[Association between serum vitamin D level and immune imbalance in advanced schistosomiasis patients with liver fibrosis].

OBJECTIVE

To examine the relationship between serum vitamin D level and immune imbalance in advanced schistosomiasis patients with liver fibrosis.

METHODS

A total of 120 advanced schistosomiasis patients with liver fibrosis that were admitted to the Department of Schistosomiasis of The First Hospital of Jiaxing City from May 2016 to September 2018 were recruited as the observation group, and 50 healthy volunteers randomly sampled from the hospital during the same period served as the control group. The serum IgG antibody, IgA antibody, C3 complement, C4 complement, CD4 cell proportion, CD8 cell proportion, 25-hydroxyvitamin D [25(OH)D] levels were compared between the two groups. Liver fibrosis was classified into grade I, II and III according to the classification criteria of liver fibrosis by ultrasonography, and the serum IgG antibody, IgA antibody, C3 complement, C4 complement, CD4 proportion, CD8 proportion, 25(OH)D levels were compared among patients with grade I, II and III liver fibrosis. In addition, all patients were classified into the sufficient group, the insufficient group and the deficient group according to the serum vitamin D level, and the serum IgG antibody, IgA antibody, C3 complement, C4 complement, CD4 proportion, CD8 proportion, 25(OH)D levels were compared among these three groups. Moreover, the associations of the serum vitamin D level with these immune indicators were examined.

RESULTS

The 120 advanced schistosomiasis patients with liver fibrosis included 58 men and 62 women, and had a mean age of (72.00 ± 3.00) years. There were 32 cases with grade I liver fibrosis, 46 cases with grade II liver fibrosis, and 42 cases with grade III liver fibrosis. There were no significant differences between the observation group and the control group in terms of serum D-dimer, total cholesterol (TC), triglyceride (TG), C3 complement or C4 complement levels ( = 2.467, 0.322, 0.790, -2.432 and -2.630, all values > 0.05); however, there were significant differences seen in alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood calcium, blood phosphorus, IgG antibody, IgA antibody, CD4 proportion, CD8 proportion, and 25(OH)D levels ( = 5.130, 6.382, -1.341, 2.361, 8.708, 11.783, -2.995, -6.543 and -3.022, all values < 0.05). In addition, there were significant differences in AST, ALT, blood phosphorus, IgA antibody, C3 complement, CD8 cell proportion and 25(OH)D levels among patients with grades I, II and III liver fibrosis ( = 19.704, 16.254, 62.669, 49.347, 5.430, 5.434 and 5.783, all values < 0.05). There were significant differences in ALT, blood phosphorus, IgA antibody, CD8 cell proportion and 25(OH)D levels between patients with grades I and III liver fibrosis (all values < 0.05), and significant differences were seen between patients with grades II and III liver fibrosis in terms of blood phosphorus, IgA antibody and CD8 cell proportion (all values < 0.05), while there was a significant difference in the CD8 cell proportion between patients with grades I and II liver fibrosis ( < 0.05). Moreover, there were significant differences among the sufficient, insufficient and deficient groups in terms of IgG antibody, IgA antibody, C3 complement, CD4 cell proportion and CD8 cell proportion ( = 13.303, 59.623, 8.698, 9.969 and 12.805, all values < 0.05), and there was a significant difference in the CD8 cell proportion between the insufficient and deficient groups ( < 0.05). Pearson correlation analysis revealed that serum 25(OH)D level were negatively associated with IgG and IgA antibody levels ( = -0.754 and -0.773, both values < 0.05), and positively associated with C3 complement, CD4 cell proportion and CD8 cell proportion in advanced schistosomiasis patients with liver fibrosis ( = 0.827, 0.850 and 0.830, all values < 0.05).

CONCLUSIONS

Immune imbalance occurs in advanced schistosomiasis patients with liver fibrosis, and serum vitamin D level may correlate with immune imbalance in advanced schistosomiasis patients with liver fibrosis.