维生素D缺乏与酒精使用障碍中的晚期肝纤维化及空腹血糖受损有关。

Vitamin D Deficiency Is Associated with Advanced Liver Fibrosis and Impaired Fasting Glucose in Alcohol Use Disorder.

作者信息

Zuluaga Paola, Casado-Carbajo Julia, Hernández-Rubio Anna, Bueno-Vélez Marvin, García-Martin Carmen, Muga Robert, Fuster Daniel

机构信息

Addiction Unit, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain.

Department of Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain.

出版信息

Nutrients. 2024 Apr 9;16(8):1099. doi: 10.3390/nu16081099.

DOI:10.3390/nu16081099

PMID:38674789

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11054091/

Abstract

BACKGROUND

Vitamin D deficiency is a risk factor for liver disease, insulin resistance, and beta cell dysfunction. Individuals with alcohol use disorder (AUD) have many comorbidities, with a heavy burden of liver disease and metabolic complications, including type 2 diabetes mellitus (T2DM).

OBJECTIVE

We aimed to analyze the prevalence and associations of vitamin D deficiency in patients admitted for in-hospital treatment of AUD.

METHODS

A cross-sectional study was conducted in patients consecutively admitted for the treatment of AUD between January 2017 and October 2023. Sociodemographic data, substance use characteristics, and blood parameters were available at admission. Vitamin D status was assessed through the serum concentrations of 25-hydroxyvitamin D [25(OH)D] levels using a direct competitive chemiluminescent immunoassay method. Deficiency of vitamin D was defined as a concentration less than 20 ng/mL; impaired fasting glucose (IFG) was defined by fasting blood glucose >100 mg/dL (5.6 mmol/L), and advanced liver fibrosis by an FIB-4 index >3.25.

RESULTS

Two hundred and forty-three patients were included (75% male) with a mean age of 49 ± 10 years, mean BMI of 26.4 ± 7.3, mean alcohol consumption of 163 ± 81 g/day, and a mean duration of AUD of 18.1 ± 11.2 years. Mean 25(OH)D, fasting blood glucose, AST, ALT, and platelets were 14.4 ± 10.2 ng/mL, 103.4 ± 40.9 mg/dL, 55.1 ± 75.8 U/L, 44.8 ± 76.6 U/L, and 206.3 ± 84.8 × 10/L, respectively. The prevalence of vitamin D deficiency was 80.6%, and 41.1% of patients had levels less than 10 ng/mL. IFG was present in 32.3% of patients, and 20.5% had FIB-4 values >3.25. In the multivariable analysis, IFG (OR, 2.51; 95% CI: 1.02-6.17, = 0.04) and advanced liver fibrosis (OR, 4.27; 95% CI: 1.21-15.0, = 0.02) were the only factors associated with vitamin D deficiency.

CONCLUSIONS

Vitamin D deficiency was very prevalent in this series of patients with AUD and was associated with impaired fasting glucose and advanced liver fibrosis.

摘要

背景

维生素D缺乏是肝脏疾病、胰岛素抵抗和β细胞功能障碍的危险因素。酒精使用障碍（AUD）患者有许多合并症，肝脏疾病和代谢并发症负担沉重，包括2型糖尿病（T2DM）。

目的

我们旨在分析因AUD住院治疗的患者中维生素D缺乏的患病率及其相关性。

方法

对2017年1月至2023年10月期间连续收治的AUD患者进行了一项横断面研究。入院时可获得社会人口学数据、物质使用特征和血液参数。采用直接竞争化学发光免疫分析法通过血清25-羟基维生素D[25(OH)D]水平评估维生素D状态。维生素D缺乏定义为浓度低于20 ng/mL；空腹血糖受损（IFG）定义为空腹血糖>100 mg/dL（5.6 mmol/L），肝纤维化进展定义为FIB-4指数>3.25。

结果

纳入243例患者（75%为男性），平均年龄49±10岁，平均BMI为26.4±7.3，平均酒精摄入量为163±81 g/天，平均AUD病程为18.1±11.2年。平均25(OH)D、空腹血糖、AST、ALT和血小板分别为14.4±10.2 ng/mL、103.4±40.9 mg/dL、55.1±75.8 U/L、44.8±76.6 U/L和206.3±84.8×10/L。维生素D缺乏的患病率为80.6%，41.1%的患者水平低于10 ng/mL。32.3%的患者存在IFG，20.5%的患者FIB-4值>3.25。在多变量分析中，IFG（OR，2.51；95%CI：1.02-6.17，P = 0.04）和肝纤维化进展（OR，4.27；95%CI：1.21-15.0，P = 0.02）是与维生素D缺乏相关的唯一因素。