Study on correlation between serum 25-hydroxyvitamin D3 level and esophageal variceal bleeding in cirrhotic patients
10.3760/cma.j.issn.1007-3418.2019.05.007
- VernacularTitle: 血清25羟维生素D3的水平与肝硬化食管静脉曲张破裂出血的相关性
- Author:
Mingyuan ZHAO
1
;
Xirun WU
2
;
Hongxia LI
1
;
Shengwen LI
1
;
Ting LU
2
;
Yanming ZHONG
2
;
Meifang YU
2
Author Information
1. Department of Gastroenterology, Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030012, China
2. Department of Gastroenterology, The Second Hospital, Shanxi Medical University, Taiyuan 030001, China
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Esophageal variceal bleeding;
25OHD3
- From:
Chinese Journal of Hepatology
2019;27(5):358-362
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlation between serum 25-hydroxyvitamin D3 (25[OH]D3) levels and esophageal variceal bleeding (EVB) in cirrhotic patients.
Methods:Eighty-three cases with liver cirrhosis hospitalized from November 2016 to January 2017 were collected. The patients were divided into bleeding group (51 cases) and non-bleeding group (32 cases) depending on the presence or absence of bleeding under gastroscopy. Serological tests were performed on both groups, including hemoglobin (Hb), albumin (ALB), alkaline phosphatase (ALP),γ-glutamyltransferase (GGT), interleukin-6 (IL-6), and 25-hydroxyvitamin D3 (25[OH]D3). Both groups were analyzed by univariate analysis. The differences between both groups were compared by t-test, after normality test. The other variables were compared by Mann-Whitney U test. The correlation between the relevant variables and EVB were analyzed by Spearman's rank correlation and a multivariate analysis. Cases with primary biliary cirrhosis were relatively low in number (four cases in bleeding group, accounting for 8%, 10 cases in non-bleeding group, accounting for 31%). The effects of ALP and GGT on serum 25(OH)D3 level were analyzed by stratified analysis. Moreover, ALP and GGT levels were divided into two and three groups: < 140 U/L and >140 U/L and < 30 U/L, > 30 U/L, and ~≤60 U/L.
Results:Bleeding group had low levels of hemoglobin (t= -2.827,P= 0.005), alkaline phosphatase (t= -3.097,P= 0.002), gamma-glutamyltransferase (t= -2.292,P= 0.022), and 25(OH)D3 (t= -3.134,P= 0.002) than non-bleeding group. Both groups (P> 0.05) had similar levels of albumin, interleukin-6, AAR, and FIB-4. Logistic regression analysis showed that 25(OH)D3, alkaline phosphatase and hemoglobin were independent risk factors for EVB. Spearman’s correlation coefficient analysis showed that 25(OH)D3was significantly positively and negatively correlated with interleukin-6 (r= 0.306,P= 0.005) and albumin (r= -0.327,P= 0.003). Stratified analysis showed that serum 25(OH)D3 level was lower in ALP≤140U/L group and the bleeding group, and the difference was statistically significant than non-bleeding group (P= 0.007), while the serum level of 25(OH)D3was decreased in both groups for alkaline phosphatase > 140 U/L group, and the difference was not statistically significant (P= 0.051). Furthermore, in the GGT > 60 U/L group, the serum level of 25(OH)D3was significantly lower in the bleeding group, and the difference was statistically significant in non-bleeding group (P= 0.003), while the difference between the two groups was not statistically significant (P> 0.05) in GGT≤30 U/ L, > 30 U/L, and ~≤60 U/L group.
Conclusion:Serum 25(OH)D3level was significantly lower in EVB cirrhotic patients, and it was an independent risk factor for EVB. Serum 25(OH)D3 low levels was more apparent with ALP normalization or GGT level > 60 U/L.
