P3639 - Impact of Vitamin D Deficiency on Progression From Metabolic Dysfunction-Associated Fatty Liver Disease to Cirrhosis: A Retrospective Cohort Study

Ahmed Abuhasna, DO¹, Abdalhakim Shubietah, MD¹, Islam Rajab, MD², Abdallah Hussein, MD³, Mohammad Ghannam, MD⁴, Qutaiba Qafisheh, MD⁵, Mohammad Alqadi, MD⁵, Muath A. Baniowda, MD⁶, Mohamed Saad Rakab, ⁷, Lefika Bathobakae, MD, MPH², Maysam Tawba, MCP⁸
1Advocate Illinois Masonic Medical Center, Chicago, IL; 2St. Joseph's University Medical Center, Paterson, NJ; 3Virtua Our Lady of Lourdes Hospital, Camden, NJ; 4Brookdale University Hospital Medical Center, New York, NY; 5University of Toledo, Toledo, OH; 6University of Missouri Kansas City School of Medicine, Kansas City, MO; 7Faculty of Medicine, Mansoura University, Mansoura, Egypt, Mansoura, Ad Daqahliyah, Egypt; 8Al Qassimi Women's and Children's Hospital, Sharjah, Sharjah, United Arab Emirates

Introduction: While vitamin D deficiency is associated with MAFLD, long-term evidence on its impact is limited.

Methods: We conducted a retrospective cohort study using de-identified TriNetX data to evaluate whether vitamin D deficiency (25[OH]D < 20 ng/mL or ICD-10 E55) predicts progression from MAFLD to cirrhosis in adults diagnosed between 2012 and 2018. After excluding those with preexisting cirrhosis, other chronic liver diseases, alcohol use disorder, advanced CKD, HIV, malabsorptive or granulomatous conditions, recent pregnancy, or use of medications affecting vitamin D metabolism, we used propensity score matching to balance baseline characteristics and followed patients for up to six years to assess cirrhosis and related outcomes.

Results: In matched cohorts (n = 37,438; mean age 52.8 y; 34.2% vs. 33.8% male), vitamin D deficiency showed no 1-year difference in MACE (RR 1.058; p = 0.125), mortality (0.979; p = 0.708), liver transplant (1.192; p = 0.251), HCC (0.881; p = 0.506), or non-alcoholic cirrhosis (0.973; p = 0.577), but lower decompensated cirrhosis (0.831; p = 0.008) and cholangiocarcinoma (0.532; p = 0.009), with higher hospitalization (1.143; p < 0.001). At 2 years, MACE (1.087; p = 0.006) and hospitalization (1.145; p < 0.001) increased, while decompensated cirrhosis (0.862; p = 0.011), cholangiocarcinoma (0.525; p = 0.003), and HCC (0.660; p = 0.007) decreased; mortality (1.025; p = 0.587), non-alcoholic cirrhosis (0.987; p = 0.748), and liver transplant (1.209; p = 0.191) remained unchanged. At 4 years, higher MACE (1.060; p = 0.014) and hospitalization (1.151; p < 0.001) persisted, with continued reductions in decompensated cirrhosis (0.865; p = 0.002), cholangiocarcinoma (0.513; p < 0.001), and HCC (0.628; p < 0.001), but no difference in mortality (0.961; p = 0.254), liver transplant (0.953; p = 0.704), or non-alcoholic cirrhosis (1.025; p = 0.465). By 6 years, mortality (0.937; p = 0.034) and decompensated cirrhosis (0.910; p = 0.027) were lower, non-alcoholic cirrhosis (1.067; p = 0.034) and hospitalization (1.127; p < 0.001) higher, with no change in MACE (1.005; p = 0.814), HCC (0.801; p = 0.078), cholangiocarcinoma (0.700; p = 0.075), or liver transplant (1.031; p = 0.804).

Discussion: In MAFLD, vitamin D deficiency over six years was linked to lower risks of decompensated cirrhosis, cholangiocarcinoma, HCC (from year 2), and mortality (year 6), but higher hospitalization, MACE, and non-alcoholic cirrhosis risks by year 6.

Disclosures:
Ahmed Abuhasna indicated no relevant financial relationships.
Abdalhakim Shubietah indicated no relevant financial relationships.
Islam Rajab indicated no relevant financial relationships.
Abdallah Hussein indicated no relevant financial relationships.
Mohammad Ghannam indicated no relevant financial relationships.
Qutaiba Qafisheh indicated no relevant financial relationships.
Mohammad Alqadi indicated no relevant financial relationships.
Muath A. Baniowda indicated no relevant financial relationships.
Mohamed Saad Rakab indicated no relevant financial relationships.
Lefika Bathobakae indicated no relevant financial relationships.
Maysam Tawba indicated no relevant financial relationships.

Ahmed Abuhasna, DO¹, Abdalhakim Shubietah, MD¹, Islam Rajab, MD², Abdallah Hussein, MD³, Mohammad Ghannam, MD⁴, Qutaiba Qafisheh, MD⁵, Mohammad Alqadi, MD⁵, Muath A. Baniowda, MD⁶, Mohamed Saad Rakab, ⁷, Lefika Bathobakae, MD, MPH², Maysam Tawba, MCP⁸. P3639 - Impact of Vitamin D Deficiency on Progression From Metabolic Dysfunction-Associated Fatty Liver Disease to Cirrhosis: A Retrospective Cohort Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.