The Clinical Study On The Correlation Between The Serum Level Of Vitamin D And Chronic Liver Disease

ObjectiveThe classic role of vitamin D is to maintain the concentration of calcium and phosphate in plasma,which plays a vital role in bone growth and remodeling.In addition,other biological effects of vitamin D are also widely concerned.Related researchs have found that vitamin D deficiency has a higher incidence in chronic liver disease,and is correlated with sustained virological response,liver function classification,therapeutic effect and the healing.In this study,the serum level of 25-hydroxyvitamin D(25(OH)D)from patients with chronic liver disease were examined and its correlation with liver function classification was discussed.MethodsFrom June 1,2017 to November 30,2017,We collected cases from department of the gastroenterology and infectious medicine in Chaohu Affiliated Hospital of Anhui Medical University.Serum 25(OH)D level was detected in 100 patients with decompensated cirrhosis,100 patients with chronic hepatitis B and 100 healthy controls from physical examination center.The serum 25(OH)D level in the present study was measured by batched electrochemiluminescence.To explore the differences between 25(OH)D level in the three groups,the correlation among serum 25(OH)D level and child-pugh grading and MELD score in patients with cirrhosis was analyzed.Results(1)The level of 25(OH)D in the cirrhosis group was significantly lower than that in the control group and the chronic hepatitis B group(P<0.001).The proportion of 25(OH)D level in the cirrhotic group deficiency(<20 ng/ml),insufficient(20-30 ng/ml)and normal(30-100 ng/ml)were 38%,35%and 27%respectively.25(OH)D level in cirrhosis group deficiency of proportion(38%)was obviously higher than hepatitis group(1%)(?~2=43.606,P<0.001)and healthy controls(15%)(?~2=13.580,P<0.001).(2)In patients with liver cirrhosis,25(OH)D level of child-pugh A was higher than that of child-pugh B(P<0.001).The level of 25(OH)D of child-pugh B patients was higher than that of child-pugh C(P<0.001),and the difference was statistically significant.25(OH)D level was negatively correlated with child-pugh score(Spearman correlation coefficient rs~2=-0.559,P<0.001).(3)In patients with liver cirrhosis,The level of 25(OH)D in patients with liver cirrhosis?14 was higher than that in patients with MELD?18.The difference between the two groups was statistically significant.(P=0.002).There was no significant difference among the group of MELD(14-18)and other two groups(P>0.05).The level of 25(OH)D was negatively correlated with MELD score(the Pearson correlation coefficient r~2=-0.551,P<0.001).(4)The 25(OH)D level was divided into sufficient(>30ng/ml),insufficient(20-30 ng/ml)and deficiency(<20 ng/ml);uncorrected age,gender confounding factor,liver function was worse in patients with 25(OH)D levels<20 ng/ml(OR=4.711,95%CI 2.542~8.723,P=0.001).Multivariate logistic regression corrected for age and gender confounding factors,Liver lesions were still more severe in patients with 25(OH)D levels<20 ng/ml(OR=4.983,95%CI 2.662~9.328,P=0.001).ConclusionThe level of serum 25(OH)D in patients with chronic liver disease is generally low,especially in patients with decompensated cirrhosis.The serum 25(OH)D level in patients with chronic liver disease is correlated with liver function grading,and the lower the level of liver function,the lower the level of 25(OH)D.