Serum Vitamin D Levels Are Not Predictive of the Progression of Chronic Liver Disease in Hepatitis C Patients with Advanced Fibrosis

PLoS ONE
Q1
Feb 2012
Citations:43
Influential Citations:2
Observational Studies (Human)
83
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Enhanced Details

Methods
Nested case-control study within the HALT-C Trial; 129 cases with progression and 129 age-matched controls with hepatitis C and Ishak fibrosis stage 3–4 at baseline; mean ages approximately 49.5 (cases) and 50.0 (controls); 69.0% male in cases vs 77.5% male in controls; four vitamin D measurements over 45 months (screening, randomization at week 24, month 27, month 45).
Results
Baseline total 25-OH vitamin D: 44.8 ng/mL in cases vs 44.0 ng/mL in controls (P=0.74). Over 45 months, levels declined in both groups with no difference in magnitude of decline (cases 25.6 ng/mL vs controls 23.3 ng/mL; P=0.77). Vitamin D2 and D3 fractions did not differ at any time. Vitamin D deficiency (≤30 ng/mL) prevalence: cases 24.6% vs controls 23.8% (P=0.88). In diabetics, baseline vitamin D higher in cases (47.9 vs 36.3 ng/mL; P=0.03). In Black subjects, baseline vitamin D higher in cases (32.7 vs 25.2 ng/mL; P=0.08). Overall, vitamin D levels were not predictive of progression; no evidence that vitamin D supplementation slows progression in this population; higher vitamin D levels may be linked to progression in diabetics and Black patients; further study warranted.
Limitations
Observational nested case-control design within HALT-C; not randomized; majority had normal vitamin D and many used supplements; 54.7% had detectable vitamin D2, which may limit exposure classification; cases and controls matched by age only, allowing potential residual confounding; limited to Ishak stage 3–4 hepatitis C; results may not generalize to other etiologies or fibrosis stages; follow-up ~4 years may be insufficient for longer-term outcomes; vitamin D measurements rely on total 25-OH vitamin D with D2 and D3 fractions; potential measurement variability and power issues in subgroups.

Abstract

In animal models and human cross-sectional studies, vitamin D deficiency has been associated with liver disease progression. Vitamin D supplementation has been suggested as a treatment to prevent disease progression. We sought to evaluate the role of...