The association between serological and dietary vitamin D levels and hepatitis C-related liver disease risk differs in African American and white males

Authors

  • D. L. White,

    Corresponding author
    1. Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    2. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
    • Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
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  • S. Tavakoli-Tabasi,

    1. Hepatitis C Clinic, Section of Infectious Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    2. Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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  • F. Kanwal,

    1. Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    2. Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    3. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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  • D. J. Ramsey,

    1. Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    2. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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  • A. Hashmi,

    1. Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
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  • J. Kuzniarek,

    1. Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    2. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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  • P. Patel,

    1. Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    2. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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  • J. Francis,

    1. Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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  • H. B. El-Serag

    1. Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    2. Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    3. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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Correspondence to:

Dr D. L. White, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd. (MS 152), Houston, TX 77030, USA.

E-mail: dwhite1@bcm.edu

Summary

Background

Vitamin D may affect the severity of HCV-related liver disease.

Aim

To examine the association between serum vitamin D levels and advanced liver disease in a multiethnic US cohort of HCV patients, and account for dietary and supplemental intake.

Methods

We measured serum 25-hydroxyvitamin D levels and used FibroSURE-ActiTest to assess hepatic pathology in a cohort of HCV-infected male veterans. We estimated and adjusted for daily intake of vitamin D from diet using a Dietary History Questionnaire, and dispensed prescriptions prior to study enrolment. We used race-stratified logistic regression analyses to evaluate the relationship between serum vitamin D levels and risk of advanced fibrosis (F3/F4–F4) and advanced inflammation (A2/A3–A3).

Results

A total of 163 African American (AA) and 126 White non-Hispanics were studied. Overall, ~44% of AAs and 15% of Whites were vitamin D deficient (<12 ng/mL) or insufficient (12–19 ng/mL); 4% of AAs and 9% of White patients had an elevated level (>50 ng/mL). Among AAs, patients with elevated serum vitamin D levels had significantly higher odds of advanced fibrosis (OR = 12.91, P = 0.03) than those with normal levels. In contrast, AAs with insufficient or deficient levels had > two-fold excess risk of advanced inflammation (P = 0.06). Among White males there was no association between vitamin D levels and advanced fibrosis (F3/F4–F4) or inflammation (A2/A3–A3) risk.

Conclusions

We observed potential differences in the association between vitamin D levels and degree of HCV-related hepatic fibrosis between White and African American males. Additional research is necessary to confirm that high serum vitamin D levels may be associated with advanced fibrosis risk in African American males, and to evaluate whether racial differences exist in HCV-infected females.

Ancillary