Abstract :
Background & Aims: Vitamin D is an important immune modulator and it potentially interferes with fibrogenesis. Previous data indicated an association between vitamin D deficiency, fibrotic stage and sustained
virologic response rates in chronic viral hepatitis C (CHC). The aim of this study was to determine the relationship between vitamin D deficiency and the fibrotic stage in chronic hepatitis B (CHB) and CHC.
Methods: A cross-sectional study was conducted in CHB and CHC patients who underwent liver biopsy at Ramathibodi hospital between January 2011 and January 2012. For each patient, biochemical tests, 25-hydroxyvitamin D (25[OH]D) level and liver biopsy were performed. The histological staging of liver biopsy (by Metavir scoring system) were obtained to determine the association between vitamin D deficiency and the fibrotic stage in patients with CHB and CHC.
Results: Eighty-one patients were enrolled. Forty-eight and thirty-three patients had CHB and CHC,respectively. Mean vitamin D levels in CHB and CHC were 21.07 ± 6.47 ng/mL and 24.15 ± 9.15 ng/mL, which were strikingly lower than the level reported from the study in healthy Thai population (32.29 ± 0.4 ng/mL). Twenty-three (48%) and eleven (33%) of CHB and CHC patients were found to have vitamin D deficiency. The 25(OH)D deficiency tended to correlate with advance fibrosis stage (37.5%, 40%, and 52.1% in metavir fibrosis score F0-1, F2, F3-4 respectively, p = 0.529). From forward stepwise logistic regression, vitamin D deficiency tended to be associated with significant fibrosis (= F2 fibrosis stage) of CHB and CHC (odds ratio [OR], 1.11; 95% confidence interval [CI], 0.379-3.250; p = 0.847) and severe fibrosis (= F3-4 fibrosis stage) of chronic hepatitis B and C (OR, 1.81; 95% CI, 0.613-5.391; p = 0.281)
Conclusions: Vitamin D deficiency is highly prevalent in patients with CHB and CHC. The 25(OH)D serum levels deficiency have a trend for correlation with advance fibrosis stage.
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file/Thai-Journal-of-gastroenterology-vol-13-no-3-1157412.pdf