Low vitamin D serum concentration is associated with high levels of hepatitis B

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https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.26488#references-section

Abstract

Vitamin D is an important immune modulator that plays an emerging role in inflammatory and metabolic liver diseases, including infection with hepatitis C virus (HCV). In contrast, the relationship between vitamin D metabolism and chronic hepatitis B (CHB) is less well characterized. Therefore, we quantified 25(OH)D3 serum levels in a cohort of 203 treatment‐naïve patients with chronic hepatitis B virus (HBV) infection and tested for their association with clinical parameters of CHB. Of 203 patients, 69 (34%), 95 (47%), and 39 (19%) had severe vitamin D deficiency (25(OH)D3 <10 ng/mL), vitamin D insufficiency (25(OH)D3 ≥10 and <20 ng/mL), or adequate vitamin D serum levels (25(OH)D3 ≥20 ng/mL), respectively. In both uni‐ and multivariate analyses, HBV DNA viral load (log10 IU/mL) was a strong predictor of low 25(OH)D3 serum levels (P = 0.0007 and P = 0.000048, respectively) and vice versa. Mean 25(OH)D3 serum concentrations in patients with HBV DNA <2,000 versus ≥2,000 IU/mL were 17 versus 11 ng/mL, respectively (P < 0.00001). In addition, hepatitis B early antigen (HBeAg)‐positive patients had lower 25(OH)D3 serum levels than HBeAg‐negative patients (P = 0.0013). Finally, 25(OH)D3 and HBV DNA serum levels showed inverse seasonal fluctuations. Conclusion: Low 25(OH)D3 serum levels are associated with high levels of HBV replication in patients with CHB. This represents a major difference from chronic hepatitis C, where numerous previous studies have shown a lack of correlation between HCV viral load and vitamin D serum levels. Inverse seasonal fluctuations of 25(OH)D3 and HBV DNA serum levels are suggestive of a functional relationship between both variables. (Hepatology 2013;58:1270–1276)

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维生素D是一种重要的免疫调节剂，在包括丙型肝炎病毒（HCV）在内的炎症和代谢性肝病中起着新兴的作用。相反，维生素D代谢与慢性乙型肝炎（CHB）之间的关系不太清楚。因此，我们对203名未接受过治疗的慢性乙型肝炎病毒（HBV）感染患者的队列中的25（OH）D 3血清水平进行了定量，并测试了它们与CHB临床参数的相关性。在203位患者中，有69位（34％），95位（47％）和39位（19％）患有严重的维生素D缺乏症（25（OH）D 3 <10 ng / mL），维生素D 缺乏症（25（OH）D 3 ≥10和<20毫微克/毫升），或适当的维生素d血清水平（25（OH）d 3≥20 ng / mL）。在单变量和多变量分析中，HBV DNA病毒载量（log 10 IU / mL）是低25（OH）D 3血清水平的有力预测指标（分别为P  = 0.0007和P  = 0.000048），反之亦然。HBV DNA <2,000 vs≥2,000IU / mL的患者的平均25（OH）D 3血清浓度分别为17 vs 11 ng / mL（P  <0.00001）。此外，乙型肝炎早期抗原（HBeAg）阳性患者的血清25（OH）D 3含量低于HBeAg阴性患者（P  = 0.0013）。最后，25（OH）D 3和HBV DNA血清水平显示反季节波动。结论：CHB患者中低25（OH）D 3血清水平与高水平HBV复制有关。这代表了与慢性丙型肝炎的主要区别，慢性丙型肝炎以前的许多研究表明，HCV病毒载量与维生素D血清水平之间缺乏相关性。25（OH）D 3和HBV DNA血清水平的反季节波动表明这两个变量之间存在功能关系。（肝病学 2013； 58：1270-1276）

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原文中有图，春季夏季体内维生素D浓度高，HBV DNA低，秋季冬季体内维生素D浓度高，HBV DNA高。

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