Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Graduate Program in Gastroenterology and Hepatology Sciences.
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil Department of Genetics; Graduate Program in Genetics and Molecular Biology.
Ann Hepatol. 2017 Sep-Oct;16(5):742-748. doi: 10.5604/01.3001.0010.2748.
Vitamin D has been associated with chronic liver diseases and low vitamin levels may contribute to progression of chronic hepatitis C. The aim of this study was to evaluate the influence of vitamin D serum levels and GC gene polymorphisms in the severity of liver fibrosis in patients with chronic hepatitis C genotype 1.
Cross-sectional study that enrolled 132 adult patients with chronic hepatitis C genotype 1 attended at the outpatient Clinic of Gastroenterology Division at Hospital de Clínicas de Porto Alegre. At the time of enrollment patients had a blood withdraw for serum 25(OH)D determination and genotypic analysis of rs7041 and rs4588 polymorphisms in GC gene. None/mild fibrosis was considered as METAVIR F0, F1 and F2 and severe fibrosis as METAVIR F3 and F4.
Median 25(OH)D levels in the sample were 19.9 ng/mL (P25-P75: 14.0-29.4). Fifty percent of patients presented vitamin D deficiency (< 20 ng/mL). In stepwise multiple linear regression the variables associated with 25(OH)D levels were blood withdrawn in Winter/spring season, the haplotypes AT/AT + AG/AT of rs7041 and rs4588 and female sex. For evaluation of severe fibrosis, variables associated in logistic regression were age, vitamin D severe deficiency (< 10 ng/mL), glucose levels, BMI and platelets count.
Vitamin D levels are associated with severity of liver fibrosis in chronic hepatitis C genotype 1 patients. Although the rs7041 and rs4588 GC polymorphisms are strong predictors of vitamin D levels, they do not play a direct role in liver fibrosis.
维生素 D 与慢性肝脏疾病有关，维生素水平低可能导致慢性丙型肝炎的进展。本研究的目的是评估维生素 D 血清水平和 GC 基因多态性对慢性丙型肝炎 1 型患者肝纤维化严重程度的影响。
这是一项横断面研究，共纳入 132 例慢性丙型肝炎 1 型成年患者，他们在 Porto Alegre 临床医院消化内科门诊就诊。在入组时，患者抽取血液用于检测血清 25(OH)D 水平，并对 GC 基因 rs7041 和 rs4588 多态性进行基因分型。无/轻度纤维化定义为 METAVIR F0、F1 和 F2，严重纤维化定义为 METAVIR F3 和 F4。
样本中 25(OH)D 水平的中位数为 19.9ng/mL（P25-P75：14.0-29.4）。50%的患者存在维生素 D 缺乏症（<20ng/mL）。在逐步多元线性回归中，与 25(OH)D 水平相关的变量为冬季/春季采血、rs7041 和 rs4588 的 AT/AT+AG/AT 单倍型和女性。在评估严重纤维化方面，逻辑回归相关的变量为年龄、维生素 D 严重缺乏症（<10ng/mL）、血糖水平、BMI 和血小板计数。
维生素 D 水平与慢性丙型肝炎 1 型患者肝纤维化的严重程度相关。尽管 rs7041 和 rs4588 GC 多态性是维生素 D 水平的强预测因子，但它们在肝纤维化中不起直接作用。
