title: The association between serological and dietary vitamin D levels and hepatitis C-related liver disease risk differs in African American and white males.
abstract: BACKGROUND
  Vitamin D may affect the severity of HCV-related liver disease.
  
  
  OBJECTIVE
  To examine the association between serum vitamin D levels and advanced liver disease in a multiethnic US cohort of HCV patients, and account for dietary and supplemental intake.
  
  
  METHODS
  We measured serum 25-hydroxyvitamin D levels and used FibroSURE-ActiTest to assess hepatic pathology in a cohort of HCV-infected male veterans. We estimated and adjusted for daily intake of vitamin D from diet using a Dietary History Questionnaire, and dispensed prescriptions prior to study enrolment. We used race-stratified logistic regression analyses to evaluate the relationship between serum vitamin D levels and risk of advanced fibrosis (F3/F4-F4) and advanced inflammation (A2/A3-A3).
  
  
  RESULTS
  A total of 163 African American (AA) and 126 White non-Hispanics were studied. Overall, ~44% of AAs and 15% of Whites were vitamin D deficient (<12 ng/mL) or insufficient (12-19 ng/mL); 4% of AAs and 9% of White patients had an elevated level (>50 ng/mL). Among AAs, patients with elevated serum vitamin D levels had significantly higher odds of advanced fibrosis (OR = 12.91, P = 0.03) than those with normal levels. In contrast, AAs with insufficient or deficient levels had > two-fold excess risk of advanced inflammation (P = 0.06). Among White males there was no association between vitamin D levels and advanced fibrosis (F3/F4-F4) or inflammation (A2/A3-A3) risk.
  
  
  CONCLUSIONS
  We observed potential differences in the association between vitamin D levels and degree of HCV-related hepatic fibrosis between White and African American males. Additional research is necessary to confirm that high serum vitamin D levels may be associated with advanced fibrosis risk in African American males, and to evaluate whether racial differences exist in HCV-infected females.
authors.affiliation: Clinical Epidemiology and Outcomes Program, Houston VA, Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA. dwhite1@bcm.edu
authors.forename: D L
authors.initials: DL
authors.lastname: White
authors.forename: S
authors.initials: S
authors.lastname: Tavakoli-Tabasi
authors.forename: F
authors.initials: F
authors.lastname: Kanwal
authors.forename: D J
authors.initials: DJ
authors.lastname: Ramsey
authors.forename: A
authors.initials: A
authors.lastname: Hashmi
authors.forename: J
authors.initials: J
authors.lastname: Kuzniarek
authors.forename: P
authors.initials: P
authors.lastname: Patel
authors.forename: J
authors.initials: J
authors.lastname: Francis
authors.forename: H B
authors.initials: HB
authors.lastname: El-Serag
mesh_terms: D001741:Black or African American; D004032:Diet; D015930:Diet Records; D019698:Hepatitis C, Chronic / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*; D044465:White People
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D