Serum vitamin D expression in advanced schistosomiasis patients with hepatic fibrosis and its association with disease progression / 中国血吸虫病防治杂志

ABSTRACT

Objective To compare the expression of serum vitamin D in advanced schistosomiasis patients with grade I and II hepatic fibrosis, and to preliminarily examine its associations with the internal diameter of the main portal vein and progression of hepatic fibrosis. Methods The medical records of 126 advanced schistosomiasis patients with grade I and II hepatic fibrosis referred to Jiaxing First Hospital from March 2012 to September 2015 were retrospectively analyzed. The internal diameter of the main portal vein and serum 25-hydroxyvitamin D3 [25(OH)D3] level were measured. The progression of hepatic fibrosis was followed up, and the serum vitamin D level was compared between patient with disease progression and stable disease. Results The 126 advanced schistosomiasis patients included 72 men and 54 women, and had ages of 62 to 80 years. There were 58 cases with grade I hepatic fibrosis and 68 cases with grade II hepatic fibrosis. There were significant differences between patients with grade I and II hepatic fibrosis in terms of hemoglobin, white blood cell count, prothrombin time, international normalized ratio, activated partial thromboplastin time, fibrinogen or 25(OH)D3 level (all P > 0.05), and significant differences were seen in alanine aminotransferase, aspartate aminotransferase, blood calcium, blood phosphorus levels and the internal diameter of the main portal vein (all P values < 0.05). In addition, a lower serum 25(OH)D3 level was detected in patients with broadened internal diameter of the main portal vein than in those with normal internal diameter of the main portal vein [(19.08 ± 1.36) nmol/L vs. (25.61 ± 6.69) nmol/L, P < 0.05]. Following 3-year follow-up, there were 73 cases with progression of hepatic fibrosis, and a significantly lower serum vitamin D level was found in patients with disease progression than in those with stable disease [(20.00 ± 0.81) nmol/L vs. (25.47 ± 5.91) nmol/L, P < 0.05]. Conclusions Vitamin D deficiency is common in advanced schistosomiasis patients with hepatic fibrosis, and it may be associated with the internal diameter of the main portal vein and the progression of hepatic fibrosis disease.