Impaired vitamin D metabolism in patients with chronic hepatitis C against the background of obesity and insulin resistance. An effect on the development of fibrosis and outcomes of antiviral therapy
The objective. To reveal the interrelation between vitamin D levels and metabolic parameters, liver fibrosis and outcomes of antiviral therapy in patients with chronic hepatitis C (CHC). Materials and methods. A retrospective analysis included 123 patients with CHC, genotype HCV 1b. 88 individuals received antiviral therapy. The levels of vitamin D depending on the presence of metabolic syndrome, insulin resistance, severity of liver fibrosis and response to antiviral therapy were determined. Results. Inadequate provision with vitamin D was found in 35.8% of patients with CHC. Decreased vitamin D levels were observed against the background of insulin resistance (87%) and obesity (79.2%). In patients with liver cirrhosis, vitamin D deficiency was associated with insulin resistance, overweight and ALT activity >2N. The absence of response to antiviral therapy was associated not only with vitamin D deficiency but also with other more weighty factors such as insulin resistance, high viral load and diabetes mellitus. Conclusion. A decrease of vitamin D levels in patients with CHC is observed against the background of obesity, insulin resistance, metabolic resistance and diabetes mellitus type 2. Vitamin D deficiency is a significant component of liver cirrhosis. Inadequate provision with vitamin D is one of the important components of a failure of antiviral therapy, which reflects the expediency of using vitamin D in complex therapy of patients with CHC against the background of obesity and insulin resistance.