Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Mod Rheumatol. 2020 Mar;30(2):385-390. doi: 10.1080/14397595.2019.1575000. Epub 2019 Mar 4.
Several epidemiological studies have suggested that patients with vitamin D insufficiency and deficiency tend to have a higher level of serum uric acid compared with those with adequate vitamin D level although the results were inconsistent across the studies. The current systematic review and meta-analysis was conducted with the aim to summarize all the available data. A systematic review was conducted using MEDLINE and EMBASE database from inception to May 2018 to identify all studies that compared the level of serum uric acid between individuals with normal vitamin D level and patients with vitamin D insufficiency/deficiency. Eligible studies must be cohort or cross-sectional studies that consisted of two groups of adult participants, one with normal level of vitamin D (vitamin D level >30 ng/ml) and one with vitamin D insufficiency (vitamin D level 20-30 ng/ml) or vitamin D deficiency (vitamin D level of <20 ng/ml). Mean serum uric acid level and standard deviation of participants were extracted from each study to calculate mean difference (MD). Pooled MD was then calculated by combining MDs of each study using random-effects model. A total of seven cross-sectional studies were eligible for the meta-analyses. Individuals with normal vitamin D level had a significantly lower serum uric acid level than patients with vitamin D insufficiency with the pooled MD of -0.33 mg/dl (95%CI, -0.61, -0.04), and also had a significantly lower serum uric acid level than patients with vitamin D deficiency with the pooled MD of -0.45 mg/dl (95%CI, -0.82, -0.08). The statistical heterogeneity of these meta-analyses was high with the of 78% and 89%, respectively. Funnel plots of both meta-analyses were fairly symmetric and did not provide a suggestive evidence for the presence of publication bias. Both patients with vitamin D insufficiency and patients with vitamin D deficiency had a significantly higher level of serum uric acid compared with individuals with normal vitamin D level.
几项流行病学研究表明，与维生素 D 水平充足的患者相比，维生素 D 不足和缺乏的患者血清尿酸水平往往更高，尽管这些研究的结果并不一致。本系统评价和荟萃分析旨在总结所有现有数据。通过对 MEDLINE 和 EMBASE 数据库进行系统评价，从建库至 2018 年 5 月，检索比较血清尿酸水平在维生素 D 水平正常者和维生素 D 不足/缺乏者之间的所有研究。合格的研究必须是队列或横断面研究，包括两组成年参与者，一组维生素 D 水平正常（维生素 D 水平>30ng/ml），一组维生素 D 不足（维生素 D 水平 20-30ng/ml）或维生素 D 缺乏（维生素 D 水平<20ng/ml）。从每项研究中提取参与者的平均血清尿酸水平和标准差，以计算平均差（MD）。然后通过使用随机效应模型合并每个研究的 MD 来计算汇总 MD。共有 7 项横断面研究符合荟萃分析的条件。与维生素 D 不足的患者相比，维生素 D 水平正常的个体血清尿酸水平显著降低，汇总 MD 为-0.33mg/dl（95%CI，-0.61，-0.04），与维生素 D 缺乏的患者相比，血清尿酸水平也显著降低，汇总 MD 为-0.45mg/dl（95%CI，-0.82，-0.08）。这些荟萃分析的统计异质性很高，分别为 78%和 89%。这两个荟萃分析的漏斗图相当对称，没有提供存在发表偏倚的提示性证据。与维生素 D 水平正常的个体相比，维生素 D 不足和维生素 D 缺乏的患者血清尿酸水平均显著升高。
