Assessment of Serum-Ascites Vitamin D Gradient (SADG) in Spontaneous Bacterial Peritonitis

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Awad S.A.; El Shewi M.E.; Abd-El-aliem S.M.; Sabry O.M.

Journal: Benha Medical Journal

Publisher: Benha University Faculty of Medicine

Publication Date: 7 September 2024

Volume / Issue: Volume 42 / Issue 1

Pages: 56–67

ISSN: 1110208X

DOI: 10.21608/bmfj.2024.295275.2096

Scopus: View on Scopus

Document Type: Article

Authors and Affiliations

Awad S.A., Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Egypt; El Shewi M.E., Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Egypt; Abd-El-aliem S.M., Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Egypt; Sabry O.M., Department of Hepatology, Gastroenterology and Infectious Diseases, Theodor Bilharz Research Institute (TBRI), Giza, Egypt

Abstract

Background: Spontaneous bacterial peritonitis (SBP) is a severe infection occurring in patients with decompensated liver cirrhosis and ascites. The diagnosis of SBP is typically confirmed by an ascitic fluid polymorphonuclear (PMN) count ≥250 cells/mm³. Recent studies suggest that vitamin D, due to its immunomodulatory properties, may play a role in the pathophysiology of SBP. This study aimed to evaluate the serum-ascites vitamin D gradient (SADG) as a potential diagnostic marker for SBP. Methods: This cross-sectional study included 50 cirrhotic patients with portal hypertensive ascites, divided into two groups: 25 patients with SBP (Group I) and 25 patients without SBP (Group II). Serum and ascitic fluid samples were collected to measure 25-hydroxy vitamin D levels, from which the SADG was calculated. Additional biochemical and clinical data were also recorded. Results: The SADG was significantly lower in the SBP group compared to the non-SBP group (1.6 ± 4.4 ng/mL vs. 3.0 ± 4.3 ng/mL; p = 0.001). A SADG cutoff value of <0.55 ng/mL demonstrated 72% sensitivity and 76% specificity (AUC = 0.77, p = 0.0008) for distinguishing between the two groups. Serum vitamin D levels were also significantly lower in SBP patients (7.9 ± 5.5 ng/mL vs. 11.4 ± 6.1 ng/mL; p = 0.014). Conclusions: SADG appears to be a promising marker for the diagnosis of SBP in cirrhotic patients with ascites. Its utility in clinical practice could enhance early detection and management of this life-threatening condition. © 2025, Benha University Faculty of Medicine. All rights reserved.

Keywords

Liver Cirrhosis; Serum-Ascites Vitamin D Gradient; Spontaneous Bacterial Peritonitis

Citation Information

Scopus Citations: 0

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