Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis

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 path...

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Autores: Diaz-Ruiz, R; Poca, M; Roman, E; Panadero-Gomez, R; Cuyàs, B; Bañares, I; Morales, A; Puerto, M; Lopez-Esteban, R; Blazquez, E; Fernández-Castillo, M; Correa-Rocha, R; Rapado-Castro, M; Breton, I; Bañares, R; Soriano, G; Garcia-Martinez, R
Tipo de documento: Artículo
Estado:Published version
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p19149
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19149
Nivel de acceso:Acceso abierto
Palabra clave:vitamin D
cognitive function
liver cirrhosis
inflammation
human
_version_ 1878741145243090944
author Diaz-Ruiz, R
author2 Poca, M
Roman, E
Panadero-Gomez, R
Cuyàs, B
Bañares, I
Morales, A
Puerto, M
Lopez-Esteban, R
Blazquez, E
Fernández-Castillo, M
Correa-Rocha, R
Rapado-Castro, M
Breton, I
Bañares, R
Soriano, G
Garcia-Martinez, R
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author_browse Bañares, I
Bañares, R
Blazquez, E
Breton, I
Correa-Rocha, R
Cuyàs, B
Diaz-Ruiz, R
Fernández-Castillo, M
Garcia-Martinez, R
Lopez-Esteban, R
Morales, A
Panadero-Gomez, R
Poca, M
Puerto, M
Rapado-Castro, M
Roman, E
Soriano, G
author_facet Diaz-Ruiz, R
Poca, M
Roman, E
Panadero-Gomez, R
Cuyàs, B
Bañares, I
Morales, A
Puerto, M
Lopez-Esteban, R
Blazquez, E
Fernández-Castillo, M
Correa-Rocha, R
Rapado-Castro, M
Breton, I
Bañares, R
Soriano, G
Garcia-Martinez, R
author_role author
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
description 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 +/- 11.3 years; 22 men; Model for End-Stage Liver Disease (MELD) 11.7 +/- 4.0; prior overt HE 33%; median 25-hydroxyvitamin D (25OHD) plasma level 12.7 mu gr/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 = -0.42; p = 0.04), attention (R = -0.48; p = 0.04), Tinnetti balance (R = -0.656; p < 0.001) and Tinnetti score (R = -0.659; p < 0.001) were linked to neuroinflammation marker IL-1 beta. Patients with lower 25OHD had a greater proportion of TH1cells at baseline and a larger amelioration of IL-1 beta and IL-6 following supplementation. An improvement in working memory was found after 25OHD replacement (46.7 +/- 13 to 50 +/- 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.
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institution Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
network_acronym_str ES
network_name_str España
oai_identifier_str oai:iibsantpau.fundanetsuite.com:p19149
publishDate 2025
publishDateSort 2025
publisher MDPI
publisherStr MDPI
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
spelling Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis Diaz-Ruiz, R Poca, M Roman, E Panadero-Gomez, R Cuyàs, B Bañares, I Morales, A Puerto, M Lopez-Esteban, R Blazquez, E Fernández-Castillo, M Correa-Rocha, R Rapado-Castro, M Breton, I Bañares, R Soriano, G Garcia-Martinez, R vitamin D cognitive function liver cirrhosis inflammation human 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 +/- 11.3 years; 22 men; Model for End-Stage Liver Disease (MELD) 11.7 +/- 4.0; prior overt HE 33%; median 25-hydroxyvitamin D (25OHD) plasma level 12.7 mu gr/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 = -0.42; p = 0.04), attention (R = -0.48; p = 0.04), Tinnetti balance (R = -0.656; p < 0.001) and Tinnetti score (R = -0.659; p < 0.001) were linked to neuroinflammation marker IL-1 beta. Patients with lower 25OHD had a greater proportion of TH1cells at baseline and a larger amelioration of IL-1 beta and IL-6 following supplementation. An improvement in working memory was found after 25OHD replacement (46.7 +/- 13 to 50 +/- 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. MDPI https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19149
spellingShingle Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis
Diaz-Ruiz, R
vitamin D
cognitive function
liver cirrhosis
inflammation
human
status_str publishedVersion
title Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis
title_full Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis
title_fullStr Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis
title_full_unstemmed Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis
title_short Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis
title_sort Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis
topic vitamin D
cognitive function
liver cirrhosis
inflammation
human
topic_facet vitamin D
cognitive function
liver cirrhosis
inflammation
human
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19149