Department of Nephrology, Rheumatology, and Immunology, Maternal and Child Health Hospital of Hubei Province, Wuhan, People's Republic of China; Department of Pediatrics, University of California, San Diego, California.
Department of Pediatrics, University of California, San Diego, California; Biology undergraduate Program, University of California, San Diego, California.
Am J Med Sci. 2019 Aug;358(2):104-114. doi: 10.1016/j.amjms.2019.04.020. Epub 2019 Apr 26.
The efficacy of vitamin D supplementation in patients with systemic lupus erythematosus (SLE) remains uncertain. This meta-analysis aimed to systematically evaluate the efficacy and safety of vitamin D supplementation in patients with SLE.
Randomized controlled trials (RCTs) were searched in PubMed, Embase, Cochrane CENTRAL and Web of Science databases. The retrieved studies were subjected to meta-analysis using the fixed-effect or random-effect model.
Five eligible RCTs enrolling 490 participants were included. Compared to the placebo treatment, vitamin D supplementation significantly increased the level of serum 25-hydroxyvitamin D (25(OH)D) (5 trials, 490 participants: standard mean difference (SMD) = 2.072, 95% CI: 1.078-3.066, P < 0.001). The pooled result from 2 RCTs showed that vitamin D supplementation decreased the fatigue severity scale scores in patients with SLE (2 trials, 79 participants: SMD = -1.179, 95% CI: -1.897 to -0.460, P = 0.001). The SLE disease activity index scores and positivity of anti-double-stranded DNA antibodies (anti-dsDNA) did not differ significantly (4 trials, 223 participants: SMD = -0.507, 95% CI: -1.055-0.041, P = 0.070; 3 trials, 361 participants: Risk ratio = 0.880, 95% CI: 0.734-1.054, P = 0.165) between the vitamin D supplementation group and the placebo treatment group. None of the included studies reported severe adverse events associated with vitamin D supplementation.
This meta-analysis suggested that vitamin D supplementation is effective in increasing the serum 25(OH)D levels, may improve fatigue, and is well-tolerated in patients with SLE, however, it does not seem to have significant effects in decreasing the positivity of anti-dsDNA and disease activity.
维生素 D 补充剂在系统性红斑狼疮（SLE）患者中的疗效尚不确定。本荟萃分析旨在系统评价维生素 D 补充剂治疗 SLE 患者的疗效和安全性。
在 PubMed、Embase、Cochrane CENTRAL 和 Web of Science 数据库中检索随机对照试验（RCT）。使用固定效应或随机效应模型对检索到的研究进行荟萃分析。
纳入了 5 项符合条件的 RCT，共纳入 490 名参与者。与安慰剂治疗相比，维生素 D 补充剂显著提高了血清 25-羟维生素 D（25（OH）D）水平（5 项试验，490 名参与者：标准均数差（SMD）=2.072，95%CI：1.078-3.066，P<0.001）。来自 2 项 RCT 的汇总结果表明，维生素 D 补充剂降低了 SLE 患者的疲劳严重程度评分（2 项试验，79 名参与者：SMD=-1.179，95%CI：-1.897 至-0.460，P=0.001）。SLE 疾病活动指数评分和抗双链 DNA 抗体（抗 dsDNA）阳性率无显著差异（4 项试验，223 名参与者：SMD=-0.507，95%CI：-1.055 至-0.041，P=0.070；3 项试验，361 名参与者：风险比=0.880，95%CI：0.734 至 1.054，P=0.165）。纳入的研究均未报告与维生素 D 补充相关的严重不良事件。
本荟萃分析表明，维生素 D 补充剂可有效提高血清 25（OH）D 水平，可能改善疲劳，且在 SLE 患者中耐受性良好，但似乎对降低抗 dsDNA 阳性率和疾病活动度无显著作用。
