AASLD 2011:Vitamin D Deficiency in Asian-American Patients with Chronic Hepatiti

StephenW

Vitamin D Deficiency in Asian-American Patients with Chronic Hepatitis B in New York Downtown Hospital
L. Mi1; L. A. Rincon-Bejarano1; R. Babbar1;E. K. Chiu1; M. Martell1; J. Karsdon2; M. G.Ghany 3
1. Medicine, New York Downtown Hospital, New York, NY, United States.
2. Pediatrics/Neonatology, New York Downtown Hospital,New York, NY, United States.
3. Liver Disease Branch/NIDDK, National Institutes of Health, Bethesda, MD, United States.

Background: Vitamin D production is related to liver function. Vitamin D levels have been shown to be associated with disease severity in a variety of liver conditions including autoimmune hepatitis and hepatitis C. Moreover, levels have been shown to improve following antiviral treatment in chronic hepatitis C. There have been limited reports on vitamin D levels in Asian patients with chronic hepatitis B (CHB).

Aims: to determine if 1) there is a difference in vitamin D levels and deficiency in Asian-American outpatients with and without CHB in a New York downtown area,and 2) whether antiviral treatment affects vitamin D levels.

Method: Of 118 outpatients attending New  York Downtown Hospital between November 4, 2010through May 30, 2011, 62 were Chinese-American patients, 25 of whom had CHB.Vitamin D3, ALT and HBV DNA levels were measured in all patients. Means were compared by Student t-test.

Results: See Table 1: Patients with CHB were significantly younger compared to those without CHB (58 vs 40 years). Among those with CHB, only 2 had cirrhosis and 10 were being treated with either entecavir (n=4) or tenofovir (n=6). There was no difference in the mean vitamin D level (ng/ml) between Asian patients with and without CHB (22.84+/-10.8 vs 23.27+/-9.27) (p=ns). Mean vitamin D levels were not significantly different in CHB patients on treatment (22.64) compared to those not on treatment (19.33) However, the rate of vitamin D deficiency (defined as a level <30mg/ml) was slightly higher in the CHB patients (40%) than in the non-CHB patients (32%) (p=ns).

Discussion: Unlike hepatitis C, Asian CHB patients without cirrhosis did notseem to have a significant higher rate of vitamin D deficiency compared tothose without CHB.

Table 1. Serum 25-OH vitamin D3 levels in Asian-American outpatients with orwithout CHB.

	Total	Non-CHB	CHB	P values
# of patients	62	37	25
Age (mean+/-sd)	50.8 +/- 18.5	58.16+/- 17.1	40.0+/- 15.4	0.0003
Vit D (ng/ml)   mean +/-sd	23.1+/- 9.82	23.27+/- 9.27	22.84+/- 12.8	0.8673
# of normal vit D (%)	13 (21%)	9 (24%)	4 (16%)	0.436
# of vit D insufficiency (%)	27 (44%)	16 (43%)	11 (44%)	0.938
# of vit D deficiency (%)	22 (35%)	12 (32)	10 (40%)	0.5228

StephenW

在纽约市中心医院的亚裔美国人与慢性乙型肝炎患者的维生素D缺乏
L. MI 1;洛杉矶吕康Bejarano1 R.巴巴尔1克朗Chiu1 M.马爹利1; J. Karsdon 2;爵Ghany 3
1。医药，纽约下城医院，纽约，纽约，美国。
2。儿科/新生儿科，纽约下城医院，纽约，纽约，美国。
3。肝病科/ NIDDK，美国马里兰州贝塞斯达国立卫生研究院。
  
背景：维生素D的生产是关系到肝功能。维生素D水平已被证明在各种肝脏疾病，包括自身免疫性肝炎和C型肝炎此外，与疾病的严重程度相关，水平已被证明改善慢性丙型肝炎的抗病毒治疗后，已经有维生素D的水平有限，报告在亚洲慢性乙型肝炎（CHB）患者。

目的：确定1）是维生素D水平，并在亚洲和美国的门诊病人缺乏的差异，并没有在纽约闹市区的慢性乙型肝炎，和2）抗病毒治疗是否会影响维生素D的水平。

方法：118之间，2010年11月4日至5月30日，2011年，62出席纽约市中心医院门诊病人美籍华裔患者，其中25例CHB。维生素D3，ALT和HBV DNA水平测定在所有患者。学生t检验方法进行了比较。

结果：见表1：与慢性乙型肝炎患者明显年轻化，比那些没有慢性乙型肝炎（58比40岁）。在慢性乙型肝炎中，只有2例肝硬化和10人正在与恩替卡韦（n = 4时）或泰诺福韦（N = 6）治疗。没有维生素D的平均水平（ng / ml的）慢性乙型肝炎（22.84 + / -10.8 VS 23.27 + / -9.27）（P = NS）与亚洲患者之间的差异。平均维生素D水平没有显著不同，在治疗慢性乙型肝炎患者（22.64），相比那些不治疗（19.33）但是，维生素D缺乏率（定义为一个水平<30mg/ml）在慢性乙型肝炎患者略高（40％）比非慢性乙型肝炎患者（32％）（P = NS）。

讨论：不同的C型肝炎，亚慢性乙型肝炎患者无肝硬化似乎并未有一个显著较高的维生素D缺乏率相比，那些没有慢性乙型肝炎。

表1。血清25 - 羟基维生素D3的水平，亚洲和美国的门诊病人慢性乙型肝炎带或不带。
                             共有                      非乙型肝炎               慢性乙型肝炎的             P值
患者                       62                         37                           25
年龄 (平均+ / - SD）50.8 + / - 18.5       58.16 + / - 17.1        40.0 + / - 15.4         0.0003
维生素D（纳克/毫升）
平均+ / - SD           23.1 + / - 9.82        23.27 + / - 9.27       22.84 + / - 12.8       0.8673
＃正常的维生素D（％）13（21％）        9（24％）               4（16％）                0.436
维生素D不足（％）      27（44％）       16（43％）             11（44％）                0.938
＃维生素D缺乏症（％）22（35％）       12（32）                10（40％）               0.5228