Department of Community Nutrition, School of Nutrition and Food Sciences, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Biochemistry and Diet Therapy, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Obes Rev. 2021 Jul;22(7):e13223. doi: 10.1111/obr.13223. Epub 2021 Apr 7.
Several epidemiological studies examined the association of serum vitamin D with metabolic syndrome (MetS), but the findings were inconsistent. We conducted a systematic review and dose-response meta-analysis to quantify the association between blood vitamin D levels and MetS in adults. A systematic search up to December 2020 was conducted in MEDLINE (PubMed), ISI (Web of Science), Scopus, and Google Scholar databases for epidemiological studies that assessed the relation of serum 25-hydroxyvitamin D (as the exposure) and MetS (as the outcome) in adults. Eligible cross-sectional studies were restricted to those with representative populations. Finally, 43 studies were included in the analysis (38 cross-sectional, one nested case-control, and four cohorts studies). Combining 41 effect sizes from 38 cross-sectional studies included 298,187 general adult population revealed that the highest level of serum vitamin D, compared with the lowest level, was significantly related to a 43% decreased odds of MetS in developed countries (odds ratio [OR]: 0.57; 95% confidence interval [CI]: 0.49-0.65) and 40% in developing countries (OR: 0.60; 95% CI: 0.52-0.70). Linear dose-response analysis (including 222,175 healthy individuals and 39,308 MetS patients) revealed that each 25 nmol/L increase in serum vitamin D level was significantly associated with a 15% decreased odds of MetS (OR: 0.85; 95% CI: 0.80-0.91); however, we found no significant nonlinear association. Meta-analysis of five prospective studies with 11,019 participants revealed no significant relation (relative risk [RR]: 0.70; 95% CI: 0.37-1.32). This meta-analysis indicated an inverse association between serum vitamin D concentrations and risk of MetS in general adult populations in cross-sectional studies in a dose-response manner. However, no significant association was found in a small number of cohorts. More prospective studies are needed to confirm the causality of this relationship.
几项流行病学研究探讨了血清维生素 D 与代谢综合征（MetS）之间的关联，但研究结果并不一致。我们进行了系统评价和剂量-反应荟萃分析，以量化成人血液维生素 D 水平与 MetS 之间的关联。系统检索了截至 2020 年 12 月的 MEDLINE（PubMed）、ISI（Web of Science）、Scopus 和 Google Scholar 数据库，以评估血清 25-羟维生素 D（作为暴露因素）与成年人代谢综合征（作为结局）之间关系的流行病学研究。符合条件的横断面研究仅限于具有代表性人群的研究。最终，有 43 项研究纳入分析（38 项横断面研究，1 项嵌套病例对照研究和 4 项队列研究）。纳入 38 项横断面研究的 41 个效应量结果显示，与最低水平相比，血清维生素 D 水平最高与发达国家代谢综合征发生风险降低 43%显著相关（比值比 [OR]：0.57；95%置信区间 [CI]：0.49-0.65），与发展中国家代谢综合征发生风险降低 40%显著相关（OR：0.60；95% CI：0.52-0.70）。线性剂量-反应分析（包括 222175 名健康个体和 39308 名 MetS 患者）显示，血清维生素 D 水平每增加 25nmol/L，MetS 发生风险降低 15%（OR：0.85；95% CI：0.80-0.91）；然而，我们未发现显著的非线性关联。纳入 11019 名参与者的 5 项前瞻性研究的荟萃分析未显示出显著关联（相对风险 [RR]：0.70；95% CI：0.37-1.32）。这项荟萃分析表明，在横断面研究中，血清维生素 D 浓度与一般成年人群代谢综合征风险之间存在一种呈剂量-反应关系的负相关。然而，在少数队列研究中，没有发现显著关联。需要更多的前瞻性研究来证实这种关系的因果关系。
