the relationship between 25-hydroxyvitamin d3 and hepatitis b surface antigen levels in patients with chronic hepatitis b in japan

Background: although there are many reports on the relationship between serum 25-hydroxyvitamin d3 levels and chronic liver diseases, the relevance of the former to the latter is still unclear. objectives: this study aimed at clarifying the relationship between serum 25-hydroxyvitamin d3 levels and hbv-related markers, such as hbv-dna, hepatitis b surface antigen (hbsag), and hepatitis b virus core-related antigen (hbcrag) in patients with chronic hepatitis b. methods: this was a multicenter retrospective study. the subjects consisted of 236 consecutive untreated patients with chronic hepatitis b. serum 25-hydroxyvitamin d3 levels were measured by double-antibody radioimmunoassay. the 25-hydroxyvitamin d3 levels were divided to three groups: ≤ 20 ng/ml for deficiency, 21 to 29 ng/ml for insufficiency, and ≥ 30 ng/ml for sufficiency. results: the subjects consisted of 127 males and 109 females, with a median age of 57 years (range, 15 to 84 years). the patients with positive hbeag and genotype c accounted for 14.4% and 63.1%, respectively. the median hbv-dna level and hbsag level were 684 iu/ml and 750 iu/ml, respectively. the median serum 25-hydroxyvitamin d3 level was significantly lower in patients (21.0 ng/ml) than in healthy volunteers (25.0 ng/ml, p = 0.013). the median serum 25-hydroxyvitamin d3 level in patients with a serum hbsag level ≥ 1000 iu/ml was significantly lower than that in patients with a serum hbsag level o f < 1000 u/ml (p = 8.06 × 1 0 ). the incidence of the hbsag level ≥ 1000 iu/ml was 55.8% in patients with vitamin d deficiency and 3 8.2% in patients with vitamin d insufficiency/sufficiency (p = 8.92 × 10 ). on multivariate analysis, female gender, the cold season, and a serum hbsag level of ≥ 1000 iu/ml were independently associated with vitamin d deficiency. from the opposite viewpoint, vitamin d deficiency and high serum hbcrag level were independent factors associated with an hbsag level of ≥ 1000 iu/ml. conclusions: this study suggests that serum vitamin d level is closely and negatively correlated with the hbsag level in chronic hepatitis b patients.