of Liver D: Diagnosis and management of primary sclerosing cholangitis","volume":"51","author":"Chapman","year":"2010","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1016\/j.jhep.2017.07.022","article-title":"Primary sclerosing cholangitis-a comprehensive review","volume":"67","author":"Karlsen","year":"2017","journal-title":"J. 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