Clin Lab. 2022 Jul 1;68(7). doi: 10.7754/Clin.Lab.2021.211034.
Vitamin D deficiency is universal among patients with chronic liver disease. Vitamin D may be involved in the regulation of immune function of chronic hepatitis B and related to disease progression.
The study was a cross-sectional study. The level of vitamin 25(OH)D was detected in patients with chronic hepatitis B, hepatitis B cirrhosis, hepatitis B cancer, and healthy groups by isotope dilution liquid chromatography tandem mass spectrometry (LC-MS/MS). At the same time, the clinical data, biochemical indexes, and T lymphocyte subsets were collected to study the relationship between vitamin 25(OH)D deficiency and clinical indexes of hepatitis B patients.
The prevalence of vitamin D deficiency (< 20 ng/mL) was higher in patients with liver cancer group (96.97%, 10.59 ± 3.06 ng/mL) and cirrhosis group (93.18%, 11.85 ± 2.66 ng/mL) than in the healthy group (76.92%, 16.38 ± 5.53 ng/mL) and chronic hepatitis B group (77.83%, 15.06 ± 4.91 ng/mL). There were significant differences in vitamin 25(OH)D levels between the cirrhosis groups and the healthy groups, the liver cancer groups and the healthy groups, the hepatitis B cirrhosis groups and the chronic hepatitis B groups, the liver cancer groups and the chronic hepatitis B groups (p < 0.05). There was no significant difference in vitamin 25 (OH)D level between liver cancer group and hepatitis B cirrhosis group, healthy group and chronic hepatitis B group (p > 0.05). Vitamin 25(OH)D level was correlated with age (r = -0.24, p = 0.015), lymphocyte (r = 0.24, p = 0.015), hemoglobin (r = 0.28, p = 0.005), platelet (r = 0.27, p = 0.006), PTA (r = 0.33, p = 0.001), albumin (r = 0.30, p = 0.002), prealbumin (r = 0.39, p = 0.001), cholinesterase (r = 0.29, p = 0.003), CD3+ (r = 0.20, p = 0.04), CD3+ CD8+ (r = 0.20, p = 0.04), CD45+ (r = 0.24, p = 0.017), but none correlated with liver function and HBV-DNA.
Vitamin D deficiency existed in patients with hepatitis B, which was related to the clinical progress of hepatitis B and may be involved in the regulation of immune function in patients with chronic HBV infection.
慢性肝病患者普遍存在维生素 D 缺乏。维生素 D 可能参与慢性乙型肝炎的免疫功能调节，并与疾病进展有关。
本研究为横断面研究。采用同位素稀释液相色谱串联质谱法（LC-MS/MS）检测慢性乙型肝炎、乙型肝炎肝硬化、乙型肝炎肝癌和健康组患者的维生素 25（OH）D 水平。同时收集临床资料、生化指标和 T 淋巴细胞亚群，研究维生素 25（OH）D 缺乏与乙型肝炎患者临床指标的关系。
肝癌组（96.97%，10.59±3.06ng/mL）和肝硬化组（93.18%，11.85±2.66ng/mL）维生素 D 缺乏（<20ng/mL）的患病率高于健康组（76.92%，16.38±5.53ng/mL）和慢性乙型肝炎组（77.83%，15.06±4.91ng/mL）。肝硬化组与健康组、肝癌组与健康组、乙型肝炎肝硬化组与慢性乙型肝炎组、肝癌组与慢性乙型肝炎组间维生素 25（OH）D 水平差异均有统计学意义（p<0.05）。肝癌组与肝硬化组、健康组与慢性乙型肝炎组间维生素 25（OH）D 水平差异无统计学意义（p>0.05）。维生素 25（OH）D 水平与年龄（r=-0.24，p=0.015）、淋巴细胞（r=-0.24，p=0.015）、血红蛋白（r=-0.28，p=0.005）、血小板（r=-0.27，p=0.006）、PTA（r=-0.33，p=0.001）、白蛋白（r=-0.30，p=0.002）、前白蛋白（r=-0.39，p=0.001）、胆碱酯酶（r=-0.29，p=0.003）、CD3+（r=-0.20，p=0.04）、CD3+CD8+（r=-0.20，p=0.04）、CD45+（r=-0.24，p=0.017）呈负相关，与肝功能和 HBV-DNA 均无相关性。
乙型肝炎患者存在维生素 D 缺乏，与乙型肝炎的临床进展有关，可能参与慢性 HBV 感染患者的免疫功能调节。
