Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran; Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran; Department of Immunology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran; Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Transpl Immunol. 2021 Aug;67:101410. doi: 10.1016/j.trim.2021.101410. Epub 2021 May 19.
Vitamin D (VitD) deficiency is associated with several diseases such as multiple sclerosis, rheumatoid arthritis, respiratory infection, and so forth. In the field of transplantation (kidney transplantation), some studies reported that patients with VitD deficiency are of increased chance of acute rejection, but other studies did not show such a chance. On the other hand, since VitD is a modulatory factor and can reduce the inflammatory response, understanding the exact role of it in transplantation may contribute to tolerance condition in these patients.
The electronic databases, including PubMed, Scopus, Embase, ProQuest, Web of Science, and Google Scholar, were searched for eligible studies. In general, 14 studies with a total of 4770 patients were included in this meta-analysis. Regarding the methodological heterogeneity, we selected a random-effects combination model. Moreover, OR was chosen as an effect size for this study.
After the combination of 14 studies, we showed that patients in the VitD-deficient group had an 82% increased chance of acute rejection compared with patients in the VitD-sufficient group, and this effect was significant (OR 1.82; 95% confidence interval [CI] [1.29, 2.56]; I = 52.3%). This result was significant, and, regarding the narrow CI, it can be a conclusive result. Study quality and gender variables were the main sources of inconsistent results in the primary studies. Moreover, using meta-regression, we showed that VitD deficiency (independent from the estimated glomerular filtration rate (eGFR) of patients) increased the chance of acute rejection.
The normal VitD status of patients a few days before and after transplantation can reduce the chance of acute rejection.
维生素 D（VitD）缺乏与多种疾病有关，如多发性硬化症、类风湿性关节炎、呼吸道感染等。在移植领域（肾移植），一些研究报告称 VitD 缺乏的患者发生急性排斥反应的几率增加，但其他研究并未显示出这种几率。另一方面，由于 VitD 是一种调节因子，可以减轻炎症反应，因此了解其在移植中的确切作用可能有助于这些患者达到耐受状态。
检索了电子数据库，包括 PubMed、Scopus、Embase、ProQuest、Web of Science 和 Google Scholar，以查找符合条件的研究。总体而言，这项荟萃分析纳入了 14 项研究，共计 4770 例患者。关于方法学异质性，我们选择了随机效应组合模型。此外，本研究选择了 OR 作为效应量。
综合 14 项研究后，我们发现 VitD 缺乏组患者发生急性排斥反应的几率比 VitD 充足组患者增加了 82%，且这种影响具有统计学意义（OR 1.82；95%置信区间 [CI] [1.29, 2.56]；I = 52.3%）。该结果具有统计学意义，且鉴于其 CI 较窄，可得出明确的结论。研究质量和性别变量是主要的异质性来源。此外，通过元回归分析，我们发现 VitD 缺乏（与患者估计肾小球滤过率（eGFR）无关）会增加急性排斥反应的几率。
患者在移植前后几天内保持正常的 VitD 状态可以降低急性排斥反应的几率。
