Theoretical Study Of The Levels And Therapeutic Effects Of Two Vitamins In Patients With Chronic Liver Disease And Molecular Mechanism

The clinical therapy of liver disease has been a problem in the medical profession. For the patients, protecting hepatic cell from oxidation damage and repairing the impaired cells is a method to getting the better treatment. Because of the importance role of vitamin D and vitamin E in the immune system and antioxidation, whether vitamin D and vitamin E could be used in the treatment of liver disease have aroused more and more social attention. In this paper, we study the theory of the levels and therapeutic effects of vitamin D and vitamin E in patients with chronic liver diseases and the molecular mechanism. The key findings are as follow:(1) Many studies have reported an association between vitamin D and liver disease. Our purpose is to summarize the available information and evaluate the risk of liver disease associated with vitamin D. We searched all publications in English language on the association of vitamin D and liver disease risk and was performed the pooled analysis by STATA. In total,12 articles from 959 articles were included in the Meta-analysis.The results from the Meta-analysis support the patients of Chronic Hepatitis C (SMD=-1.08, 95%CI=[-1.34,-0.82]), Non-alcoholic fatty liver disease (SMD=-0.51,95%CI= [-0.73,-0.29]) and cirrhosis (SMD=-1.25,95%CI=[-1.52,-0.98]) have lower vitamin D levels than the healthy control. In order to find the relationship between vitamin D and the liver pathological changes, we make a further study between cirrhosis and chronic liver disease. The results show the cirrhotic have lower vitamin D levels than the noncirrhotic (SMD= 0.95,95%CI=[0.72,1.18]). So we suggest vitamin D insufficient is common in the most patients with CHC, NAFLD and cirrhosis, especially in the cirrhotic.(2) There are many reasons for the patients of liver disease with low level of vitamin D. In addition to the damaged hepatocyte leading to impaired vitamin D metabolism, the polymorphism of cytochrome p450 is another important reason. In this paper, we select rs10741657, rs12794714 from the cytochrome p4502R1, the data including the number of homozygous and homozygous for risk allele, and vitamin D concentrations in the two groups. The results show that, in rs 12794714, more people have the genotypes for non-risk allele than the homozygous for risk allele and people with non-risk allele have higher vitamin D concentrations than the homozygous for risk allele. Therefore, in the patients of liver disease, rs 12794714 mutations have an effect on the metabolism of vitamin D.(3) In view of the vital role of oxidative stress in the pathogenesis of liver disease, the potential of vitamin E supplements to prevent the progress of liver disease have gained much interest, while there are conflicting results on this topic in recent years. The purpose of the present study is to comprehensively evaluate the therapeutic effect of vitamin E supplementation in the liver disease. We searched all publications in Pubmed from inception to March,2013 in this analysis. In total,12 articles from 611 articles were included in the Meta-analysis. According to the results,supplementation with vitamin E makes a beneficial effect of decreasing alanine aminotransferase levels in the treatment of NAFLD (SMD=1.01,95%CI=[0.40,1.62]), NASH (SMD=4.04,95%CI=[1.76, 6.33]) and CHC (SMD=0.73,95%CI=[0.34,1.12]). This finding supports vitamin E supplementation can make a lower level of aminotransferase which means vitamin E supplementation made a positive role in chronic liver disease treatment.The research results show that the concentrations of vitamin D in the patients with chronic liver disease is lower than the healthy people, and vitamin E supplements make an effectively reduction the concentration of aminotransferase. These findings provide an important clue to the theory of vitamin D and vitamin E deficiency in the pathogenesis of liver disease.