Correlation of severity of infantile cholestatic liver disease with serum vitamin D level / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the correlation of serum 25-hydroxy vitamin D［25(OH)D］ level with the severity of infantile cholestatic hepatopathy (ICH). MethodsA total of 121 infants with ICH who were admitted or referred to Liver Research Center in our hospital from July 2015 to December 2017 were enrolled, and according to the presence or absence of liver cirrhosis, these infants were divided into liver cirrhosis group with 26 infants and non-liver cirrhosis group with 95 infants. The two groups were compared in terms of age, sex ratio, 25(OH)D, liver function parameters ［total bilirubin (TBil), direct bilirubin (DBil), total protein (TP), albumin (Alb), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), total bile acid (TBA), and prothrombin time (PT)］, serological markers of liver fibrosis ［procollagen Ⅲ peptide (PⅢNP), laminin (LN), hyaluronic acid (HA), and type Ⅳ collagen (C-Ⅳ)］, and indices associated with vitamin D metabolism (Ca and P). The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A binary logistic regression analysis was used to investigate the factors associated with the development of liver cirrhosis. ResultsOf all 121 infants, 107 (88.43%) had vitamin D deficiency, and all 26 infants with liver cirrhosis had vitamin D deficiency. Compared with the non-liver cirrhosis group, the liver cirrhosis group had significant reductions in the serum levels of 25(OH)D and Alb (Z=3.029, t=2.294, P＜0.05) and significant increases in the levels of DBil, AST, GGT, HA, and C-Ⅳ(Z=3.032, 2.026, 3.439, 3.143, and 2.247, P＜0.05), while there were no significant differences in the other indices between the two groups (all P＞0.05). The multivariate logistic regression analysis showed that 25(OH)D (odds ratio ［OR］=0.865, 95% confidence interval ［CI］ 0.755-0.922, P=0.038), GGT(OR=1.002, 95%CI 1.000-1.004, P=0.039), and HA (OR=1.004, 95%CI 1.000-1.008, P=0.034) were associated with liver cirrhosis in infants with ICH. ConclusionSerum 25(OH)D has a certain clinical value in predicting the severity of hepatocyte damage and the development of early liver cirrhosis in infants with ICH.