Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University.
Department of Infectious Diseases, Hospital of Traditional Chinese Medicine of Yuyang District.
J Nutr Sci Vitaminol (Tokyo). 2022;68(1):16-22. doi: 10.3177/jnsv.68.16.
Vitamin D deficiency is common in chronic liver diseases, it may increase the severity of the diseases. However, studies on the potential role of vitamin D in hepatitis B virus (HBV) related end stage liver disease are still limited. This study was performed to assess the prevalence of vitamin D deficiency in patients with different stages of chronic HBV infection and explore whether vitamin D deficiency can be established as an index of severity and prognosticator of disease progression. Serum 25(OH)D levels were measured in a cohort of 363 patients with chronic HBV infection. Biochemical parameters, the alpha fetoprotein level, HBV DNA load, hepatitis B surface antigen level, and hepatitis B early antigen level were tested. The mean 25(OH)D level was significantly lower in patients with chronic HBV-related liver disease than in healthy controls. Overall, 74.9% of patients had 25(OH)D deficiency. The 25(OH)D level was significantly positively correlated with the albumin level. In total, 77.6% (121/156) of patients with cirrhosis had vitamin D deficiency. The 25(OH)D level significantly decreased as the Child-Pugh classification increased in severity. The 25(OH)D level was negatively correlated with the model for end-stage liver disease (MELD) score and low 25(OH)D concentrations were significantly associated with high MELD score and mortality in patients with liver failure. Vitamin D deficiency is prevalent in patients with chronic HBV infection. Severe vitamin D deficiency is strongly related to liver dysfunction and disease severity in the cirrhosis and liver failure patients.
维生素 D 缺乏在慢性肝病中很常见，它可能会加重疾病的严重程度。然而，关于维生素 D 在乙型肝炎病毒（HBV）相关终末期肝病中的潜在作用的研究仍然有限。本研究旨在评估不同阶段慢性 HBV 感染患者中维生素 D 缺乏的患病率，并探讨维生素 D 缺乏是否可以作为疾病严重程度和疾病进展预测指标。在 363 例慢性 HBV 感染患者的队列中测量了血清 25(OH)D 水平。检测了生化参数、甲胎蛋白水平、HBV DNA 载量、乙型肝炎表面抗原水平和乙型肝炎早期抗原水平。与健康对照组相比，慢性 HBV 相关肝病患者的平均 25(OH)D 水平明显较低。总体而言，74.9%的患者存在 25(OH)D 缺乏。25(OH)D 水平与白蛋白水平呈显著正相关。在总共 156 例肝硬化患者中，77.6%（121/156）存在维生素 D 缺乏。25(OH)D 水平随着 Child-Pugh 分级的严重程度而显著降低。25(OH)D 水平与终末期肝病模型（MELD）评分呈负相关，低 25(OH)D 浓度与肝衰竭患者的高 MELD 评分和死亡率显著相关。维生素 D 缺乏在慢性 HBV 感染患者中很常见。严重的维生素 D 缺乏与肝硬化和肝衰竭患者的肝功能障碍和疾病严重程度密切相关。
