Bae Jong-Myon
Department of Preventive Medicine, Jeju National University College of Medicine, 102 Jejudaehak-ro, Jeju-si, Jeju Province, 63243, Korea.
Clin Hypertens. 2022 May 15;28(1):15. doi: 10.1186/s40885-022-00196-4.
Previous systematic reviews reported that serum vitamin D deficiency was associated with risk of hypertension. The aim was to conduct a meta-epidemiological analysis for evaluating the potential effects of publication bias.
The selection criterion was defined as a follow-up study for evaluating the association between circulating 25-hydroxyvitam D level and hypertension risk in adults. A funnel plot and Egger's test were used to detect a publication bias. If a publication bias was identified, trim-and-fill analysis (TFA) with linear estimator was performed to estimate a summary relative risk (sRR).
The meta-analysis of 13 cohorts resulted in the lower the vitamin D, the higher the risk of hypertension statistically significant (sRR, 1.22; 95% confidence interval [CI], 1.05 to 1.41). But The P-value of Egger's test (=0.015) and asymmetry of the funnel plot showed that there was a publication bias. TFA resulted in that statistical significance disappeared in the association between vitamin D level and hypertension risk in total cohorts (filled sRR, 1.03; 95% CI, 0.89 to 1.18) as well as men and women cohorts.
The publication bias-adjusted results by TFA had no statistically significant association between vitamin D levels and the risk of hypertension. The significant results in previous systematic reviews might be interpreted as due to publication bias.
既往的系统评价报告称,血清维生素D缺乏与高血压风险相关。目的是进行一项meta流行病学分析,以评估发表偏倚的潜在影响。
选择标准定义为一项随访研究,用于评估成人循环25-羟维生素D水平与高血压风险之间的关联。采用漏斗图和Egger检验来检测发表偏倚。如果发现存在发表偏倚,则采用线性估计器的修剪填充分析(TFA)来估计汇总相对风险(sRR)。
对13个队列的meta分析结果显示,维生素D水平越低,高血压风险越高,具有统计学意义(sRR,1.22;95%置信区间[CI],1.05至1.41)。但Egger检验的P值(=0.015)和漏斗图的不对称性表明存在发表偏倚。TFA结果显示,在全部队列以及男性和女性队列中,维生素D水平与高血压风险之间的关联的统计学意义消失(填充后的sRR,1.03;95%CI,0.89至1.18)。
经TFA调整发表偏倚后的结果显示,维生素D水平与高血压风险之间无统计学意义的关联。既往系统评价中的显著结果可能是由于发表偏倚所致。