摘要:慢性肝?。–LD)及其相關(guān)的肝外表現(xiàn),如肝性骨營(yíng)養(yǎng)不良與維生素D缺乏相關(guān),因此,有人建議將其作為治療靶點(diǎn)。維生素D在肝臟進(jìn)行25 - 羥化,因而肝臟對(duì)于這種維生素的代謝活化至關(guān)重要。維生素D缺乏在CLD患者中非常普遍,并且維生素D水平與CLD的嚴(yán)重程度成反比。在CLD時(shí),載體蛋白如白蛋白和維生素D結(jié)合蛋白水平的下降也可能非常重要。zui近有研究報(bào)道,在改善CLD特別是丙型肝炎病毒感染后肝臟狀況并進(jìn)行一定量的補(bǔ)充有利于其健康預(yù)后。
內(nèi)容:在這篇綜述我們將討論維生素D的來(lái)源、功能和代謝,重點(diǎn)介紹分析測(cè)量的固有并發(fā)癥,如對(duì)25 - 羥基維生素D和1,25 - 二羥維生素D C-3差向異構(gòu)體的干擾。我們還討論了對(duì)血清*25 - 羥維生素D水平在定義上的差異,并綜述了在CLD中維生素D缺乏癥的患病率。我們隨后討論了維生素D缺乏的功能機(jī)制,即維生素D代謝和CLD在遺傳變異之間的關(guān)聯(lián)。zui后,我們指出了CLD中維生素D缺乏對(duì)健康的影響,并提出了相應(yīng)的治療方案。
文章來(lái)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
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