Aa
Normal vit D levels are associated with hbsag seroclearance.
Normal vitamin D levels are associated with spontaneous hepatitis B surface antigen seroclearance.
Mahamid M, Nseir W, Abu Elhija O, Shteingart S, Mahamid A, Smamra M, Koslowsky B.
Source
Mahmud Mahamid, Shimon Shteingart, Mosab Smamra, Benjamin Koslowsky, Digestive Disease Institute, Shaare Zedek Medical Center, Jerusalem 93722, Israel.
Abstract
AIM:
To investigate a possible association between serum vitamin D levels and spontaneous hepatitis B surface antigen (HBsAg) seroclearance.
METHODS:
Fifty-three patients diagnosed with chronic inactive hepatitis B and spontaneous HBsAg seroclearance were followed up in two Israeli liver units between 2007 and 2012. This retrospective study reviewed medical charts of all the patients, extracting demographic, serological and vitamin D rates in the serum, as well as medical conditions and current medical therapy. Spontaneous HBsAg seroclearance was defined as the loss of serum HBsAg indefinitely. Vitamin D levels were compared to all patients who underwent spontaneous HBsAg seroclearance.
RESULTS:
Out of the 53 patients who underwent hepatitis B antigen seroclearance, 44 patients (83%) had normal levels of 25-hydroxyvitamin vitamin D compared to 9 patients (17%) who had below normal levels. Multivariate analysis showed that age (> 35 years) OR = 1.7 (95%CI: 1.25-2.8, P = 0.05), serum vitamin D levels (> 20 ng/mL) OR = 2.6 (95%CI: 2.4-3.2, P = 0.02), hepatitis B e antigen negativity OR = 2.1 (95%CI: 2.2-3.1, P = 0.02), low viral load (hepatitis B virus DNA 8 years) OR = 1.6 (95%CI: 1.15-2.6, P = 0.04) were also associated with spontaneous HBsAg seroclearance.
CONCLUSION:
We found a strong correlation between normal vitamin D levels and spontaneous HBsAg seroclearance.
Mahamid M, Nseir W, Abu Elhija O, Shteingart S, Mahamid A, Smamra M, Koslowsky B.
Source
Mahmud Mahamid, Shimon Shteingart, Mosab Smamra, Benjamin Koslowsky, Digestive Disease Institute, Shaare Zedek Medical Center, Jerusalem 93722, Israel.
Abstract
AIM:
To investigate a possible association between serum vitamin D levels and spontaneous hepatitis B surface antigen (HBsAg) seroclearance.
METHODS:
Fifty-three patients diagnosed with chronic inactive hepatitis B and spontaneous HBsAg seroclearance were followed up in two Israeli liver units between 2007 and 2012. This retrospective study reviewed medical charts of all the patients, extracting demographic, serological and vitamin D rates in the serum, as well as medical conditions and current medical therapy. Spontaneous HBsAg seroclearance was defined as the loss of serum HBsAg indefinitely. Vitamin D levels were compared to all patients who underwent spontaneous HBsAg seroclearance.
RESULTS:
Out of the 53 patients who underwent hepatitis B antigen seroclearance, 44 patients (83%) had normal levels of 25-hydroxyvitamin vitamin D compared to 9 patients (17%) who had below normal levels. Multivariate analysis showed that age (> 35 years) OR = 1.7 (95%CI: 1.25-2.8, P = 0.05), serum vitamin D levels (> 20 ng/mL) OR = 2.6 (95%CI: 2.4-3.2, P = 0.02), hepatitis B e antigen negativity OR = 2.1 (95%CI: 2.2-3.1, P = 0.02), low viral load (hepatitis B virus DNA 8 years) OR = 1.6 (95%CI: 1.15-2.6, P = 0.04) were also associated with spontaneous HBsAg seroclearance.
CONCLUSION:
We found a strong correlation between normal vitamin D levels and spontaneous HBsAg seroclearance.
https://www.youtube.com/watch?v=hOfO29rL-gI
dr coimbra and experience on more than 2500 patients treated by high dose vit d3
during this long interview (portuguese plus italian subtitles) i have learnt a lot especially on our resistance to vit d due to our chronic infection, our vdr types, our nagalase and other factors.they use a very simple test available everywhere to see biological activity of vit d and see the level of resistance by PTH
vitamin d suppresses PTH, so as biological activity of vit d increases the pth goes down to low end of normal
when we supplement and increase vitd25oh we can check serum PTH and we have to make it low end of normal, at the point we know we have got around the vit d resistance problem
for example i found out:
my sister with vitd25oh 150ng/ml (max safe level while on no diaries diet) has PTH to 39.3pg/ml (range 11-67).if there was no resistance PTH should have been to very low
dr coimbra and experience on more than 2500 patients treated by high dose vit d3
during this long interview (portuguese plus italian subtitles) i have learnt a lot especially on our resistance to vit d due to our chronic infection, our vdr types, our nagalase and other factors.they use a very simple test available everywhere to see biological activity of vit d and see the level of resistance by PTH
vitamin d suppresses PTH, so as biological activity of vit d increases the pth goes down to low end of normal
when we supplement and increase vitd25oh we can check serum PTH and we have to make it low end of normal, at the point we know we have got around the vit d resistance problem
for example i found out:
my sister with vitd25oh 150ng/ml (max safe level while on no diaries diet) has PTH to 39.3pg/ml (range 11-67).if there was no resistance PTH should have been to very low
. I would never know for importance of vit d if it wasn't this forum and you Guys,especially Stef, I began to take vit d only 2 months ago because i saw my levels was 33, and only because of you. Doctor didn't say nothing. We have to be aware of every detail. Thank you
SEVERE 25-HYDROXYVITAMIN D DEFICIENCY IDENTIFIES
HCC PATIENTS WITH A POOR PROGNOSIS
F. Finkelmeier, V. Ko ̈berle, B. Kronenberger, J. Bojunga, S. Zeuzem, J. Trojan, A. Piiper, O. Waidmann. Internal Medicine, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
E-mail: fabian.***@****
Background and Aims: We performed a prospective cohort study to investigate the relation of vitamin D levels to stage and the prognosis of HCC patients.
Methods: 200 patients with the diagnosis of HCC presenting at the Department of Internal Medicine 1 of the Frankfurt University Hospital outpatient clinic were consecutively enrolled into the present study. 25-hydroxyvitamin (25(OH)D3) levels were quantified. Patients were followed until death or last contact. The primary end point was overall survival (OS).
Results: The mean follow-up was 322 days + 342 days with a range of 1–1508 days. 19 patients underwent liver transplantation and 60 (30%) patients died within the observation time. 34.5% patients had 25(OH)D3 levels below 10ng/ml (insufficient), 38% had levels between 10 and 20 ng/ml (deficient) and 27.5% patients had levels above 20ng/ml. 25(OH)D3 levels differed significantly between Child Pugh stages and showed a negative correlation
with the MELD score. Patients with decompensated liver disease had significantly lowered 25(OH)D3 levels. There were significant differences between stages of HCC according to BCLC and CLIP score. Patients with severe 25(OH)D3 deficiency had a significantly shorter OS (hazard ratio (HR) 2.631, (CI) 1.354–5.113, P = 0.004). In a multivariate Cox regression model 25(OH)D3 levels 2 were independently associated with shorter OS. Conclusions: We show that 25(OH)D3 serum levels differ between HCC stages and correlate with the severity of liver insufficiency. 25(OH)D3 levels below 10ng/ml were associated with a higher mortality risk in univariate and multivariate analyses.
HCC PATIENTS WITH A POOR PROGNOSIS
F. Finkelmeier, V. Ko ̈berle, B. Kronenberger, J. Bojunga, S. Zeuzem, J. Trojan, A. Piiper, O. Waidmann. Internal Medicine, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
E-mail: fabian.***@****
Background and Aims: We performed a prospective cohort study to investigate the relation of vitamin D levels to stage and the prognosis of HCC patients.
Methods: 200 patients with the diagnosis of HCC presenting at the Department of Internal Medicine 1 of the Frankfurt University Hospital outpatient clinic were consecutively enrolled into the present study. 25-hydroxyvitamin (25(OH)D3) levels were quantified. Patients were followed until death or last contact. The primary end point was overall survival (OS).
Results: The mean follow-up was 322 days + 342 days with a range of 1–1508 days. 19 patients underwent liver transplantation and 60 (30%) patients died within the observation time. 34.5% patients had 25(OH)D3 levels below 10ng/ml (insufficient), 38% had levels between 10 and 20 ng/ml (deficient) and 27.5% patients had levels above 20ng/ml. 25(OH)D3 levels differed significantly between Child Pugh stages and showed a negative correlation
with the MELD score. Patients with decompensated liver disease had significantly lowered 25(OH)D3 levels. There were significant differences between stages of HCC according to BCLC and CLIP score. Patients with severe 25(OH)D3 deficiency had a significantly shorter OS (hazard ratio (HR) 2.631, (CI) 1.354–5.113, P = 0.004). In a multivariate Cox regression model 25(OH)D3 levels 2 were independently associated with shorter OS. Conclusions: We show that 25(OH)D3 serum levels differ between HCC stages and correlate with the severity of liver insufficiency. 25(OH)D3 levels below 10ng/ml were associated with a higher mortality risk in univariate and multivariate analyses.
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