摘要:慢性肝病(CLD)及其相关的肝外表现,如肝性骨营养不良与维生素D缺乏相关,因此,有人建议将其作为治疗靶点。维生素D在肝脏进行25 - 羟化,因而肝脏对于这种维生素的代谢活化至关重要。维生素D缺乏在CLD患者中非常普遍,并且维生素D水平与CLD的严重程度成反比。在CLD时,载体蛋白如白蛋白和维生素D结合蛋白水平的下降也可能非常重要。zui近有研究报道,在改善CLD特别是丙型肝炎病毒感染后肝脏状况并进行一定量的补充有利于其健康预后。
内容:在这篇综述我们将讨论维生素D的来源、功能和代谢,重点介绍分析测量的固有并发症,如对25 - 羟基维生素D和1,25 - 二羟维生素D C-3差向异构体的干扰。我们还讨论了对血清*25 - 羟维生素D水平在定义上的差异,并综述了在CLD中维生素D缺乏症的患病率。我们随后讨论了维生素D缺乏的功能机制,即维生素D代谢和CLD在遗传变异之间的关联。zui后,我们指出了CLD中维生素D缺乏对健康的影响,并提出了相应的治疗方案。
文章来源:Liver International
原文地址:http://onlinelibrary.wiley.com/doi/10.1111/liv.12106/abstract
原文:
Title: Vitamin D in chronic liver disease
Authors: Caroline S. Stokes, Dietrich A. Volmer, Frank Grünhage, Frank Lammert
Abstract:
Chronic liver disease (CLD) and several related extrahepatic manifestations such as hepatic osteodystrophy are associated with deficiency of vitamin D, which has therefore been suggested as therapeutic target. Vitamin D undergoes hepatic 25-hydroxylation, rendering the liver critical to the metabolic activation of this vitamin. Vitamin D deficiency is highly prevalent in CLD patients, and vitamin D levels are inversely related to the severity of CLD. Declining levels of carrier proteins such as albumin and vitamin D-binding protein might also be critical in CLD. Intervention studies report improvements of CLD following supplementation, and benefits to health outcomes in particular with respect to hepatitis C virus infection have recently been documented.
Content: We discuss vitamin D sources, functions and metabolism with a focus on the inherent complications of analytical measurements, such as the interference of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D C-3 epimers. Global discrepancies in the definition of optimal serum 25-hydroxyvitamin D levels are covered, and the prevalence of vitamin D deficiency in CLD is reviewed. We also address the functional mechanisms underlying this deficiency, and refer to associations between genetic variation in vitamin D metabolism and CLD. Lastly, we consider the health implications of a vitamin D deficiency in CLD and consider therapeutic options
Journal: Liver International
Published: March 2013