Gentile Ivan, Scarano Filomena, Celotti Anna, DE Iuliis Enrica, Scarano Rosanna, Granata Vincenza, Pinchera Biagio, Meola Mariangela, D'Ambra Antonietta, Piccirillo Mauro, DI Paola Flaviano, Cavalcanti Ernesta, Izzo Francesco, Scarpato Nicola, Borgia Guglielmo
Department of Clinical Medicine and Surgery - Section of Infectious Diseases, Federico II, University of Naples, Naples, Italy
Department of Clinical Medicine and Surgery - Section of Infectious Diseases, Federico II, University of Naples, Naples, Italy.
In Vivo. 2015 May-Jun;29(3):399-404.
BACKGROUND/AIM: Mixed Cryoglobulinemia (MC) represents the most frequent extrahepatic manifestation of chronic Hepatitis C Virus (HCV) infection. Its pathogenic mechanisms involve HCV-induced chronic stimulation of B-lymphocytes. We aimed to investigate the relationship between serum levels of vitamin D (a regulator of immune response) and the presence of serum cryoglobulins in the setting of HCV infection.
We evaluated the serum concentration of 25(OH)vitamin D and cryoglobulins in 106 patients with chronic HCV infection.
Thirty patients (28.3%) showed the presence of serum cryoglobulins. For the cohort overall, the median serum 25(OH)vitamin D level was 10.95 ng/ml. Patients with serum cryoglobulins had significantly lower levels of 25(OH)vitamin D (5.61 ng/ml) than those without (13.65 ng/ml, p=0.029). At multivariate analysis, severe hypovitaminosis [i.e. 25(OH)vitamin D <13 ng/ml] was the only independent predictor of cryoglobulinemia (odds ratio=3.108).
Severe deficiency of vitamin D was independently associated with mixed cryoglobulinemia in patients with HCV infection.
背景/目的：混合性冷球蛋白血症（MC）是慢性丙型肝炎病毒（HCV）感染最常见的肝外表现。其发病机制涉及HCV诱导的B淋巴细胞慢性刺激。我们旨在研究在HCV感染情况下血清维生素D水平（一种免疫反应调节剂）与血清冷球蛋白存在之间的关系。
我们评估了106例慢性HCV感染患者的血清25（OH）维生素D和冷球蛋白浓度。
30例患者（28.3%）血清中存在冷球蛋白。在整个队列中，血清25（OH）维生素D水平的中位数为10.95 ng/ml。有血清冷球蛋白的患者25（OH）维生素D水平（5.61 ng/ml）显著低于无血清冷球蛋白的患者（13.65 ng/ml，p=0.029）。在多变量分析中，严重维生素D缺乏[即25（OH）维生素D<13 ng/ml]是冷球蛋白血症的唯一独立预测因素（比值比=3.108）。
维生素D严重缺乏与HCV感染患者的混合性冷球蛋白血症独立相关。
