Case Control Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2015; 21(39): 11152-11159
Published online Oct 21, 2015. doi: 10.3748/wjg.v21.i39.11152
Serum vitamin D3 does not correlate with liver fibrosis in chronic hepatitis C
Yan Ren, Mei Liu, Jing Zhao, Feng Ren, Yu Chen, Jun-Feng Li, Jing-Yun Zhang, Feng Qu, Jin-Lan Zhang, Zhong-Ping Duan, Su-Jun Zheng
Yan Ren, Mei Liu, Jing Zhao, Yu Chen, Jun-Feng Li, Jing-Yun Zhang, Zhong-Ping Duan, Su-Jun Zheng, Artificial Liver Center, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
Feng Ren, Institute of Liver Diseases, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
Feng Qu, Jin-Lan Zhang, State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
Author contributions: Ren Y and Liu M contributed equally; Ren Y and Liu M designed the study and wrote the manuscript; Zhao J, Ren F and Zhang JY collected all the human materials; Qu F and Ren Y performed the majority of experiments; Zhang JL and Chen Y designed the study; Ren Y and Li JF analyzed the data; Duan ZP and Zheng SJ designed the study and revised the manuscript.
Supported by Grants from High technical personnel training item from Beijing Health System, No. 2011-3-083, No. 2013-3-071; Beijing Municipal Science & Technology Commission, No. Z131107002213019, No. Z151100004015066; Base to Clinical Scientific Research Cooperation fund of Capital Medical University No. 15JL67; National Science and Technology Key Project on “Major Infectious Diseases such as HIV/AIDS, Viral Hepatitis Prevention and Treatment”, No. 2012ZX10002004-006, No. 2012ZX10004904-003-001, and No. 2013ZX10002002-006; Beijing Municipal Administration of Hospitals Clinical medicine Development of special funding support, No. XM201308; National Key Subject Construction Project, NO. WJWYA-2014-002; and Scientific research base construction - the major infectious diseases prevention and control of collaborative innovation center, No. 115215.
Institutional review board statement: The study was approved by the Ethics Committee of Beijing YouAn Hospital, Capital Medical University.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Su-Jun Zheng, PhD, MD, Artificial Liver Center, Beijing YouAn Hospital, Capital Medical University, No. 8 Xitou Tiao Road, Youwai Street, Beijing 100069, China. zhengsujun003@126.com
Telephone: +86-10-63291007 Fax: +86-10-63295285
Received: April 18, 2015
Peer-review started: April 20, 2015
First decision: June 19, 2015
Revised: July 2, 2015
Accepted: September 2, 2015
Article in press: September 2, 2015
Published online: October 21, 2015
Abstract

AIM: To investigate the relationship between serum vitamin D3 levels and liver fibrosis or inflammation in treatment-naive Chinese patients with chronic hepatitis C (CHC).

METHODS: From July 2010 to June 2011, we enrolled 122 CHC patients and 11 healthy controls from Dingxi city, Gansu Province, China. The patients were infected with Hepatitis C virus (HCV) during blood cell re-transfusion following plasma donation in 1992-1995, and had never received antiviral treatment. At present, all the patients except two underwent liver biopsy with ultrasound guidance. The Scheuer Scoring System was used to evaluate hepatic inflammation and the Metavir Scoring System was used to evaluate hepatic fibrosis. Twelve-hour overnight fasting blood samples were collected in the morning of the day of biopsy. Serum levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, cholinesterase, prothrombin activity, albumin, γ-glutamyl transpeptidase, hemoglobin, calcium and phosphorus were determined. Serum HCV RNA levels were measured by real-time PCR. Serum levels of 25-hydroxyvitamin D3 [25(OH)D3] and 24,25-dihydroxyvitamin D3 [24,25(OH)2D3] were measured by high-performance liquid chromatography tandem mass spectrometry.

RESULTS: Serum levels of 25(OH)D3 but not 24,25(OH)2D3 were significantly lower in CHC patients than in control subjects. Serum 25(OH)D3 levels did not correlate with liver fibrosis, inflammation, patient age, or levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, prothrombin activity, cholinesterase or HCV RNA. However, serum 25(OH)D3 levels did correlate with serum 24,25(OH)2D3 levels. Serum 25(OH)D3 and 24,25(OH)2D3 levels, and the 25(OH)D3/24,25(OH)2D3 ratio, have no difference among the fibrosis stages or inflammation grades.

CONCLUSION: We found that serum levels of 25(OH)D3 and its degradation metabolite 24,25(OH)2D3 did not correlate with liver fibrosis in treatment-naive Chinese patient with CHC.

Keywords: Hepatitis C virus, 25-Hydroxyvitamin D3, 24,25-Dihydroxyvitamin D3, Fibrosis, Inflammation

Core tip: We studied the relationship between liver fibrosis, based on liver biopsies, and serum vitamin D3 levels in Chinese treatment-naive patients with chronic hepatitis C (CHC). The levels of serum 25-hydroxyvitamin D3 [25(OH)D3] were significantly lower in the patients than in healthy control subjects. The levels of the degradation metabolite 24,25-dihydroxyvitamin D3 [24,25(OH)2D3] did not differ between the patients and controls. Spearman’s rank correlation analysis indicated that serum 25(OH)D3 levels did not correlate with the extent of liver fibrosis or inflammation. However, serum 25(OH)D3 levels did correlate with serum 24,25(OH)2D3 levels. Serum 25(OH)D3 and 24,25(OH)2D3 levels, and the 25(OH)D3/24,25(OH)2D3 ratio, have no difference among the fibrosis stages or inflammation grades. In conclusion, the levels of serum 25(OH)D3 and its metabolite 24,25(OH)2D3 did not correlate with liver fibrosis in treatment-naive Chinese patient with CHC.