Evaluation of serum vitamin D levels in patients with hepatitis B virus (HBV)

by   MAJ Dr. Sorush niknamian, et al.

Introduction Recently, several studies have shown that vitamin D deficiency is a significant contributor to a number of diseases, including those with hepatitis B virus (HBV) viral infection. Also, its role as an effective factor in the progression of the disease to the complications associated with chronic hepatitis B (CHB), such as cirrhosis (LC) and hepatocellular carcinoma (HCC), has been investigated. The aim of this study was to compare serum vitamin D levels between patients with HBV and healthy controls. Method In this descriptive cross-sectional study, 114 HBV patients (59 active chronic hepatitis, 42 inactive carriers and 15 patients with liver cirrhosis) and 104 healthy controls were enrolled. Patients were examined by the infectious specialists, internal specialists, and gastroenterologists and they were referred to the laboratory for the purpose of conducting an examination and recording of information during the year 2016 at Shaheed Mohammadi Hospital in Bandar Abbas (Hormozgan province). Participants' data included demographic information, height, weight, BMI, serum levels of 25-hydroxyvitamin D, creatinine, urea, albumin, alpha Phyto protein, calcium, phosphorus, FBS, alkaline phosphatase, ALT, and AST was collected and entered into SPSS16 software. T-test, Mann-Whitney, and regression were used to determine the effect of vitamin D on other variables. Results 67 (58.8%) patients with HBV and 54 (52.90%) healthy controls were male. The mean age of HBV patients was 42.96 ± 15.33 and the mean age of healthy controls was 39.06 ± 12.7 years. The prevalence of reduced serum vitamin D levels lower than 30 ng / ml was observed in 94 cases (81.03%) in HBV group and in 70 cases (67.30%) in healthy controls. Also, the prevalence of severe deficiency (<10 ng / ml) and deficiencies between 10-20 ng / ml in HBV patients was 51.7%. The frequency of these deficiencies in the subgroups of HBV patients was as follows: CHB (% 43.10), L.C (% 80), Inactive carriers (% 52.41), while in the healthy control group (H.C) was (44.20%) (P <0.001). Distribution of vitamin D deficiency in rural people is more than urban population. (OR = 2.321 CI 95% 1.31-4.11), which is statistically significant in two groups (P=0.004). Logistic regression analysis of the frequency distribution of vitamin D level for ALT (P = 0.38 OR = 1.016), AST (P = 0.005 OR = 1.027), AFP (P = 0.005 OR = 1.281), and ALB (P = 0.085 OR = 0.57) shows that a meaningful relationship between these variables exists. Conclusion The study showed that vitamin D level was significantly lower in all groups of patients with HBV compared with healthy controls. It is necessary to routinely test blood serum vitamin D levels and, if necessary, prescribe these supplements by specialists for patients to increase their level of vitamin D sufficiently and standardly. The point to be considered is that in healthy controls, inadequate level and insufficient vitamin D deficiencies compared to the standard range were observed. Therefore, it is suggested that in addition to screening these people, a broad study be conducted to identify possible causes for these deficiencies.



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