在研究纳入时,77% 的患者显示血清维生素 A 降低。抑制维生素 A 在酒精性肝硬化(52% 对 8%)和 NASH 相关肝硬化(16% 对 9%)中比在病毒相关肝硬化中更常见。 MELD 评分和 Child-Pugh 评分与抑制维生素 A 显着相关(P < 0.001)。单变量和多变量回归分析证实了维生素 A 抑制程度与肝功能之间的关联。随访1年,57例死亡,21例接受肝移植。此外,在严重腹水(P = 0.001)、肝性脑病(P = 0.002)和肝肾综合征(P = 0.008)的患者中更常见的是低维生素A水平。此外,维生素A减少的患者感染发生率增加(P = 0.02),尤其是呼吸道感染(P = 0.04)。
结论:
抑制血清学维生素 A 在肝硬化患者中很常见,并且与肝功能有关。肝硬化和维生素 A 抑制患者的临床并发症和感染更为常见。作者: StephenW 时间: 2022-9-5 20:30
Suppressed serological vitamin A in patients with liver cirrhosis is associated with impaired liver function and clinical detoriation
Nagel, Michaela,b,c; Labenz, Christiana,b; Dobbermann, Henriked; Czauderna, Carolind; Wallscheid, Nina Cabezase; Schattenberg, Jörn M.a,b; Wörns, Marcus A.c; Galle, Peter R.a,b; Marquardt, Jens U.d
Author Information
European Journal of Gastroenterology & Hepatology: October 2022 - Volume 34 - Issue 10 - p 1053-1059
doi: 10.1097/MEG.0000000000002418
Open
SDC
Abstract
Background
The liver is of critical importance for the homeostasis of metabolic and immunomodulatory properties as well as the storage of vitamins, especially vitamin A. In this prospective analysis, the incidence of serological vitamin A deficiency and the association with disease severity as well as clinical complications in patients with liver cirrhosis were investigated.
Method
From May 2017 to May 2018, 159 patients with primarily alcohol-associated and non-alcoholic steatohepatitis (NASH)-associated preexisting liver cirrhosis were prospectively enrolled and vitamin A status was collected. Clinical complications and infections were followed and recorded over a period of 1-year follow-up. Selected findings were validated in an independent cohort of 44 patients.
Results
At study inclusion, 77% of patients showed decreased serological vitamin A. Suppressed vitamin A was more common in alcoholic (52 vs. 8%) and NASH-associated liver cirrhosis (16 vs. 9%) than in viral-associated liver cirrhosis. MELD score as well as Child-Pugh score were significantly associated with suppressed vitamin A (P < 0.001). The association between the degree of vitamin A suppression and liver function was confirmed in univariate and multivariate regression analysis. After 1 year of follow-up, 57 patients died and 21 patients received a liver transplant. In addition, low vitamin A levels were more commonly observed in patients with severe ascites (P = 0.001), hepatic encephalopathy (P = 0.002) and hepatorenal syndromes (P = 0.008). In addition, patients with reduced vitamin A showed an increased incidence of infections (P = 0.02), especially respiratory infections (P = 0.04).
Conclusion:
Suppressed serological Vitamin A is common in patients with liver cirrhosis and is associated with liver function. Clinical complications and infections are more frequent in patients with liver cirrhosis and vitamin A suppression. 作者: StephenW 时间: 2022-9-5 20:30