Severe vitamin D-deficiency and increased bone turnover in patients with hepatitis B from northeastern China.
BACKGROUND
Vitamin D plays a key role in maintaining calcium homeostasis and skeletal health. The liver is critically involved in vitamin D metabolism, as 25-hydroxyvitamin D₃ (25(OH)D₃) is synthesized in the liver. Therefore liver dysfunction may lead to vitamin D deficiency and bone problems. The aim of this study was to examine vitamin D status and bone turnover markers in hepatitis B patients from northeastern China.


METHODS
We recruited 39 patients with hepatitis B (23 noncirrhotic and 16 cirrhotic) and 48 healthy controls in Shenyang, a metropolitan city in northeastern China, and measured serum 25(OH)D₃ levels and serum and urinary bone turnover markers in these subjects.


RESULTS
Serum 25(OH)D₃ levels in the patients with or without cirrhosis were markedly lower compared to the nonhepatitis controls (19.2 ± 1.2 and 18.5 ± 1.3 vs. 31.6 ± 1.3 nmol/L control), whereas serum and urinary bone turnover markers (alkaline phosphatase, C-terminal telopeptide of type I collagen, and pyridinoline) were significantly higher in these patients than in the controls. Moreover, serum levels of osteoprotegerin, a bone mass-regulating protein, were substantially reduced in the patients, with the lowest seen in patients with cirrhosis (2.7 ± 1.1 and 1.4 ± 0.4 vs. 3.4 ± 0.7 pg/mL control). Serum 25(OH)D₃ levels below 30 nmol/L were positively correlated with serum osteoprotegerin levels in this cohort.


CONCLUSIONS
Severe vitamin D deficiency is very common in hepatitis B patients in northeastern China, which negatively impacts their bone health. These data strongly suggest a need to treat these patients with vitamin D supplementation to protect their bone health.
Laboratory of Metabolic Disease Research and Drug Development, Shengjing Hospital, China Medical University , Shenyang , China.
Juan
J
Kong
Yang
Y
Ding
Cong
C
Zhang
Yu
Y
Fu
Jie
J
Du
Cheng
C
Lu
Xiaoguang
X
Dou
Yunzi
Y
Chen
Yan Chun
YC
Li
Qun
Q
Zhao
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000596:Amino Acids / Q000097:blood / Q000652:urine; D016723:Bone Remodeling; D001862:Bone Resorption / Q000209:etiology*; D002112:Calcifediol / Q000097:blood; D002681:China; D024042:Collagen Type I / Q000097:blood / Q000652:urine; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood / Q000652:urine; D014808:Vitamin D Deficiency / Q000209:etiology*
D000596:Amino Acids; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; C015484:pyridinoline; D000469:Alkaline Phosphatase; D002112:Calcifediol