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维生素D在肝硬化并发症中的作用

王溢 李晚晴 赵婕

引用本文:
Citation:

维生素D在肝硬化并发症中的作用

DOI: 10.12449/JCH250831
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:王溢负责撰写论文;李晚晴参与查找文献,修改论文;赵婕负责拟定写作思路,指导论文撰写并最后定稿。
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    通信作者:

    赵婕, zhaojie1710@126.com (ORCID: 0000-0003-2324-2603)

Role of vitamin D in complications of liver cirrhosis

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  • 摘要: 肝硬化是肝实质被纤维化组织和再生结节替代的一种慢性肝病,其主要并发症包括门静脉高压、肝性脑病、自发性细菌性腹膜炎及肝细胞癌。尽管在治疗和管理上已经取得了很大进步,但其并发症仍然给个人及社会造成重大负担。近年来,维生素D的生物学作用及其与肝硬化并发症的关系受到广泛关注。维生素D不仅是一种重要的脂溶性维生素,还具有抗纤维化、抗炎及抗肿瘤的多重作用。本文旨在总结目前维生素D在肝硬化主要并发症中的作用及潜在临床应用价值,探索预防和延缓并发症发展的辅助性治疗新途径。

     

  • [1] GINÈS P, KRAG A, ABRALDES JG, et al. Liver cirrhosis[J]. Lancet, 2021, 398( 10308): 1359- 1376. DOI: 10.1016/s0140-6736(21)01374-x.
    [2] GBD 2017 Cirrhosis Collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet Gastroenterol Hepatol, 2020, 5( 3): 245- 266. DOI: 10.1016/S2468-1253(19)30349-8.
    [3] LU WY, LI XF, LIU N, et al. Vitamin D alleviates liver fibrosis by inhibiting histidine-rich calcium binding protein(HRC)[J]. Chem Biol Interact, 2021, 334: 109355. DOI: 10.1016/j.cbi.2020.109355.
    [4] CAO MY, HE CR, GONG M, et al. The effects of vitamin D on all-cause mortality in different diseases: An evidence-map and umbrella review of 116 randomized controlled trials[J]. Front Nutr, 2023, 10: 1132528. DOI: 10.3389/fnut.2023.1132528.
    [5] GIUSTINA A, BILEZIKIAN JP, ADLER RA, et al. Consensus statement on vitamin D status assessment and supplementation: Whys, whens, and hows[J]. Endocr Rev, 2024, 45( 5): 625- 654. DOI: 10.1210/endrev/bnae009.
    [6] PŁUDOWSKI P, KOS-KUDŁA B, WALCZAK M, et al. Guidelines for preventing and treating vitamin D deficiency: A 2023 update in Poland[J]. Nutrients, 2023, 15( 3): 695. DOI: 10.3390/nu15030695.
    [7] BOUILLON R, MARCOCCI C, CARMELIET G, et al. Skeletal and extraskeletal actions of vitamin D: Current evidence and outstanding questions[J]. Endocr Rev, 2019, 40( 4): 1109- 1151. DOI: 10.1210/er.2018-00126.
    [8] TRIANTOS C, AGGELETOPOULOU I, THOMOPOULOS K, et al. Vitamin D-liver disease association: Biological basis and mechanisms of action[J]. Hepatology, 2021, 74( 2): 1065- 1073. DOI: 10.1002/hep.31699.
    [9] RAVAIOLI F, PIVETTI A, DI MARCO L, et al. Role of vitamin D in liver disease and complications of advanced chronic liver disease[J]. Int J Mol Sci, 2022, 23( 16): 9016. DOI: 10.3390/ijms23169016.
    [10] GASCON-BARRÉ M, DEMERS C, MIRSHAHI A, et al. The normal liver harbors the vitamin D nuclear receptor in nonparenchymal and biliary epithelial cells[J]. Hepatology, 2003, 37( 5): 1034- 1042. DOI: 10.1053/jhep.2003.50176.
    [11] LIN JL, CHEN JL, LI ZC, et al. Appraising the causal effects of circulating micronutrients on liver cirrhosis: Evidence from large-scale Mendelian randomization analysis[J]. Portal Hypertens Cirrhosis, 2024, 3( 3): 160- 170. DOI: 10.1002/poh2.90.
    [12] ADIRI WN, BASIL B, ONYIA CP, et al. Association between serum vitamin D status and severity of liver cirrhosis: Implications for therapeutic targeting in Nigerian patients[J]. BMC Gastroenterol, 2024, 24( 1): 259. DOI: 10.1186/s12876-024-03353-1.
    [13] YOUSIF MM, SADEK AMEM, FARRAG HA, et al. Associated vitamin D deficiency is a risk factor for the complication of HCV-related liver cirrhosis including hepatic encephalopathy and spontaneous bacterial peritonitis[J]. Intern Emerg Med, 2019, 14( 5): 753- 761. DOI: 10.1007/s11739-019-02042-2.
    [14] TRIANTOS C, AGGELETOPOULOU I, KALAFATELI M, et al. Prognostic significance of vitamin D receptor(VDR) gene polymorphisms in liver cirrhosis[J]. Sci Rep, 2018, 8: 14065. DOI: 10.1038/s41598-018-32482-3.
    [15] TOURKOCHRISTOU E, TSOUNIS EP, TZOUPIS H, et al. The influence of single nucleotide polymorphisms on vitamin D receptor protein levels and function in chronic liver disease[J]. Int J Mol Sci, 2023, 24( 14): 11404. DOI: 10.3390/ijms241411404.
    [16] ZHOU LL, ZHANG CQ. Association between collateral circulation and gastroesophageal varices in portal hypertension[J]. J Clin Hepatol, 2023, 39( 9): 2210- 2216. DOI: 10.3969/j.issn.1001-5256.2023.09.027.

    周丽丽, 张春清. 门静脉高压侧支循环与食管胃静脉曲张的关系[J]. 临床肝胆病杂志, 2023, 39( 9): 2210- 2216. DOI: 10.3969/j.issn.1001-5256.2023.09.027.
    [17] LEE PC, YANG YY, LEE WP, et al. Comparative portal hypotensive effects as propranolol of vitamin D₃ treatment by decreasing intrahepatic resistance in cirrhotic rats[J]. J Gastroenterol Hepatol, 2015, 30( 3): 628- 637. DOI: 10.1111/jgh.12721.
    [18] WANG P, LI J, JI MT, et al. Vitamin D receptor attenuates carbon tetrachloride-induced liver fibrosis via downregulation of YAP[J]. J Hazard Mater, 2024, 478: 135480. DOI: 10.1016/j.jhazmat.2024.135480.
    [19] PATERNOSTRO R, WAGNER D, REIBERGER T, et al. Low 25-OH-vitamin D levels reflect hepatic dysfunction and are associated with mortality in patients with liver cirrhosis[J]. Wien Klin Wochenschr, 2017, 129( 1-2): 8- 15. DOI: 10.1007/s00508-016-1127-1.
    [20] LIU QF, JIANG A. Progress in noninvasive measurement of portal vein pressure in cirrhotic portal hypertension[J/OL]. Chin J Hepat Surg(Electronic Edition), 2024, 13( 3): 270- 275. DOI: 10.3877/cma.j.issn.2095-3232.2024.03.004.

    刘起帆, 蒋安. 肝硬化门静脉高压症门静脉压力无创测量进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13( 3): 270- 275. DOI: 10.3877/cma.j.issn.2095-3232.2024.03.004.
    [21] ZHAO MY, WU XR, LI HX, et al. Correlation between serum 25-hydroxyvitamin D3 level and esophageal variceal bleeding in liver cirrhosis[J]. Chin J Hepatol, 2019, 27( 5): 358- 362. DOI: 10.3760/cma.j.issn.1007-3418.2019.05.007.

    赵明远, 武希润, 李红霞, 等. 血清25羟维生素D3的水平与肝硬化食管静脉曲张破裂出血的相关性[J]. 中华肝脏病杂志, 2019, 27( 5): 358- 362. DOI: 10.3760/cma.j.issn.1007-3418.2019.05.007.
    [22] TIAN Y, ZHANG Q, LIANG HM, et al. Value of hepatic blood flow ultrasound parameters combined with serum 25 hydroxyvitamin D3 in predicting esophageal variceal hemorrhage in patients with liver cirrhosis[J] J Med Imag, 2022, 32( 11): 1935- 1939.

    田勇, 张强, 梁海明, 等. 肝血流超声参数联合血清25羟维生素D3在肝硬化患者食管胃底静脉曲张破裂出血中的预测价值[J]. 医学影像学杂志, 2022, 32( 11): 1935- 1939.
    [23] ZHANG XX, WANG HR, WEI M, et al. Association of vitamin D levels with risk of cognitive impairment and dementia: A systematic review and meta-analysis of prospective studies[J]. J Alzheimers Dis, 2024, 98( 2): 373- 385. DOI: 10.3233/JAD-231381.
    [24] GÁLL Z, SZÉKELY O. Role of vitamin D in cognitive dysfunction: New molecular concepts and discrepancies between animal and human findings[J]. Nutrients, 2021, 13( 11): 3672. DOI: 10.3390/nu13113672.
    [25] AFIFI MAE, HUSSEIN AM, RIZK M. Low serum 25-hydroxy vitamin D(25-OHD) and hepatic encephalopathy in HCV-related liver cirrhosis[J]. Int J Hepatol, 2021, 2021: 6669527. DOI: 10.1155/2021/6669527.
    [26] European Association for the Study of the Liver. EASL clinical practice guidelines on the management of hepatic encephalopathy[J]. J Hepatol, 2022, 77( 3): 807- 824. DOI: 10.1016/j.jhep.2022.06.001.
    [27] MIWA TK, HANAI T, HIRATA S, et al. Vitamin D deficiency stratifies the risk of covert and overt hepatic encephalopathy in patients with cirrhosis: A retrospective cohort study[J]. Clin Nutr ESPEN, 2024, 63: 267- 273. DOI: 10.1016/j.clnesp.2024.06.055.
    [28] ZHAO HN, CHEN JH, BAI ZH, et al. Effect of human albumin on oxidative stress in patient with hepatic encephalopathy due to liver cirrhosis[J]. Clin J Med Offic, 2024, 52( 9): 965- 967. DOI: 10.16680/j.1671-3826.2024.09.24.

    赵浩南, 陈纪宏, 白朝辉, 等. 人血白蛋白对肝硬化肝性脑病患者氧化应激反应影响[J]. 临床军医杂志, 2024, 52( 9): 965- 967. DOI: 10.16680/j.1671-3826.2024.09.24.
    [29] BARREA L, MUSCOGIURI G, FRIAS-TORAL E, et al. Nutrition and immune system: From the Mediterranean diet to dietary supplementary through the microbiota[J]. Crit Rev Food Sci Nutr, 2021, 61( 18): 3066- 3090. DOI: 10.1080/10408398.2020.1792826.
    [30] LEE PC, HSIEH YC, HUO TI, et al. Active vitamin D3 treatment attenuated bacterial translocation via improving intestinal barriers in cirrhotic rats[J]. Mol Nutr Food Res, 2021, 65( 3): e2000937. DOI: 10.1002/mnfr.202000937.
    [31] ZHANG C, ZHAO LR, DING Y, et al. Enhanced LL-37 expression following vitamin D supplementation in patients with cirrhosis and spontaneous bacterial peritonitis[J]. Liver Int, 2016, 36( 1): 68- 75. DOI: 10.1111/liv.12888.
    [32] MOHAMED AA, AL-KARMALAWY AA, EL-KHOLY AA, et al. Effect of Vitamin D supplementation in patients with liver cirrhosis having spontaneous bacterial peritonitis: A randomized controlled study[J]. Eur Rev Med Pharmacol Sci, 2021, 25( 22): 6908- 6919. DOI: 10.26355/eurrev_202111_27239.
    [33] ABDEL HAFEZ H, MADANI H, ABDEL ALEM S, et al. Is serum-ascites vitamin D gradient a valid marker for diagnosing spontaneous bacterial peritonitis in patients with cirrhotic ascites?[J]. Lab Med, 2021, 52( 6): 567- 573. DOI: 10.1093/labmed/lmab019.
    [34] BANDERA MERCHAN B, MORCILLO S, MARTIN-NUÑEZ G, et al. The role of vitamin D and VDR in carcinogenesis: Through epidemiology and basic sciences[J]. J Steroid Biochem Mol Biol, 2017, 167: 203- 218. DOI: 10.1016/j.jsbmb.2016.11.020.
    [35] ZHANG YG, JIANG XF, LI XJ, et al. Serum vitamin D levels and risk of liver cancer: A systematic review and dose-response meta-analysis of cohort studies[J]. Nutr Cancer, 2021, 73( 8): 1- 9. DOI: 10.1080/01635581.2020.1797127.
    [36] FANG AP, LONG JG, ZHANG YJ, et al. Serum bioavailable, rather than total, 25-hydroxyvitamin D levels are associated with hepatocellular carcinoma survival[J]. Hepatology, 2020, 72( 1): 169- 182. DOI: 10.1002/hep.31013.
    [37] GOTO RL, TABLAS MB, PRATA GB, et al. Vitamin D3 supplementation alleviates chemically-induced cirrhosis-associated hepatocarcinogenesis[J]. J Steroid Biochem Mol Biol, 2022, 215: 106022. DOI: 10.1016/j.jsbmb.2021.106022.
    [38] VASHI PG, TRUKOVA K, LAMMERSFELD CA, et al. Impact of oral vitamin D supplementation on serum 25-hydroxyvitamin D levels in oncology[J]. Nutr J, 2010, 9: 60. DOI: 10.1186/1475-2891-9-60.
    [39] QIN LN, ZHANG H, LI QQ, et al. Vitamin D binding protein(VDBP) hijacks twist1 to inhibit vasculogenic mimicry in hepatocellular carcinoma[J]. Theranostics, 2024, 14( 1): 436- 450. DOI: 10.7150/thno.90322.
    [40] WU YQ, FAN WZ, XUE M, et al. 25-OH-vitamin D deficiency identifies poor tumor response in hepatocellular carcinoma treated with transarterial chemoembolization[J]. Clin Transl Oncol, 2020, 22( 1): 70- 80. DOI: 10.1007/s12094-019-02146-3.
    [41] LI YL, ZOU DH, YANG DW. Relationship between serum 25-hydroxyvitamin D3 and peripheral blood vitamin D receptor levels with the efficacy and survival outcomes of sorafenib targeted therapy in patients with advanced stage hepatocellular carcinoma[J]. Lab Med Clin, 2024, 21( 21): 3111- 3116. DOI: 10.3969/j.issn.1672-9455.2024.21.002.

    李玉苓, 邹东花, 杨大伟. 血清25(OH)D3及外周血维生素D受体水平与晚期肝细胞癌患者索拉非尼靶向治疗疗效及生存情况的关系[J]. 检验医学与临床, 2024, 21( 21): 3111- 3116. DOI: 10.3969/j.issn.1672-9455.2024.21.002.
    [42] SHU J, ZHANG MJ, DONG XC, et al. Vitamin D receptor gene polymorphisms, bioavailable 25-hydroxyvitamin D, and hepatocellular carcinoma survival[J]. J Natl Cancer Inst, 2024, 116( 10): 1687- 1696. DOI: 10.1093/jnci/djae116.
    [43] European Association for the Study of the Liver. EASL clinical practice guidelines on nutrition in chronic liver disease[J]. J Hepatol, 2019, 70( 1): 172- 193. DOI: 10.1016/j.jhep.2018.06.024.
    [44] BOWMAN CA, BICHOUPAN K, POSNER S, et al. A prospective open-label dose-response study to correct vitamin D deficiency in cirrhosis[J]. Dig Dis Sci, 2024, 69( 3): 1015- 1024. DOI: 10.1007/s10620-023-08224-5.
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  • 收稿日期:  2024-12-04
  • 录用日期:  2025-01-06
  • 出版日期:  2025-08-25
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