摘要：慢性肝病（CLD）及其相關的肝外表現，如肝性骨營養不良與維生素D缺乏相關，因此，有人建議將其作為治療靶點。維生素D在肝臟進行25 - 羥化，因而肝臟對于這種維生素的代謝活化至關重要。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的嚴重程度成反比。在CLD時，載體蛋白如白蛋白和維生素D結合蛋白水平的下降也可能非常重要。zui近有研究報道，在改善CLD特別是丙型肝炎病毒感染后肝臟狀況并進行一定量的補充有利于其健康預后。
內容：在這篇綜述我們將討論維生素D的來源、功能和代謝，重點介紹分析測量的固有并發癥，如對25 - 羥基維生素D和1,25 - 二羥維生素D C-3差向異構體的干擾。我們還討論了對血清*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缺乏的功能機制，即維生素D代謝和CLD在遺傳變異之間的關聯。zui后，我們指出了CLD中維生素D缺乏對健康的影響，并提出了相應的治療方案。
文章來源：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
