单位：[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory on Translational Medicine on Cirrhosis, National Clinical Research Center for Digestive Diseases, Beijing,临床科室国家中心肝病分中心首都医科大学附属北京友谊医院[2]Tianjin Institute of Hepatology, Tianjin Second People’s Hospital, Tianjin,[3]Clinical Laboratory, the Second Hospital of Dalian Medical University, Dalian, Liaoning,[4]International School, Capital Medical University, Beijing, People’s Republic of China,[5]Department of Biochemistry & Molecular Biology, University of Texas Medical School, Houston, TX.
Vitamin D deficiency is common in patients with chronic liver diseases. However, vitamin D status in persons with chronic hepatitis B virus (HBV) infection is not consistently reported. Specifically, the impact of liver dysfunction on vitamin D status has not been well addressed. We recruited a group of patients (n = 345) with chronic hepatitis B (n = 115), hepatitis B related cirrhosis (n = 115), and age-and gender-matched healthy controls (n = 115). Serum 25-hydroxyvitamin D3 [25(OH)D3], its related metabolic enzymes, intact parathyroid hormone were measured. Calcium, magnesium, and phosphorus were obtained from medical record. Serum 25(OH)D3 levels in chronic hepatitis B patients (7.83 +/- 3.47ng/mL) were significantly lower than that in healthy controls (9.76 +/- 4.36 ng/mL, P < 0.001), but significantly higher than that in hepatitis B-related cirrhotic patients (5.21 +/- 3.67ng/mL, P < 0.001). Furthermore, 25(OH)D3 decreased stepwise with higher Child-Pugh classification. However, there were no significant differences in 25(OH)D3 levels between (1) hepatitis B e antigen (HBeAg +) and HBeAg(-) persons, or (2) among persons with different HBV viral load, or (3) between treatment naive and patients on antiviral therapy. Multiple logistic regression analyses confirmed that higher Child-Pugh score was independently associated with 25(OH)D3 deficiency (< 10ng/mL) with an odds ratio of 1.20 (confidence interval 1.03-1.39, P = 0.016). Levels of cytochrome P450 (CYP) 27A1 were significantly decreased, whereas levels of CYP24A1 were significantly elevated in cirrhotic patients. These results suggest that decreasing vitamin D levels are likely to be a result, rather than a cause, of liver dysfunction and irrespective of HBV viral load. Reduction in 25(OH)D3 levels is possibly due to downregulation of the synthetic hydroxylase CYP27A1 and concurrent upregulation of degrading CYP24A1 in patients with liver cirrhosis.
基金：
Beijing Nova programBeijing Municipal Science & Technology Commission [200945]; Beijing Health System Talents Plan [2013-3-069]; Beijing Municipal Science and Technology CommissionBeijing Municipal Science & Technology Commission [Z09050700940902, D121100003912003]; Program for National Science and Technology Major Project [2013ZX10002004]
第一作者单位：[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory on Translational Medicine on Cirrhosis, National Clinical Research Center for Digestive Diseases, Beijing,
共同第一作者：
通讯作者：
通讯机构：[1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory on Translational Medicine on Cirrhosis, National Clinical Research Center for Digestive Diseases, Beijing,[*1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong-An Road, Xicheng District, Beijing 100050, People’s Republic of China
推荐引用方式(GB/T 7714)：
Zhao Xinyan,Li Jia,Wang Jinghan,et al.Vitamin D serum level is associated with Child-Pugh score and metabolic enzyme imbalances, but not viral load in chronic hepatitis B patients[J].MEDICINE.2016,95(27):doi:10.1097/MD.0000000000003926.
APA：
Zhao, Xinyan,Li, Jia,Wang, Jinghan,Habib, Sohail,Wei, Wei...&Jia, Jidong.(2016).Vitamin D serum level is associated with Child-Pugh score and metabolic enzyme imbalances, but not viral load in chronic hepatitis B patients.MEDICINE,95,(27)
MLA：
Zhao, Xinyan,et al."Vitamin D serum level is associated with Child-Pugh score and metabolic enzyme imbalances, but not viral load in chronic hepatitis B patients".MEDICINE 95..27(2016)
