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A higher risk of deficiency is present in patients with malabsorptive syndrome and/or unusually low sun exposure, those who have undergone gastric bypass surgery, or those on prolonged glucocorticoid use (which alters intestinal absorption) ( Cancer patients may have a higher risk of deficiency due to causes of intestinal fat malabsorption (i.e., intestinal surgery, pancreatectomy, gastrectomy) or due to oncologic treatments, such as aromatase inhibitors
Further studies investigating the effect of these factors are needed to determine and refine the predictive value of this and other HRM metrics for pathological reflux among LT candidates
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