Buonomo Antonio Riccardo, Scotto Riccardo, Zappulo Emanuela, Nerilli Mariagiovanna, Pinchera Biagio, Perruolo Giuseppe, Formisano Pietro, Nappa Salvatore, Gentile Ivan
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. 2019 Jan-Feb;33(1):177-182. doi: 10.21873/invivo.11456.
The aim of this study was to investigate the association between vitamin D deficiency (<10 mg/ml) and mortality in patients with and without hepatocellular carcinoma (HCC) in a cohort of patients with liver cirrhosis.
A prospective study was conducted among 345 patients with liver cirrhosis.
At enrolment, 46 (13.3%) patients had HCC. Severe vitamin D deficiency was associated with mortality (p<0.01). At the survival analysis, alpha-fetoprotein >10 ng/ml (p=0.003), vitamin D deficiency (p<0.001), a Model for End-Stage Liver Disease score ≥15 (p<0.001), Child-Pugh class B and C (versus A) (p<0.001) and the presence of active HCC (p<0.001) were strongly associated with death. At the multivariate Cox regression analysis, only Child-Pugh class B and C (versus A) and vitamin D deficiency were found to be significantly associated with death during the follow-up period (p<0.001 and p=0.006, respectively).
Vitamin D deficiency is common in patients with HCC, it is associated with active HCC and it negatively affects the overall survival of patients with cirrhosis.
本研究旨在调查肝硬化患者队列中,维生素D缺乏(<10mg/ml)与有或无肝细胞癌(HCC)患者死亡率之间的关联。
对345例肝硬化患者进行了一项前瞻性研究。
入组时,46例(13.3%)患者患有HCC。严重维生素D缺乏与死亡率相关(p<0.01)。在生存分析中,甲胎蛋白>10ng/ml(p=0.003)、维生素D缺乏(p<0.001)、终末期肝病模型评分≥15(p<0.001)、Child-Pugh B级和C级(相对于A级)(p<0.001)以及活动性HCC的存在(p<0.001)与死亡密切相关。在多变量Cox回归分析中,仅发现Child-Pugh B级和C级(相对于A级)以及维生素D缺乏与随访期间的死亡显著相关(分别为p<0.001和p=0.006)。
维生素D缺乏在HCC患者中很常见,它与活动性HCC相关,并且对肝硬化患者的总体生存有负面影响。