Department of Paediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China.
Clin Nutr. 2020 Jun;39(6):1735-1741. doi: 10.1016/j.clnu.2019.08.010. Epub 2019 Aug 27.
The consequences of vitamin D deficiency regarding sepsis in children remain controversial. We conducted a meta-analysis of studies evaluating the association between vitamin D status and sepsis in children.
We used EMBASE, Ovid Medline and Cochrane Library to conduct a meta-analysis of studies published in English before November 21, 2017.
Among 1146 initially identified studies, we included 13 studies according to predefined inclusion criteria comprising 975 patients and 770 control participants. According to a random effects model, the mean difference in 25(OH)D levels (nmol/L) between participants with sepsis (444) and controls (528) was (mean difference, -18.55; 95% confidence interval (CI), -19.45 to -17.66, p < 0.05). The association between vitamin D deficiency and sepsis was significant, with an odds ratio (OR) = 1.13 (95% CI, 1.18 to 1.50, p < 0.05). Factors that could explain differences in the results include the study location/medical conditions, study design, 25(OH)D assay methods, diagnostic sepsis at different ages, diagnostic criteria for sepsis, and sepsis with comorbidities.
The association between vitamin D deficiency/lower 25(OH)D levels and sepsis was significant in children and neonates. Further studies are required to confirm the results by considering more confounders.
维生素 D 缺乏与儿童脓毒症的关系仍存在争议。我们对评估维生素 D 状态与儿童脓毒症之间关系的研究进行了荟萃分析。
我们使用 EMBASE、Ovid Medline 和 Cochrane Library，对截至 2017 年 11 月 21 日发表的英文研究进行了荟萃分析。
在最初确定的 1146 项研究中，我们根据预先确定的纳入标准纳入了 13 项研究，这些研究包括 975 名患者和 770 名对照参与者。根据随机效应模型，脓毒症患者（444 人）与对照组（528 人）25(OH)D 水平（nmol/L）的均数差值为（平均差值，-18.55；95%置信区间，-19.45 至-17.66，p<0.05）。维生素 D 缺乏与脓毒症之间的关联具有统计学意义，比值比（OR）=1.13（95%可信区间，1.18 至 1.50，p<0.05）。可能导致结果差异的因素包括研究地点/医疗条件、研究设计、25(OH)D 检测方法、不同年龄诊断脓毒症、脓毒症的诊断标准以及伴有合并症的脓毒症。
维生素 D 缺乏/25(OH)D 水平较低与儿童和新生儿脓毒症之间存在显著关联。需要进一步的研究来确认结果，并考虑更多的混杂因素。
