- 2025-07-11
- Nutrition reviews 83(11)
- Petrana Martinekova
- Mahmoud Obeidat
- Mihaela Topala
- Szilárd Váncsa
- Dániel Sándor Veres
- Ádám Zolcsák
- Miheller Pál
- László Földvári-Nagy
- Peter Banovcin
- Bálint Erőss
- Péter Hegyi
- Krisztina Hagymasi
Study Design
- Type
- Meta-Analysis
- Sample size
- n = 4,084
- Population
- patients with chronic liver disease (46 RCTs, comprising 4084 patients)
- Methods
- systematic review and meta-analysis of randomized controlled trials; searched PubMed, EMBASE, Cochrane Library on July 2, 2024
Context
Vitamin D deficiency is highly prevalent in chronic liver disease. Although international societies recommend vitamin D supplementation in cases of proven deficiency, the impact of vitamin D on chronic liver disease remains uncertain.Objective
Our aim was to evaluate the effects of vitamin D supplementation in patients with chronic liver disease by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs).Data sources
We systematically searched PubMed, EMBASE and the Cochrane Library on July 2, 2024.Data extraction
Our primary outcomes involved survival, controlled attenuation parameter (CAP), liver stiffness measurement (LSM), and effects on changes in liver enzymes. Secondary outcomes included lipid profile and homeostasis model assessment of insulin resistance (HOMA-IR), among others. The pooled risk ratio (RR), mean difference (MD), and corresponding 95% CIs were calculated using the random-effects model.Data analysis
Forty-six RCTs were included, comprising 4084 patients. When we compared the vitamin D group with the control, the RR for overall survival was 1.14 (95% CI, 0.85-1.54; 4 RCTs) at 6 months and 0.99 (95% CI, 0.83-1.17; 4 RCTs) at the 12-month follow-up. Vitamin D supplementation did not result in a lower CAP (MD, -23.50 dB/m; 95% CI, -81.72 to 34.72; 3 RCTs) and LSM (MD, -0.65 kPa; 95% CI, -1.98 to 0.68; 3 RCTs). A significant reduction in HOMA-IR was observed in the vitamin D group (MD, -0.31; 95% CI, -0.62 to -0.01; 15 RCTs). Alanine aminotransferase (ALT) (MD, -4.98 IU/L; 95% CI, -8.28 to -1.68; 24 RCTs), aspartate aminotransferase (AST) (MD, -3.33 IU/L; 95% CI, -6.25 to -0.40; 23 RCTs), gamma-glutamyl transferase (GGT) (MD, -5.14 IU/L; -6.40; -3.88; 11 RCTs), triglycerides (MD, -7.59 mg/dL; 95% CI, -15.09 to -0.81), and insulin (MD -0.79 μIU/L; 95% CI, -1.36 to -0.21) were significantly reduced in the patients with vitamin D supplementation.Conclusion
Our results showed significantly reduced ALT, AST, GGT, triglycerides, insulin, and HOMA-IR in the vitamin D-supplemented group; however, the effect was modest. In addition, there were no differences in survival, CAP, or LSM. Further RCTs with adequate power are warranted to clarify the results.Systematic review registration
PROSPERO registration No. CRD42022370312.