ABSTRACT
Objective To investigate the levels and clinical significance of serum 25 -hydroxy vitamin D[25 (OH)D]in patients with chronic liver disease.Methods A total of 153 hospitalized patients with chronic liver disease in the First Affiliated Hospital of Jilin Univer-sity from June 2012 to September 2013 were enrolled in the study group.The levels of serum 25(OH)D were measured by liquid chromatog-raphy tandem mass spectrometry.The serum samples from 300 healthy volunteers who underwent physical examination in our hospital were used as controls.The study group was divided into three subgroups:non -cirrhosis,liver cirrhosis [Child -Pugh (CP)grades A,B,and C],and primary biliary cirrhosis.Comparison of continuous data between groups was made by t test and analysis of variance,and compari-son of categorical data was made by chi -square test.Correlation between different variables was investigated by Pearson linear regression a-nalysis.Results Of the 153 patients with chronic liver disease,the percentages of those who had vitamin D adequacy (≥30 ng/ml),in-sufficiency (20 -30 ng/ml),deficiency (10 -20 ng/ml),and severe deficiency (<10 ng/ml)were 20.3%,22.9%,35.9%,and 20.9%,respectively.The percentages of patients with vitamin D deficiency and severe deficiency were significantly higher in the cirrhosis subgroup than in the non -cirrhosis and primary biliary cirrhosis subgroups (41.7%,25.0% vs 27.5%,12.5% and 23.5%,17.6%,re-spectively;χ2 =6.261 -18.474,P =0.001 -0.012).The serum 25(OH)D levels in patients with cirrhosis were significantly lower com-pared with those in patients without cirrhosis and in controls (18.58 ±12.48 vs 23.78 ±11.81 and 25.69 ±12.39 ng/ml,P =0.029 and 0.001).CP class C cirrhotic patients had significantly lower serum levels of 25(OH)D compared with CP class A patients (P =0.009). Conclusion Serum 25(OH)D deficiency is common in patients with chronic liver disease.25(OH)D levels in cirrhotic patients,especial-ly in CP class C patients,are markedly lower than those in non -cirrhotic patients.
ABSTRACT
Objective To analyze the changes in platelet parameters and their influential factors in cirrhotic patients with hepatocellular car-cinoma (HCC).Methods The clinical data of 602 cirrhotic patients with HCC who were admitted to the First Hospital of Jilin University from January 201 1 to December 2012,as well as 200 cirrhotic patients hospitalized during the same period,were collected.Statistical analy-sis was performed using SPSS 19.0.Normally distributed continuous data were expressed as mean ± standard deviation;comparison be-tween two groups was made by t test,and comparison between multiple groups was made by analysis of variance.Non-normally distributed data were expressed as median and interquartile range (P25 -P75 );comparison between groups was made by rank sum test.Results Com-pared with the cirrhotic group,the HCC group had significantly higher platelet count (PLT)and plateletcrit (PCT)(t=5.019,P=0.000;t=5.017,P=0.000)and a significantly lower mean platelet volume (MPV)/PLT (t=5.877,P=0.000);there were no significant differences in MPV and platelet distribution width between the two groups (t=-0.942,P=0.347;t=-1.040,P=0.298).The receiv-er operating characteristic (ROC)analysis showed that the area under the ROC curve was 0.636 for PLT,0.633 for PCT,and 0.639 for MPV/PLT in the diagnosis of HCC in cirrhotic patients.Decreases in PLT and PCT were closely related to hepatitis C virus (HCV)infec-tion.Patients with Child-Pugh class A cirrhosis had significantly higher PLT and PCT than those with Child-Pugh class B and C cirrhosis (P<0.01);patients with a maximum tumor diameter of≥5 cm had significantly higher PLT and PCT than those with maximum tumor di-ameters of2-5 cm and≤2 cm (P<0.01).Patients with Child-Pugh class A cirrhosis had a significantly lower MPV/PLT than those with Child-Pugh class B and C cirrhosis (P<0.01);patients with a maximum tumor diameter of≥5 cm had a significantly lower MPV/PLT than those with maximum tumor diameters of2-5 cm and≤2 cm (P<0.01).Conclusion PLT,PCT,and MPV/PLT can be used in the auxiliary diagnosis of HCC in cirrhotic patients,which are related to HCV,Child-Pugh classification,and tumor size.