International Centre for Medical Research, Dorset, United Kingdom.
Alltrista, Christchurch, Dorset, United Kingdom.
Inflamm Bowel Dis. 2020 Nov 19;26(12):1819-1830. doi: 10.1093/ibd/izaa087.
Vitamin D deficiency has been implicated in the pathogenesis of inflammatory bowel disease. Emerging literature suggests that optimization of vitamin D levels may be associated with improvements in disease activity and quality of life. We conducted a meta-analysis exploring the effect of vitamin D on serum 25-hydroxyvitamin D (s-25[OH]D) levels, clinical improvement, and biomarkers.
MEDLINE, EMBASE, the Cochrane Library, and sources for grey literature were searched from inception until September 2019. The primary outcome was s-25(OH)D mean differences. Heterogeneity was assessed using the χ 2 test and the I2 statistic. Review Manager software v. 5.3 was used.
Twelve randomized controlled trials (n = 611) and 4 observational studies (n = 359) were included in the meta-analysis. On average, in the randomized controlled trials, vitamin D supplementation increased s-25(OH)D levels by 15.50 ng/mL (95% confidence interval [CI], 11.08-19.92, P ≤ 0.00001, I2 = 90%) and in observational studies they increased by 18.39 ng/mL (95% CI, 8.91-27.88, P = 0.0001, I2 = 82%). Subgroup analyses between vitamin D and placebo groups revealed that vitamin D increased s-25(OH)D by 14.85 ng/mL (95% CI, 9.96-19.73, P ≤ 0.00001, I2 = 90%) and when high doses of vitamin D were compared with low doses, high doses increased s-25(OH)D by 18.27 ng/mL (95% CI, 5.44-31.10, P = 0.005, I2 = 90%). The Harvey Bradshaw Index improved by -1.47 points (95% CI, -2.47 to -0.47, P = 0.004, I2 = 0%) and the high-sensitivity C-reactive protein decreased by -1.58 mg/L (95% CI, -2.95 to -0.21, P = 0.02, I2 = 0%).
Vitamin D supplementation in patients with IBD and vitamin D deficiency is effective at correcting vitamin D levels and is associated with improvement in clinical and biochemical disease activity scores.
维生素 D 缺乏与炎症性肠病的发病机制有关。新出现的文献表明，优化维生素 D 水平可能与改善疾病活动度和生活质量有关。我们进行了一项荟萃分析，探讨了维生素 D 对血清 25-羟维生素 D（s-25[OH]D）水平、临床改善和生物标志物的影响。
从开始到 2019 年 9 月，检索了 MEDLINE、EMBASE、Cochrane 图书馆和灰色文献来源。主要结局是 s-25（OH）D 的平均差异。使用 χ²检验和 I² 统计评估异质性。使用 Review Manager 软件 v. 5.3。
纳入了 12 项随机对照试验（n = 611）和 4 项观察性研究（n = 359）进行荟萃分析。平均而言，在随机对照试验中，维生素 D 补充剂使 s-25（OH）D 水平增加了 15.50ng/mL（95%置信区间[CI]，11.08-19.92，P ≤ 0.00001，I² = 90%），在观察性研究中增加了 18.39ng/mL（95%CI，8.91-27.88，P = 0.0001，I² = 82%）。维生素 D 组与安慰剂组之间的亚组分析表明，维生素 D 使 s-25（OH）D 增加了 14.85ng/mL（95%CI，9.96-19.73，P ≤ 0.00001，I² = 90%），而高剂量维生素 D 与低剂量维生素 D 相比，高剂量使 s-25（OH）D 增加了 18.27ng/mL（95%CI，5.44-31.10，P = 0.05，I² = 90%）。Harvey Bradshaw 指数改善了-1.47 分（95%CI，-2.47 至-0.47，P = 0.004，I² = 0%），高敏 C 反应蛋白降低了-1.58mg/L（95%CI，-2.95 至-0.21，P = 0.02，I² = 0%）。
在 IBD 和维生素 D 缺乏的患者中补充维生素 D 可有效纠正维生素 D 水平，并与改善临床和生化疾病活动评分相关。
