{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T21:58:13Z","timestamp":1779400693108,"version":"3.53.1"},"reference-count":61,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI16\/00920"],"award-info":[{"award-number":["PI16\/00920"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["JR14\/00019"],"award-info":[{"award-number":["JR14\/00019"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["ICI20\/00063 y PI21\/00189"],"award-info":[{"award-number":["ICI20\/00063 y PI21\/00189"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FI19\/00120"],"award-info":[{"award-number":["FI19\/00120"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["RYC-2017-23144"],"award-info":[{"award-number":["RYC-2017-23144"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fundacion Familia Alonso","award":["FFA-2024"],"award-info":[{"award-number":["FFA-2024"]}]},{"DOI":"10.13039\/100000874","name":"Brain & Behavior Research Foundation","doi-asserted-by":"publisher","award":["NARSAD 24628"],"award-info":[{"award-number":["NARSAD 24628"]}],"id":[{"id":"10.13039\/100000874","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia, Innovaci\u00f3n y Universidades","doi-asserted-by":"publisher","award":["CNS2023-144038"],"award-info":[{"award-number":["CNS2023-144038"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia, Innovaci\u00f3n y Universidades","doi-asserted-by":"publisher","award":["PI21\/00701M"],"award-info":[{"award-number":["PI21\/00701M"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia, Innovaci\u00f3n y Universidades","doi-asserted-by":"publisher","award":["PI24\/01298"],"award-info":[{"award-number":["PI24\/01298"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006541","name":"Comunidad de Madrid","doi-asserted-by":"publisher","award":["S2022\/BMD-7216 AGES 3-CM"],"award-info":[{"award-number":["S2022\/BMD-7216 AGES 3-CM"]}],"id":[{"id":"10.13039\/501100006541","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Decompensated cirrhosis is characterized by systemic inflammation and innate and adaptive immune dysfunction. Hepatic encephalopathy (HE) is a prevalent and debilitating condition characterized by cognitive disturbances in which ammonia and inflammation play a synergistic pathogenic role. Extraskeletal functions of vitamin D include immunomodulation, and its deficiency has been implicated in immune dysfunction and different forms of cognitive impairment. The aim was to assess changes in cognitive function and inflammation in decompensated patients with cirrhosis receiving vitamin D supplementation. Methods: Patients with cirrhosis discharged from decompensation in two tertiary hospitals in Spain (from September 2017 to January 2020) were assessed before, at 6 and 12 months after vitamin D supplementation. A comprehensive neuropsychological battery and neuroinflammatory markers were examined. In a subgroup of patients, peripheral immune blood cells were analyzed. Results: Thirty-nine patients were recruited. Of those, 27 completed the 6 months evaluation and were analyzed [age 62.4 \u00b1 11.3 years; 22 men; Model for End-Stage Liver Disease (MELD) 11.7 \u00b1 4.0; prior overt HE 33%; median 25-hydroxyvitamin D (25OHD) plasma level 12.7 \u00b5gr\/L] and 22 achieved 12 months assessment. At baseline, learning and memory (R = 0.382; p = 0.049) and working memory (R = 0.503; p = 0.047) subtests correlated with plasma 25OHD levels. In addition, processing speed (R = \u22120.42; p = 0.04), attention (R = \u22120.48; p = 0.04), Tinnetti balance (R = \u22120.656; p &lt; 0.001) and Tinnetti score (R = \u22120.659; p &lt; 0.001) were linked to neuroinflammation marker IL-1\u03b2. Patients with lower 25OHD had a greater proportion of TH1cells at baseline and a larger amelioration of IL-1\u03b2 and IL-6 following supplementation. An improvement in working memory was found after 25OHD replacement (46.7 \u00b1 13 to 50 \u00b1 11; p = 0.047). Conclusions: This study supports that vitamin D supplementation modulates low-grade inflammation in decompensated cirrhosis providing cognitive benefits, particularly in working memory.<\/jats:p>","DOI":"10.3390\/nu17020226","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T05:17:08Z","timestamp":1736399828000},"page":"226","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis"],"prefix":"10.3390","volume":"17","author":[{"given":"Raquel","family":"Diaz-Ruiz","sequence":"first","affiliation":[{"name":"Department of Digestive Diseases, Instituto de Investigaci\u00f3n Sanitaria, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense Madrid, 28007 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), 28029 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":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), 28029 Madrid, Spain"},{"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, 08041 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Roman","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), 28029 Madrid, Spain"},{"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, 08041 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocio","family":"Panadero-Gomez","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Instituto de Investigaci\u00f3n Sanitaria, Hospital General Universitario Gregorio Mara\u00f1on, Universidad Complutense Madrid, Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Salud Mental (CIBERSam), 28009 Madrid, 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":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), 28029 Madrid, Spain"},{"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, 08041 Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Ba\u00f1ares","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1on, 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Morales","sequence":"additional","affiliation":[{"name":"Nutrition Unit, Hospital General Universitario Gregorio Mara\u00f1on, Universidad Complutense Madrid, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1263-9296","authenticated-orcid":false,"given":"Marta","family":"Puerto","sequence":"additional","affiliation":[{"name":"Department of Digestive Diseases, Instituto de Investigaci\u00f3n Sanitaria, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense Madrid, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocio","family":"Lopez-Esteban","sequence":"additional","affiliation":[{"name":"Laboratory of Immune-Regulation, Instituto de Investigacion Sanitaria Gregorio Mara\u00f1on, 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Blazquez","sequence":"additional","affiliation":[{"name":"Laboratory of Immune-Regulation, Instituto de Investigacion Sanitaria Gregorio Mara\u00f1on, 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9435-3792","authenticated-orcid":false,"given":"Marta","family":"Fern\u00e1ndez-Castillo","sequence":"additional","affiliation":[{"name":"Laboratory of Immune-Regulation, Instituto de Investigacion Sanitaria Gregorio Mara\u00f1on, 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3456-9986","authenticated-orcid":false,"given":"Rafael","family":"Correa-Rocha","sequence":"additional","affiliation":[{"name":"Laboratory of Immune-Regulation, Instituto de Investigacion Sanitaria Gregorio Mara\u00f1on, 28009 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":"Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Instituto de Investigaci\u00f3n Sanitaria, Hospital General Universitario Gregorio Mara\u00f1on, Universidad Complutense Madrid, Centro de Investigaci\u00f3n Biom\u00e9dica en Red-Salud Mental (CIBERSam), 28009 Madrid, Spain"},{"name":"Department of Psychiatry, The University of Melbourne, Melbourne, VIC 3053, 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Universitario Gregorio Mara\u00f1on, Universidad Complutense Madrid, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1053\/jhep.2002.31250","article-title":"Hepatic encephalopathy--definition, nomenclature, diagnosis, and quantification: Final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998","volume":"35","author":"Ferenci","year":"2002","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1002\/hep.27210","article-title":"Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the 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