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维生素 D 状态、维生素 D 补充、阳光暴露与帕金森病的关联:系统评价和荟萃分析。

The Association Between Vitamin D Status, Vitamin D Supplementation, Sunlight Exposure, and Parkinson's Disease: A Systematic Review and Meta-Analysis.

机构信息

Department of Epidemiology and Biostatistics, Sichuan University West China School of Public Health, Chengdu, Sichuan, China (mainland).

Department of Anorectal Surgery, Changhai Hospital of Shanghai, Shanghai, China (mainland).

出版信息

Med Sci Monit. 2019 Jan 23;25:666-674. doi: 10.12659/MSM.912840.


DOI:10.12659/MSM.912840
PMID:30672512
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6352758/
Abstract

BACKGROUND This literature review and meta-analysis aimed to determine the association between deficiency of vitamin D, or 25-hydroxyvitamin D, and Parkinson's disease, and whether vitamin D from supplements and sunlight improves the symptoms of Parkinson's disease. MATERIAL AND METHODS A literature review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Systematic literature review was performed using databases that included the Web of Science, PubMed, the Cochrane Library, and Embase. The Jadad scale (the Oxford quality scoring system) and the Newcastle-Ottawa scale (NOS) were used to evaluate the quality of the studies. RESULTS Eight studies were included in the meta-analysis. Both 25-hydroxyvitamin D insufficiency (<30 ng/mL) (OR, 1.77; 95% CI, 1.29-2.43; P<0.001) and deficiency (<20 ng/mL) (OR, 2.55; 95% CI, 1.98-3.27; P<0.001) were significantly associated with an increased risk of Parkinson's disease when compared with normal controls Sunlight exposure (³15 min/week) was significantly associated with a reduced risk of Parkinson's disease (OR, 0.02; 95% CI, 0.00-0.10; P<0.001). The use of vitamin D supplements was effective in increasing 25-hydroxyvitamin D levels (SMD, 1.79; 95% CI, 1.40-2.18; P<0.001), but had no significant effect on motor function (MD, -1.82; 95% CI, -5.10-1.45; P=0.275) in patients with Parkinson's disease. CONCLUSIONS Insufficiency and deficiency of 25-hydroxyvitamin D and reduced exposure to sunlight were significantly associated with an increased risk of Parkinson's disease. However, vitamin D supplements resulted in no significant benefits in improving motor function for patients with Parkinson's disease.

摘要

背景:本文献综述和荟萃分析旨在确定维生素 D 或 25-羟维生素 D 缺乏与帕金森病之间的关联,以及补充维生素 D 和阳光是否能改善帕金森病的症状。

材料和方法:根据系统评价和荟萃分析的首选报告项目(PRISMA)声明进行文献综述和荟萃分析。系统文献综述使用包括 Web of Science、PubMed、Cochrane 图书馆和 Embase 在内的数据库进行。使用 Jadad 量表(牛津质量评分系统)和 Newcastle-Ottawa 量表(NOS)评估研究质量。

结果:共有 8 项研究纳入荟萃分析。与正常对照组相比,25-羟维生素 D 不足(<30ng/ml)(OR,1.77;95%CI,1.29-2.43;P<0.001)和缺乏(<20ng/ml)(OR,2.55;95%CI,1.98-3.27;P<0.001)均显著增加患帕金森病的风险。每周暴露于阳光(³15 分钟)与帕金森病风险降低显著相关(OR,0.02;95%CI,0.00-0.10;P<0.001)。使用维生素 D 补充剂可有效提高 25-羟维生素 D 水平(SMD,1.79;95%CI,1.40-2.18;P<0.001),但对帕金森病患者的运动功能无显著影响(MD,-1.82;95%CI,-5.10-1.45;P=0.275)。

结论:25-羟维生素 D 不足和缺乏以及阳光暴露减少与帕金森病风险增加显著相关。然而,维生素 D 补充剂对改善帕金森病患者的运动功能没有显著益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/b8014c8b8ddb/medscimonit-25-666-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/bbc222861716/medscimonit-25-666-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/b5247dc988af/medscimonit-25-666-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/fc93a2662a0a/medscimonit-25-666-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/12fd0c4e65d9/medscimonit-25-666-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/b8014c8b8ddb/medscimonit-25-666-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/bbc222861716/medscimonit-25-666-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/b5247dc988af/medscimonit-25-666-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/fc93a2662a0a/medscimonit-25-666-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/12fd0c4e65d9/medscimonit-25-666-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7186/6352758/b8014c8b8ddb/medscimonit-25-666-g005.jpg

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本文引用的文献

[1]
Vitamin D in the prevention, prediction and treatment of neurodegenerative and neuroinflammatory diseases.

EPMA J. 2017-11-15

[2]
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Nat Rev Dis Primers. 2017-3-23

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Vitamin D Treatment Attenuates Neuroinflammation and Dopaminergic Neurodegeneration in an Animal Model of Parkinson's Disease, Shifting M1 to M2 Microglia Responses.

J Neuroimmune Pharmacol. 2016-12-16

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Mov Disord. 2016-7

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Neurol Neuroimmunol Neuroinflamm. 2015-10-29

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Low 25-hydroxyvitamin D, but not the bioavailable fraction of 25-hydroxyvitamin D, is a risk factor for multiple sclerosis.

Eur J Neurol. 2016-1

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