77 Background: Emerging evidence highlights the critical role of vitamin D in liver health, especially concerning the risk of liver cirrhosis and hepatocellular carcinoma (HCC). This investigation aims to explore the association between vitamin D deficiency and the prevalence of these liver diseases, contrasting outcomes between individuals with deficient and normal vitamin D levels. Methods: This cohort study utilized the US Collaborative Network within the TrinetX database, encompassing 63 medical institutions. It enrolled participants aged 20 years and older from 2011 to 2023. Vitamin D status was determined through serum 25-hydroxyvitamin D levels, categorizing deficiency as 20-30 ng/mL and normal levels as 30-80 ng/mL. Employing 1:1 propensity score matching, the study controlled for 32 characteristics, such as demographic information, health conditions, and medication use, to ensure equitable group comparisons. Additionally, a 1-year washout period was established. The primary aim was to assess the incidence of liver cirrhosis and HCC over a decade. Results: Analyzing data from over 1.86 million participants, the study ensured a balanced comparison across all variables. Participants had an average age of 50.6 years, with 66% identifying as white and 9% as black. Notably, vitamin D deficiency was significantly associated with an increased risk of liver cirrhosis (HR 1.16 [CI 1.11-1.21]) and HCC (HR 1.25 [CI 1.15-1.36]). Kaplan-Meier cumulative risk analysis further confirmed these elevated risks for both liver conditions in individuals with vitamin D deficiency compared to those with sufficient levels. Conclusions: This study confirms a significant association between vitamin D deficiency and a higher risk of liver cirrhosis and HCC, underscoring the importance of vitamin D in maintaining liver health. The findings support the potential of vitamin D level management as a preventive strategy against liver diseases. The implications of this research necessitate further exploration into the efficacy of vitamin D supplementation for liver disease prevention.
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