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维生素 D 补充对多囊卵巢综合征妇女血脂谱的影响:一项随机对照试验的荟萃分析。

Effectiveness of vitamin D supplementation on lipid profile in polycystic ovary syndrome women: a meta-analysis of randomized controlled trials.

机构信息

Department of Obstetrics and Gynecology, Chengdu Integrated TCM &Western Medicine Hospital, Chengdu, China.

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; The Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

出版信息

Ann Palliat Med. 2021 Jan;10(1):114-129. doi: 10.21037/apm-20-2492.

Abstract

BACKGROUND

Vitamin D deficiency (VDD) is prevalent in polycystic ovary syndrome (PCOS) and the relationship between dyslipidemia and vitamin D status is close. This meta-analysis was to evaluate the effect of vitamin D (alone or with co-supplementation) on lipid profile in PCOS patients.

METHODS

Medline, the Cochrane Library, PubMed, and Web of Science were searched, and randomized controlled trials (RCTs) published prior to January, 2020 were identified. The pooled estimates of standardized mean deviation (SMD) with 95% confidence intervals (CI) were calculated using a fixed effect model or random effect model.

RESULTS

A total of 954 identified studies were retrieved, and 11 RCTs involving 677 participants were ultimately included in the meta-analysis. The pooled results suggested an association between vitamin D supplementation and a reduction in total cholesterol (TC) concentrations (SMD: -0.36 mg/dL, 95% CI: -0.54 to -0.18 mg/dL, P<0.0001), triglycerides (TG) (SMD: -0.50 mg/dL, 95% CI: -0.68 to -0.32 mg/dL, P<0.00001), low-density lipoprotein cholesterol (LDL-C) (SMD: -0.28 mg/dL, 95% CI: -0.45 to -0.11 mg/dL, P=0.001), and very low-density lipoprotein cholesterol (VLDL-C) (SMD: -0.54 mg/dL, 95% CI: -0.74 to -0.35 mg/dL, P<0.00001), but no effect on high-density lipoprotein cholesterol (HDL-C) (SMD: 0.01 mg/dL, 95% CI: -0.16 to 0.18 mg/dL, P=0.89) was found. Subgroup analyses showed that the dosage of vitamin D used, the duration of intervention and the type of vitamin D supplementation (alone or with co-supplementation) might influence the effect of vitamin D on the lipid profile.

CONCLUSIONS

This meta-analysis demonstrated that PCOS patients with the therapy of vitamin D had a statistical improvement in TC, TG, LDL-C, and VLDL-C, but did not affect HDL-C concentrations.

摘要

背景

维生素 D 缺乏症(VDD)在多囊卵巢综合征(PCOS)中很常见,且脂代谢异常与维生素 D 状态密切相关。本荟萃分析旨在评估维生素 D(单独或联合补充)对 PCOS 患者血脂谱的影响。

方法

检索 Medline、Cochrane 图书馆、PubMed 和 Web of Science,并确定截至 2020 年 1 月发表的随机对照试验(RCT)。采用固定效应模型或随机效应模型计算标准化均数差(SMD)的合并估计值及其 95%置信区间(CI)。

结果

共检索到 954 项研究,最终纳入 11 项 RCT 共 677 名参与者进行荟萃分析。汇总结果表明,维生素 D 补充与总胆固醇(TC)浓度降低相关(SMD:-0.36mg/dL,95%CI:-0.54 至-0.18mg/dL,P<0.0001),甘油三酯(TG)(SMD:-0.50mg/dL,95%CI:-0.68 至-0.32mg/dL,P<0.00001),低密度脂蛋白胆固醇(LDL-C)(SMD:-0.28mg/dL,95%CI:-0.45 至-0.11mg/dL,P=0.001)和极低密度脂蛋白胆固醇(VLDL-C)(SMD:-0.54mg/dL,95%CI:-0.74 至-0.35mg/dL,P<0.00001),但高密度脂蛋白胆固醇(HDL-C)(SMD:0.01mg/dL,95%CI:-0.16 至 0.18mg/dL,P=0.89)无明显变化。亚组分析显示,维生素 D 的使用剂量、干预时间以及维生素 D 的补充类型(单独或联合补充)可能会影响维生素 D 对血脂谱的影响。

结论

本荟萃分析表明,PCOS 患者接受维生素 D 治疗后 TC、TG、LDL-C 和 VLDL-C 有统计学意义的改善,但不影响 HDL-C 浓度。

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