Serum vitamin d levels in Nigerian patients with chronic hepatitis B- related liver disease
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Tóm tắt
Background: Vitamin D refers to a group of seco
steroid compounds and synthesized predominantly in
the liver. Liver function is crucial for physiologic
vitamin D metabolism. Vitamin D itself is considered
inactive and is hydroxylated to 25-hydroxyvitamin D
{25(OH)D3 } in the liver and is the main circulating
vitamin D. Low 25(OH)D3 levels may indicate
reduced liver function and might contribute to liver
damage possibly mediated by increased inflammation
and fibrosis as well as reduced antiviral response. It
has been demonstrated that replication of hepatitis B
virus is high in chronic hepatitis B infection when the
serum level of vit D is low.
Objective: This study was aimed at assessing the
level of serum vitamin D in patients with HBV-related
chronic liver disease (CLD) compared with healthy
controls.
Methods: This was a cross-sectional comparative
study involving consenting patients with HBV-related
CLD and age and sex-matched healthy controls.
25(OH)D3 was analyzed in the sera of both groups
using electrochemiluminis centimmunometric method
with Roche Cobas e411 chemistry analyzer. CHB
was diagnosed with serum positive hepatitis B surface
antigen (HBsAg) of < 6 months duration or the
presence of immunoglobulin G (IgG) core antibody
(HBcAb) and HBsAg sero-positivity in the absence
of immunoglobulin M against Hepatitis B Core
antigen (IgM-anti-HBc) and the antibody to the
HBsAg (anti-HBs). Liver cirrhosis was diagnosed
using abdominal ultrasound while diagnosis of HCC
was made using abdominal ultrasound, alpha feto
protein (AFP), triphasic abdominal computer
tomography (CT) scan and liver biopsy where
necessary. Data obtained were entered into SPSS
(version 20) and analyzed using inferential and
descriptive statistics.
Results: The groups consisted of 96 patients with
CHB-related liver diseases and 96 controls. The
CHB-related CLD group was comprised of
uncomplicated CHB (30), liver cirrhosis (30) and
hepatocellular carcinoma (36). Controls were healthy
blood donors. Seventy-three (76%) of the CHB
related liver disease group had low levels of serum
25(OH)D3 while only 22 (22.9%) of the controls had
low serum vitamin D levels. Among the HBV-related
CLD group, 11 (36.7%) of the CHB, 30 (100%) of
the liver cirrhosis (LC), and 32 (88.9%) of the
hepatocellular carcinoma (HCC) patients had low
serum vitamin D levels. The mean serum level of
25(OH)D3 among the control group was
25.77±8.59ng/ml, and that among the CLD groups
that was 13.11±10.54ng/ml (P<0.001) {95% CI
(9.919-15.393)}. The mean serum vitamin D values
of: CHB, Cirrhosis and HCC were 21.53±4.88ng/
ml, 8.13±3.16ng/ml and 10.25±13.53ng/ml,
respectively. However, there was no statistically
significant difference found between the mean serum
vitamin D levels of LC and HCC patients (P
value=0.058).
Conclusion: Serum vitamin D level is significantly
low in Nigerian patients with HBV-related CLD
compared with normal controls, and the degree of
deficiency is directly related to the stage of disease
progression.
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