Luo Xiaoyue, Ou Ruwei, Dutta Rajib, Tian Yuan, Xiong Hai, Shang Huifang
Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Department of Geriatrics, The Fourth Affiliated Hospital of Sichuan University, Chengdu, China.
Front Neurol. 2018 Nov 12;9:909. doi: 10.3389/fneur.2018.00909. eCollection 2018.
Vitamin D is an important secosteroid which is involved the development and regulation of brain activity. Several studies have focused on exploring the relationship between serum vitamin D levels and Parkinson's disease (PD), but the conclusion remains ambiguous. We searched observational studies that explored the association between serum vitamin D levels and PD based on PubMed, EMBASE and Cochrane library from inception through to January 2018. The quality of included studies was evaluated by using Newcastle-Ottawa Scale (NOS). Statistical analysis of this meta-analysis was performed by Stata version 12.0 and R software. Twenty studies with a total of 2,866 PD patients and 2,734 controls were included. Compared with controls, PD patients had lower serum vitamin D levels (WMD -3.96, 95%CI -5.00, -2.92), especially in higher latitude regions (WMD -4.20, 95%CI -5.66, -2.75). Assay methods contributed significantly to high heterogeneity. Furthermore, PD patients with deficient vitamin D levels had advanced risk (OR 2.08, 95%CI 1.35, 3.19) than those patients with insufficient ones (OR = 1.73, 95%CI 1.48, 2.03). In addition, serum vitamin D levels were also related to the severity of PD (WMD -5.27, 95%CI -8.14, -2.39) and the summary correlation coefficient showed strongly negative correlation ( = -0.55, 95%CI -0.73, -0.29). Moreover, the pooled correlation coefficient revealed that serum vitamin D levels were also negatively correlated to the Unified Parkinson's Disease Rating Scale III (UPDRS III) ( = -0.36, 95%CI -0.53, -0.16), but did not correlate with the duration of PD ( = 0.37) and age of patients ( = 0.49). Serum vitamin D levels are inversely associated with the risk and severity of PD. Our results provided an updated evidence of association between low vitamin D levels and PD and prompt the adjunctive therapeutic decisions about vitamin D replacement in PD.
维生素D是一种重要的类固醇激素，参与大脑活动的发育和调节。多项研究聚焦于探索血清维生素D水平与帕金森病（PD）之间的关系，但结论仍不明确。我们检索了从创刊至2018年1月期间基于PubMed、EMBASE和Cochrane图书馆的观察性研究，这些研究探讨了血清维生素D水平与PD之间的关联。采用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。本荟萃分析的统计分析通过Stata 12.0版和R软件进行。共纳入20项研究，包括2866例PD患者和2734例对照。与对照组相比，PD患者的血清维生素D水平较低（加权均数差-3.96，95%可信区间-5.00，-2.92），尤其是在高纬度地区（加权均数差-4.20，95%可信区间-5.66，-2.75）。检测方法对高异质性有显著影响。此外，维生素D水平缺乏的PD患者比维生素D水平不足的患者有更高的风险（比值比2.08，95%可信区间1.35，3.19）（比值比=1.73，95%可信区间1.48，2.03）。此外，血清维生素D水平还与PD的严重程度相关（加权均数差-5.27，95%可信区间-8.14，-2.39），汇总相关系数显示出强负相关（=-0.55，95%可信区间-0.73，-0.29）。此外，汇总相关系数显示血清维生素D水平也与统一帕金森病评定量表III（UPDRS III）呈负相关（=-0.36，95%可信区间-0.53，-0.16），但与PD病程（=0.37）和患者年龄（=0.49）无关。血清维生素D水平与PD的风险和严重程度呈负相关。我们的结果为低维生素D水平与PD之间的关联提供了最新证据，并促使在PD中做出关于维生素D替代的辅助治疗决策。
