Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
J Evid Based Med. 2020 Aug;13(3):183-191. doi: 10.1111/jebm.12383. Epub 2020 May 5.
Vitamin D status plays an important role in immunoregulation, and a deficiency is believed to be related to Graft Versus Host Disease (GVHD) in patients after hematopoietic stem cell transplantation (HSCT). We aim to study the association between vitamin D deficiency and GVHD after HSCT.
A literature search was conducted utilizing MEDLINE, EMBASE, and The Cochrane Library Database from inception to July 2019. Eligible studies were required to be clinical trials or observational studies (cohort, case-control, or cross-sectional studies); provide data to calculate the odds ratios (OR) of GVHD in HSCT patients with vitamin D deficiency. Two reviewers independently extracted the data and assessed the risk of bias. Pooled odds ratios (OR) with 95% confidence interval (CI) were estimated using random-effects meta-analysis through the Comprehensive Meta-Analysis 3.3 software.
In total, 8 observational studies consisting of 1335 HSCT patients were enrolled in this systematic review. Overall, there was no significant association between vitamin D deficiency and acute GVHD (OR = 1.06, 95% CI 0.74-1.53, P > 0.05). There was no significant association between vitamin D deficiency and chronic GVHD (OR = 1.75, 95% CI 0.72-4.26, P > 0.05). Funnel plots and Egger regression asymmetry test were performed and showed no publication bias.
There is not a statistically significant association between vitamin D deficiency and neither acute nor chronic GVHD.
维生素 D 状态在免疫调节中起着重要作用，据信其缺乏与造血干细胞移植（HSCT）后患者的移植物抗宿主病（GVHD）有关。我们旨在研究 HSCT 后维生素 D 缺乏与 GVHD 之间的关系。
我们利用 MEDLINE、EMBASE 和 The Cochrane Library 数据库进行了文献检索，检索时间从建库至 2019 年 7 月。合格的研究需要是临床试验或观察性研究（队列、病例对照或横断面研究）；提供数据以计算维生素 D 缺乏的 HSCT 患者 GVHD 的比值比（OR）。两位审查员独立提取数据并评估偏倚风险。通过 Comprehensive Meta-Analysis 3.3 软件，使用随机效应荟萃分析估计汇总比值比（OR）及其 95%置信区间（CI）。
本系统评价共纳入了 8 项观察性研究，共 1335 例 HSCT 患者。总体而言，维生素 D 缺乏与急性 GVHD 之间无显著相关性（OR=1.06，95%CI 0.74-1.53，P>0.05）。维生素 D 缺乏与慢性 GVHD 之间也无显著相关性（OR=1.75，95%CI 0.72-4.26，P>0.05）。进行了漏斗图和 Egger 回归不对称检验，未显示发表偏倚。
维生素 D 缺乏与急性或慢性 GVHD 之间无统计学显著相关性。
