维生素 D 对桥本甲状腺炎甲状腺自身免疫标志物的影响：系统评价和荟萃分析。

Effects of vitamin D on thyroid autoimmunity markers in Hashimoto's thyroiditis: systematic review and meta-analysis.

机构信息

Department of Endocrinology, Long Hua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Department of Endocrinology, Zhejiang Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang Province, China.

出版信息

J Int Med Res. 2021 Dec;49(12):3000605211060675. doi: 10.1177/03000605211060675.

OBJECTIVE

To perform a meta-analysis of randomized controlled trials to evaluate the efficacy of vitamin D supplementation on thyroid autoimmunity markers in Hashimoto's thyroiditis (HT).

METHODS

This meta-analysis included randomized controlled clinical trials identified by a systematic search of electronic databases (PubMed®, MEDLINE®, EMBASE, The Cochrane Library, China National Knowledge Infrastructure) from inception to August 2020. All studies included patients with HT that received vitamin D supplementation irrespective of the doses administered or the duration of treatment. The primary and secondary outcome measures were thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TGAb) titres.

RESULTS

Eight studies ( = 652) were included. There was significant heterogeneity between the studies. Using a random-effect model, vitamin D supplementation reduced TPOAb titre (standardized mean difference [SMD]: -1.11; 95% confidence interval [CI]: 1-1.92, -0.29) and TGAb titre (SMD: -1.12; 95% CI: -1.96, -0.28). A subgroup analysis demonstrated that vitamin D supplementation for >3 months resulted in a decrease in TPOAb titre (SMD: -1.66, 95% CI: -2.91, -0.41) but treatment ≤3 months was ineffective. Treatment with vitamin D decreased TPOAb titre (SMD: -1.48; 95% CI: -2.53, -0.42) whereas vitamin D did not.

CONCLUSION

These data suggest that vitamin D reduces autoantibody titre in patients with HT.

目的

对随机对照试验进行荟萃分析，以评估维生素 D 补充剂对桥本甲状腺炎（HT）甲状腺自身免疫标志物的疗效。

方法

本荟萃分析纳入了通过系统检索电子数据库（PubMed®、MEDLINE®、EMBASE、The Cochrane Library、中国国家知识基础设施）从成立到 2020 年 8 月期间确定的随机对照临床试验。所有研究均纳入接受维生素 D 补充剂的 HT 患者，无论给予的剂量或治疗持续时间如何。主要和次要结局指标为甲状腺过氧化物酶抗体（TPOAb）和/或甲状腺球蛋白抗体（TGAb）滴度。

结果

纳入了 8 项研究（n=652）。研究之间存在显著异质性。使用随机效应模型，维生素 D 补充剂降低了 TPOAb 滴度（标准化均数差 [SMD]：-1.11；95%置信区间 [CI]：1-1.92，-0.29）和 TGAb 滴度（SMD：-1.12；95% CI：-1.96，-0.28）。亚组分析表明，维生素 D 补充剂治疗>3 个月可降低 TPOAb 滴度（SMD：-1.66，95% CI：-2.91，-0.41），但治疗≤3 个月无效。维生素 D 治疗降低了 TPOAb 滴度（SMD：-1.48；95% CI：-2.53，-0.42），而维生素 D 则没有。