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血清学和饮食维生素 D 水平与丙型肝炎相关肝病风险之间的关联在非裔美国男性和白种男性中存在差异。

The association between serological and dietary vitamin D levels and hepatitis C-related liver disease risk differs in African American and white males.

机构信息

Clinical Epidemiology and Outcomes Program, Houston VA, Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.

出版信息

Aliment Pharmacol Ther. 2013 Jul;38(1):28-37. doi: 10.1111/apt.12341. Epub 2013 May 26.

Abstract

BACKGROUND

Vitamin D may affect the severity of HCV-related liver disease.

AIM

To examine the association between serum vitamin D levels and advanced liver disease in a multiethnic US cohort of HCV patients, and account for dietary and supplemental intake.

METHODS

We measured serum 25-hydroxyvitamin D levels and used FibroSURE-ActiTest to assess hepatic pathology in a cohort of HCV-infected male veterans. We estimated and adjusted for daily intake of vitamin D from diet using a Dietary History Questionnaire, and dispensed prescriptions prior to study enrolment. We used race-stratified logistic regression analyses to evaluate the relationship between serum vitamin D levels and risk of advanced fibrosis (F3/F4-F4) and advanced inflammation (A2/A3-A3).

RESULTS

A total of 163 African American (AA) and 126 White non-Hispanics were studied. Overall, ~44% of AAs and 15% of Whites were vitamin D deficient (<12 ng/mL) or insufficient (12-19 ng/mL); 4% of AAs and 9% of White patients had an elevated level (>50 ng/mL). Among AAs, patients with elevated serum vitamin D levels had significantly higher odds of advanced fibrosis (OR = 12.91, P = 0.03) than those with normal levels. In contrast, AAs with insufficient or deficient levels had > two-fold excess risk of advanced inflammation (P = 0.06). Among White males there was no association between vitamin D levels and advanced fibrosis (F3/F4-F4) or inflammation (A2/A3-A3) risk.

CONCLUSIONS

We observed potential differences in the association between vitamin D levels and degree of HCV-related hepatic fibrosis between White and African American males. Additional research is necessary to confirm that high serum vitamin D levels may be associated with advanced fibrosis risk in African American males, and to evaluate whether racial differences exist in HCV-infected females.

摘要

背景

维生素 D 可能会影响 HCV 相关肝病的严重程度。

目的

在一个多民族的美国 HCV 患者队列中,检查血清维生素 D 水平与晚期肝病之间的关系,并考虑饮食和补充摄入。

方法

我们测量了 HCV 感染男性退伍军人队列的血清 25-羟维生素 D 水平,并使用 FibroSURE-ActiTest 评估肝病理。我们使用膳食历史问卷估计并调整了维生素 D 的每日饮食摄入量,并在研究入组前开具了处方。我们使用种族分层的逻辑回归分析来评估血清维生素 D 水平与晚期纤维化 (F3/F4-F4) 和晚期炎症 (A2/A3-A3) 风险之间的关系。

结果

共研究了 163 名非裔美国人 (AA) 和 126 名白人非西班牙裔。总体而言,约 44%的 AA 和 15%的白人维生素 D 缺乏 (<12ng/mL) 或不足 (12-19ng/mL);4%的 AA 和 9%的白人患者维生素 D 水平升高 (>50ng/mL)。在 AA 中,血清维生素 D 水平升高的患者发生晚期纤维化的几率明显高于正常水平 (OR=12.91,P=0.03)。相比之下,维生素 D 水平不足或缺乏的 AA 患者发生晚期炎症的风险高出两倍以上 (P=0.06)。在白人男性中,维生素 D 水平与 HCV 相关肝纤维化 (F3/F4-F4) 或炎症 (A2/A3-A3) 风险之间没有关联。

结论

我们观察到维生素 D 水平与 HCV 相关肝纤维化程度之间的关联在白人和非裔美国男性之间存在潜在差异。需要进一步研究以确认高血清维生素 D 水平可能与非裔美国男性的晚期纤维化风险相关,并评估 HCV 感染女性是否存在种族差异。

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Prevalence of vitamin D deficiency in chronic liver disease.慢性肝病患者中维生素 D 缺乏症的流行情况。
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