ALB and Cirrhosis: There are several proposed mechanisms to explain vitamin D status in chronic liver disease including reduced exogenous exposure of patients to vitamin D sources (e.g. dietary, sunlight), intestinal malabsorption of dietary vitamin D, reduced endogenous production of vitamin D-binding protein and albumin in the liver (which are impaired in the presence of cirrhosis), impaired hepatic hydroxylation of vitamin D to 25(OH)D3 and increased catabolic removal of 25(OH)D3 [11].