Association between serum vitamin D and severity of liver fibrosis in chronic hepatitis C patients: a systematic meta-analysis

Abstract

Abstract:To conduct a systematic review of group studies assessing the association of serum vitamin D status with the severity of liver fibrosis in chronic hepatitis C patients using meta-analysis. The relevant research literatures were identified by searching PubMed and EMBASE databases prior to October 2013 with no restrictions. We included group studies that reported odds ratio (OR) estimates with 95% confidence intervals (CIs) or a mean with standard deviation (SD) for the association between serum vitamin D status and the severity of liver fibrosis in chronic hepatitis C patients. Approximately 8321 participants from several countries were included in this analysis. Six studies on serum vitamin D status and the severity of liver fibrosis were included in this meta-analysis. ORs with 95% CIs were extracted from four studies and the pooled ORs were 0.866 (95% CI, 0.649 to 1.157). The means with SDs were extracted from three studies and the pooled means were −0.487 (95% CI, −0.659 to −0.315). There was statistically significant heterogeneity among the mean data extracted studies (P=0.029; I 2 =71.8%) but not among the OR data extracted studies (P=0.061; I 2 =55.6%). Finally, results from the mean data extracted studies suggest that lower serum vitamin D is a risk factor for the severity of liver fibrosis in chronic hepatitis C patients. However, there is no conclusive evidence on this association because of inconsistencies between the OR data extracted studies and the mean data extracted studies.

Vitamin D and Osteoporosis in HIV/HCV Coinfected Patients: A Literature Review

“…Older and more recent research has investigated the link between vitamin D homeostasis and bone loss in patients with liver disease [ 7 , 8 , 22 , 46 ]. Vitamin D deficiency in chronic liver disease is only partly the result of a synthesis dysfunction of the liver or/and decreased vitamin D absorption caused by intestinal edema due to portal hypertension or to cholestasis.…”

“…HCV and HIV infections are both associated with increased levels of proinflammatory cytokines that can promote osteoclastogenesis or inhibit osteoblast differentiation and collagen synthesis [ 7 , 8 , 22 ].…”

“…While there are recommendations for the evaluation, treatment, and prevention of vitamin D deficiency in healthy patients at risk of deficiency [ 3 , 24 ] and in specific HIV populations such as young HIV-positive adults with 25-hydroxyvitamin D (25-OHD) < 20 ng/mL [ 29 ], there is still some debate about the evaluation, treatment, and prevention of vitamin D deficiency in the HIV population [ 30 ] and in particular in HIV/HCV coinfected subjects [ 7 , 8 , 31 , 32 ].…”

Controversial Effects of Vitamin D and Related Genes on Viral Infections, Pathogenesis, and Treatment Outcomes

“…A significant inverse relationship between the severity of inflammatory fibrosis and cirrhosis and serum 25(OH)D 3 levels was observed in HCV patients [32,33,37,40,[62][63][64]. This implies VD deficiency as an independent predictor and risk factor for inflammatory liver complications in HCV patients [38,39,[65][66][67]. VD deficiency was also associated with reduced hepcidin expression, mixed cryoglobulinemia, and hepatic encephalopathy in HCV patients [41][42][43].…”

Prevalence of Vitamin D deficiency in patients of Chronic Hepatitis C.

“…11,12 Nearly 200 million people worldwide are chronically infected with hepatitis C which could lead to the development of cirrhosis, end stage liver disease, hepatocellular carcinoma and liver transplantation. 13 role in progression of liver disease severity especially of chronic hepatitis C. 14 It has been suggested that many patients of chronic liver disease have insufficient serum level of 25 OH vitamin D. 15…”