维生素 D 与慢性乙型肝炎功能性治愈的关系：一项回顾性队列研究和一项干预研究的启示。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2024-10-16 DOI:10.1016/j.clnesp.2024.10.145

Peipei Wang , Junjian Chen , Zhipeng Li , Husheng Xiong , Ziying Lei , Dabiao Chen , Ying Zhang , Zhiliang Gao , Zhishuo Mo

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引用次数: 0

摘要

背景和目的：使用核苷（t）ide 类似物（NAs）和聚乙二醇干扰素α（Peg-IFNα）联合治疗可实现慢性乙型肝炎（CHB）患者的功能性治愈。然而，维生素 D 在功能性治愈中的作用仍不清楚。我们旨在研究维生素 D 水平与慢性阻塞性肺病患者功能性治愈之间的关系：方法：我们进行了一项回顾性研究，以检测 526 名慢性阻塞性肺病患者血清 25- 羟维生素 D（25(OH)D）水平的变化。此外，还对 90 名维生素 D 基线不足的慢性阻塞性肺病患者进行了干预研究，其中 45 名患者被随机分配到接受 NAs/Peg-IFNα 治疗的对照组，而其余患者则被分为维生素 D 组（VD 组），在接受 NAs/Peg-IFNα 治疗的同时每天补充 800 IU 的维生素 D：一项回顾性研究显示，在整个治疗过程中，血清 25(OH)D 水平逐渐升高。治疗结束时，治愈组的血清 25（OH）D 水平明显高于未治愈组（P = 0.046），两组间血清 25（OH）D（Δ25（OH）D）水平的变化有显著差异（P < 0.0001）。在干预研究中，与对照组（34.3%）相比，在二元逻辑回归方程分析中，VD 组的功能治愈率（48.0%）有增加的趋势（P = 0.09）。值得注意的是，纵向分析中的线性混合效应模型显示，血清25（OH）D水平对治疗结果有显著影响（P = 0.017）：结论：在这项回顾性研究中，血清25（OH）D和Δ25（OH）D均与功能性治愈呈正相关，补充维生素D可能有助于CHB患者的功能性治愈：临床试验注册号：ChiCTR1800020108。

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Association of vitamin D with functional cure in chronic hepatitis B: Insights from a retrospective cohort study and an intervention study

Background & aim

Functional cure for chronic hepatitis B (CHB) patients can be achieved using nucleos(t)ide analogues (NAs) and pegylated interferon alpha (Peg-IFNα) combination treatment. However, the role of vitamin D in functional cure remains unclear. We aimed to investigate the association between vitamin D levels and functional cure in CHB patients.

Methods

A retrospective study was conducted to detect changes in serum 25-hydroxyvitamin D (25(OH)D) levels in 526 CHB patients. Furthermore, an intervention study was conducted on 90 CHB patients with baseline vitamin D insufficiency, and 45 patients were randomly assigned to the control group receiving NAs/Peg-IFNα treatment, whereas the remaining patients were categorized into the vitamin D group (VD group) receiving NAs/Peg-IFNα treatment combined with vitamin D supplementation at 800 IU/day.

Results

A retrospective study revealed a progressive elevation in serum 25(OH)D levels throughout the duration of treatment. The cured group displayed significantly higher serum 25(OH)D levels than the uncured group (P = 0.046) at the end of treatment, and the changes in serum 25(OH)D (Δ25(OH)D) levels between the two groups were found to be significantly different (P < 0.0001). In the intervention study, the VD group tended to have an increased functional cure rate (48.0 %) compared with the control group (34.3 %) in the binary logistic regression equation analysis (P = 0.09). Notably, a linear mixed-effects model in the longitudinal analysis indicated a significant impact of serum 25(OH)D levels on treatment outcomes (P = 0.017).

Conclusions

Serum 25(OH)D and Δ25(OH)D were both positively associated with functional cure in this retrospective study, and vitamin D supplementation may be helpful for functional cure in CHB patients.

Registration number of clinical trial

ChiCTR1800020108.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.