Association of serum 25-hydroxyvitamin D(3) levels and insulin resistance with viral load and degree of liver fibrosis in Egyptian chronic HBV patients: a case-control study

AIM OF THE STUDY: To assess serum 25-hydroxyvitamin D(3) level and insulin resistance (IR) in hepatitis B virus (HBV) patients compared with controls and to evaluate the correlation with HBV viral load, severity of liver disease and degree of liver fibrosis. MATERIAL AND METHODS: A case-control study. Sixty HBV patients and 60 controls were enrolled. Chemiluminescence was used to determine 25-hydroxyvitamin D(3) levels. Insulin resistance was evaluated using the homeostasis model assessment method. Polymerase chain reaction was used to quantify HBV viral loads. Severity of liver disease was assessed by Child-Pugh scores. Transient elastography was used to evaluate the degree of liver fibrosis. RESULTS: 25-Hydroxyvitamin D(3) deficiency is more prevalent among HBV patients compared to controls. 25-Hydroxyvitamin D(3) levels declined considerably as viral load rose (p < 0.001). 25-Hydroxyvitamin D(3) level declined as liver fibrosis progressed (34.0 ±0.0 ng/ml in F1 vs. 12.67 ±8.0 ng/ml in F4) and the severity of the disease increased (22.75 ±6.36 ng/ml in Child A vs. 5.50 ±0.58 ng/ml in Child C). Insulin resistance is more prevalent among HBV patients compared to controls and it appeared to deteriorate progressively with boosting of the viral load, degree of fibrosis and severity of liver disease (p < 0.001). CONCLUSIONS: HBV patients had significantly lower 25-hydroxyvitamin D(3) levels compared to healthy individuals and HBV infection is associated with IR. 25-Hydroxyvitamin D(3) deficiency and IR were associated with HBV viral loads, severity of liver disease, and degree of liver fibrosis.