EASL2015:补充维生素D对肝脏硬度的影响

StephenW

P0507
EFFECTS OF VITAMIN D SUPPLEMENTATION ON LIVER STIFFNESS
IN PATIENTS WITH CHRONIC LIVER DISEASES
A. K¨ onig1, C.S. Stokes1, M. Krawczyk1, F. Lammert1, F. Gr ¨ unhage1.
1Medical Department II, Saarland University Hospital, Homburg,
Homburg, Germany
E-mail: [email protected]
Background and Aims: Vitamin D deficiency is common in
patients with chronic liver diseases (CLD) and unfavorable genetic
polymorphisms of genes controlling vitamin D metabolism have
been associated with increased liver stiffness in patients with CLD
(Gr ¨ unhage et al. Hepatology 2012; 56: 1883–91). No data on the
effect of vitamin D supplementation on liver stiffness is available.
Our aim was to analyse patients with CLD with respect to vitamin D
and liver phenotypes.
Methods: Patients were randomly retrieved in our hospital
data management system and included if they fulfilled the
characteristics of at least one of the following groups. Group 1
consists of patients with vitamin D deficiency (<20 ng/ml) who
received vitamin D supplements; group 2 was defined as patients
with deficiency who did not receive any supplementation,
and group 3 comprised patients without vitamin D deficiency
(vitamin D levels >20 ng/ml). Patient characteristics such as age,
gender, etiology of liver disease as well as baseline parameters (liver
stiffness, AST, ALT, GGT) and follow-up parameters were analysed
in pairwise comparisons.
Results: We included 100 patients in groups 1 and 2 but we were
only able to identify 33 patients with CLD who presented with
normal vitamin D levels without supplementation, reflecting the
increased incidence of vitamin D deficiency in this population.
In all three groups, patients with chronic hepatitis C virus
infection represented the largest subgroup (41%, 55%, 64%). The
supplementation of vitamin D for at least 6 months resulted in
a significant rise of vitamin D levels in group 1 (10.6±5.2 vs
32.9±14.8). Interestingly, these patients also presented with
a significant decrease in median liver stiffness (16.0±19.9 kPa
vs. 12.9±11.7 kPa; P = 0.02), while no significant changes were
detected in pairwise comparisons in groups 2 and 3 (both
P > 0.05). Interestingly, ALT declined significantly in patients with
supplementation (66±74 U/L vs. 49±41 U/L, P = 0.01), but also in
patients of group 2 (67±80 U/L vs. 49±49 U/L; P = 0.03) but patients
without vitamin D deficiency and without supplementation showed
no change (P > 0.05).
Conclusions: Our data indicate that vitamin D supplementation
might have an influence on liver stiffness in patients with CLD
independent from improvement of liver function tests, consistent
with our findings in preclinical models (Hochrath et al. 2014).
Prospective trials are mandatory to assess the therapeutic potential
of vitamin D in patients with chronic liver diseases.

StephenW

P0507
补充维生素D对肝脏硬度的影响
在慢性肝病患者
A.K。onig1，CS Stokes1，M. Krawczyk1，F. Lammert1，F.的Gr¨unhage1。
1医药二部，萨尔州大学医院，洪堡，
洪堡，德国
电子邮件：[email protected]
背景和目的：维生素D缺乏症是常见的
患有慢性肝病（CLD）和不利的遗传
基因多态性控制维生素D代谢有
已与增加肝脏硬度患者CLD相关
（GR¨unhage等肝病2012; 56：1883年至1891年）。在无数据
可用补充维生素D对肝脏硬度的效果。
我们的目的是分析患者的CLD相对于维生素D
和肝的表型。
方法：将患者随机在我院检索
数据管理系统，其中包括他们是否履行了
下列基团中的至少一个的特征。第1组
由患者的维生素D缺乏症（<20毫微克/毫升）谁
服用维生素D补充剂;组2被定义为患者
有补中益气，谁没有收到任何的补充，
第3组由患者无维生素D缺乏症
（维生素D水平> 20纳克/毫升）。患者特征，如年龄，
性别，肝脏疾病的病因以及基线参数（肝
刚度，AST，ALT，GGT）和后续参数进行了分析
在两两比较。
结果：纳入100例患者中组1和2，但我们
只能够识别33例CLD谁提出用
正常的维生素D水平没有补充，反映
在这个人口增长，维生素D缺乏症的发病率。
在所有三组中，患者患有慢性丙型肝炎病毒
感染表示的最大的亚组（41％，55％，64％）。该
补充为至少6个月的维生素D导致
在第1组（10.6±5.2 VS一个显著上升的维生素D水平
32.9±14.8）。有趣的是，这些患者还呈现
中位数肝脏硬度一个显著下降（16.0±19.9千帕
与12.9±11.7千帕; P = 0.02），而没有显著变化是
在成对比较中检测到组2和3（均
P> 0.05）。有趣的是，ALT显著患者拒绝
补充（66±74 U / L比49±41 U / L，P = 0.01），而且在
但患者;第2组（P = 0.03±67 80 U / L比49±49 U / L）的病人
不含维生素D缺乏和不补充显示
没有变化（P> 0.05）。
结论：我们的数据表明补充维生素D
可能有患者CLD的肝脏硬度的影响
独立于改善肝功能试验的，一致的
我们在临床前模型结果（Hochrath等，2014年）。
前瞻性研究是强制性的，以评估治疗潜力
的慢性肝脏疾病的维生素D。