Correlation between vitamin D levels and apoptosis in geriatric patients infected with hepatitis C virus genotype 4

Figures & data

Table 1 Demographics, parameters studied, and clinical characteristics of geriatric CHC and control subjects

Groups/parameters	Control subjects (n=20)	All CHC patients (n=100)
Age (years)#	48.3±6.1	47.8±4.9
Sex (male/female)#	15/5	80/20
BMI (kg/m^2)#	23.7±4.1	24.9±5.7*
AST (IU/mL)##	22.3±6.3	68.4±11.2**
ALT (IU/mL)##	28.3±5.6	85.7±22.3**
Albumin (gm/dL)	4.2±0.27	2.9±0.94**
Bilirubin (mg/dL)	0.7±0.46	3.8±0.94**
Platelets (109/L)#	235±46.8	187±24.7**
Duration of HCV (years)	–	7.6±2.3
HCV RNA (IU/mL)	–	8.3×10^5
HCV genotypes	–	G4
Viral load	–	38.7±6.2
AFP (ng/mL)##	3.6±4.4	25.4±2.7**
TNFα (pg/mL)	76.6±35.7	310.0±52.1**
Glucose (mg/dL)	85±4.3	98±6.1*
HOMA-IR	1.85±0.87	3.15±1.2*
IR, n (%)	0 (0%)	48 (48%)
ASC/fibrosis/cirrhosis	–	30/25/45
Fatty liver	–	20 (20%)
Portal hypertension and/or ascites	–	35 (35%)
Length of liver-biopsy core	–	20.3±0.65 cm
Portal tracts	–	15±5.7
Necroinflammation
A0–A1	–	30 (30%)
A2–A3	–	70 (70%)

Notes: All values represent mean ± standard deviation or n (%). “–” indicates these parameters are related to viral estimation and hepatic pathology;

# Student’s t-test;

## Mann–Whitney U-test;

* P<0.05;

** P<0.01.

Abbreviations: CHC, chronic hepatitis C; BMI, body mass index; HCV, hepatitis C virus; HOMA, homeostatic model assessment; IR, insulin resistance; ASC, asymptomatic CHC; AST, Aspartate aminotransferase; ALT, Alanine aminotransferase; AFP, alpha fetoprotein; TNFα, tumor necrosis factor-α.

Table 2 Biochemical profiles of geriatric CHC patients according to liver-fibrosis scores

Groups/parameters	Control (n=20)	All CHC patients (n=100)			Significance
		ASC (n=30)	Fibrosis (n=25)	Cirrhosis (n=45)	P1	P2	P3
AST (IU/mL)	22.3±6.3	38.5±5.2a	75.5±12.1a	62.5±6.3a	0.01	0.001	0.001
ALT (IU/mL)	28.3±5.6	35.9±8.3a	98.4±15.3a	48.6±9.4a	0.01	0.01	0.001
Albumin (gm/dL)	4.2±0.27	4.0±0.54a	3.1±0.31a	2.7±0.89a	0.01	0.001	0.001
Bilirubin (mg/dL)	0.7±0.46	0.96±0.84a	2.7±1.4a	4.9±3.4a	0.05	0.01	0.001
Glucose (mg/dL)	85±4.3	92±3.8	85.9±2.7	89.1±3.2	0.05	0.01	0.05
HOMA-IR	1.85±0.87	2.85±1.2	4.38±1.4	4.2±1.1	NS	NS	0.05
IR, n (%)	0	11 (36.7%)	14 (56%)	29 (64.4%)	NS	NS	0.05
AFP (ng/mL)	3.6±4.4	5.4±3.7a	8.5±6.1a	16.7±5.3a	0.01	0.003	0.001
TNFα (pg/mL)	76.6±35.7	20.0±72.1a	24.0±24.7a	29.8±51.3a	0.005	0.001	0.001

Notes: All values represent mean ± standard deviation or n (%);

a significant difference from healthy controls at P≤0.05; P₁, comparison of ASC and fibrosis groups; P₂, comparison of fibrosis and cirrhosis groups; P₃, comparison of ASC and cirrhosis groups.

Abbreviations: CHC, chronic hepatitis C; ASC, asymptomatic CHC; HOMA, homeostatic model assessment; IR, insulin resistance; NS, not significant; AST, Aspartate aminotransferase; ALT, Alanine aminotransferase; AFP, alpha fetoprotein; TNFα, tumor necrosis factor-α.

Table 3 Change in 25(OH)D levels, oxidative stress, and apoptosis-related biomarkers of geriatric CHC patients based on liver-fibrosis scores

Groups/parameters	Control (n=20)	All CHC patients (n=100)			Significance
		ASC (n=30)	Fibrosis (n=25)	Cirrhosis (n=45)	P1	P2	P3
Serum 25(OH)D (nmol/L)	38.7±5.8	31.8±3.9a	24.2±3.8a	20.3±2.4a	0.001	0.001	0.001
TAC (nmol/μL)	24.8±4.7	21.4±5.1a	14.2±1.9a	8.3±3.6a	0.01	0.01	0.001
NO (nmol/dL)	12.7±0.42	15.8±0.87a	24.8±0.97a	34.5±1.3a	0.01	0.001	0.001
sFas (ng/mL)	0.42±0.25	4.8±1.5a	8.5±3.6a	11.5±4.6a	0.05	0.01	0.001
ssDNA (μ/g)	0.05×10^5	3.7×10^5	14.9×10^5	21.2×10^5	0.01	0.01	0.001

Notes: All values represent mean ± standard deviation;

a significant difference from healthy controls at P≤0.05; P₁, comparison of ASC and fibrosis groups; P₂, comparison of fibrosis and cirrhosis groups; P₃, comparison of ASC and cirrhosis groups.

Abbreviations: 25(OH)D, 25-hydroxyvitamin D; CHC, chronic hepatitis C; ASC, asymptomatic CHC; TAC, total antioxidant capacity; sFas, soluble Fas; ssDNA, single-stranded DNA; ASC, asymptomatic CHC; NO, nitri oxide.

Figure 1 Correlation between viral markers and serum 25(OH)D levels based on liver fibrosis.

Abbreviations: 25(OH)D, 25-hydroxyvitamin D; HCV, hepatitis C virus; ASC, asymptomatic chronic HCV.

Table 4 Correlation coefficients (r) of apoptosis-related markers ssDNA and sFas with other parameters in geriatric patients with CHC (n=100)

Groups/parameters	Apoptotic markers
	ASC (n=30)		Fibrosis (n=25)		Cirrhosis (n=45)
	sFas	ssDNA	sFas	ssDNA	sFas	ssDNA
HCV RNA (IU/mL)	0.15*	0.35*	0.15**	0.35**	0.65***	0.40***
Viral load	0.23*	0.18*	0.12**	0.64**	0.88***	0.31***
AFP (ng/mL)	0.45*	0.35*	0.24**	0.76**	0.61***	0.39***
TNFα (pg/mL)	0.38*	0.18*	0.26**	0.36**	0.58***	0.58***
TAC (nmol/μL)	0.31*	0.51*	0.48**	0.64**	0.71***	0.67***
NO (nmol/dL)	0.37*	0.35*	0.54**	0.53**	0.56***	0.62***

Notes:

* P<0.05;

** P<0.01;

*** P<0.001.

Abbreviations: ssDNA, single-stranded DNA; sFas, soluble Fas; CHC, chronic hepatitis C; ASC, asymptomatic CHC; HCV, hepatitis C virus; TAC, total antioxidant capacity; AFP, alpha fetoprotein; TNFα, tumor necrosis factor-α; NO, nitric oxide.

Table 5 Correlation coefficients (r) of 25(OH)D deficiency with other parameters in geriatric patients with CHC (n=100)

Groups/parameters	25(OH)D deficiency (nmol/L)
	ASC (n=30)	Fibrosis (n=25)	Cirrhosis (n=45)
Age	−0.22*	−0.84*	−0.93*
Sex	−0.18*	−0.28*	−0.31**
Liver function	−0.32**	−0.43**	−0.71***
BMI	−0.28**	−0.23**	−0.51***
HOMA-IR	−0.48**	−0.63**	−0.71***
HCV RNA (IU/mL)	−0.35**	−0.198**	−0.510***
Viral load	−0.18**	−0.214**	−0.478***
AFP (ng/mL)	0.35**	0.251**	0.612***
TNFα (pg/mL)	0.18**	0.243**	0.478***
TAC (nmol/μL)	0.51**	0.78**	0.681***
NO (nmol/dL)	0.35**	0.514**	0.156***
sFas (ng/mL)	0.231**	0.452**	0.714***
ssDNA (μ/g)	0.583**	0.463**	0.245***

Notes:

* P<0.05;

** P<0.01;

*** P<0.001.

Abbreviations: 25(OH)D, 25-hydroxyvitamin D; CHC, chronic hepatitis C; ASC, asymptomatic CHC; BMI, body mass index; HOMA, homeostatic model assessment; IR, insulin resistance; HCV, hepatitis C virus; TAC, total antioxidant capacity; sFas, soluble Fas; ssDNA, single-stranded DNA; AFP, alpha fetoprotein; TNFα, tumor necrosis factor-α; NO, nitric oxide.