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维生素D补充剂与哮喘治疗的Meta分析

A Meta-Analysis on Vitamin D Supplementation and Asthma Treatment.

作者信息

Liu Meiqi, Wang Jun, Sun Xinrong

机构信息

Department of Respiratory Medicine, Xi'an Children's Hospital, Xi'an Jiaotong University, Xi'an, China.

Department and Institute of Infectious Disease, Xi'an Children's Hospital, Xi'an Jiaotong University, Xi'an, China.

出版信息

Front Nutr. 2022 Jul 6;9:860628. doi: 10.3389/fnut.2022.860628. eCollection 2022.

Abstract

BACKGROUND

Vitamin D, as an immunomodulator, may be related to the therapeutic effect of asthma patients, but the research in this area is still controversial. The aim of this meta-analysis was to analyze the role of vitamin D supplementation in the treatment of asthma patients.

MATERIALS AND METHODS

Randomized Controlled Trials (RCTs) of vitamin D supplementation in asthma were searched in PubMed, EMBASE, and the Cochrane library. Primary outcomes were forced expiratory volume in one second (FEV1), asthma exacerbations, Asthma Control Test scores (ACT scores), and fractional exhaled nitric oxide (FENO).

RESULTS

A total of 10 RCTs were included, including 1,349 patients. Vitamin D supplementation didn't affect the ACT scores (SMD = 0.04, 95% CI = -0.13 to 0.21, = 0.87), FEV1 (SMD = 0.04, 95% CI = -0.35 to 0.43, < 0.01) and FENO (SMD = -0.01, 95% CI = -0.22 to 0.20, = 0.27), but reduced the rate of asthma exacerbations (RR = 0.69, 95% CI = 0.41 to 0.88, < 0.01), especially in subgroups of children (RR = 0.46, 95% CI = 0.30 to 0.70, = 0.83) and follow up time less than 6 months (RR = 0.45, 95% CI = 0.32 to 0.63, = 0.95). Additionally, though there was only one study included in the subgroup, it significantly enhanced FEV1 at the last visit for patients whose FEV1 baseline value was less than 70% (SMD = 0.94, 95% CI = 0.47 to 1.41).

CONCLUSION

Vitamin D supplementation can reduce asthma exacerbations, especially in children, and within 6 months of follow up time. In addition, vitamin D has a positive effect on improving FEV1 of patients whose FEV1 baseline value is less than 70%, but more RCTs are still needed to support this conclusion.

SYSTEMATIC REVIEW REGISTRATION

[https://inplasy.com], identifier [10.37766/inplasy20 22.6.0049].

摘要

背景

维生素D作为一种免疫调节剂,可能与哮喘患者的治疗效果有关,但该领域的研究仍存在争议。本荟萃分析的目的是分析补充维生素D在哮喘患者治疗中的作用。

材料与方法

在PubMed、EMBASE和Cochrane图书馆中检索补充维生素D治疗哮喘的随机对照试验(RCT)。主要结局指标为一秒用力呼气容积(FEV1)、哮喘急性发作、哮喘控制测试评分(ACT评分)和呼出一氧化氮分数(FENO)。

结果

共纳入10项RCT,包括1349例患者。补充维生素D对ACT评分(标准化均数差[SMD]=0.04,95%置信区间[CI]=-0.13至0.21,P=0.87)、FEV1(SMD=0.04,95%CI=-0.35至0.43,P<0.01)和FENO(SMD=-0.01,95%CI=-0.22至0.20,P=0.27)无影响,但降低了哮喘急性发作率(风险比[RR]=0.69,95%CI=0.41至0.88,P<0.01),尤其是在儿童亚组(RR=0.46,95%CI=0.30至0.70,P=0.83)和随访时间少于6个月的亚组(RR=0.45,95%CI=0.32至0.63,P=0.95)中。此外,虽然亚组中仅纳入了一项研究,但对于FEV1基线值低于70%的患者,在末次随访时补充维生素D显著提高了FEV1(SMD=0.94,95%CI=0.47至1.41)。

结论

补充维生素D可降低哮喘急性发作率,尤其是在儿童中以及随访6个月内。此外,维生素D对FEV1基线值低于70%的患者改善FEV1有积极作用,但仍需要更多RCT来支持这一结论。

系统评价注册

[https://inplasy.com],标识符[10.37766/inplasy2022.6.0

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9d6/9300755/ca8b6ed3e1d5/fnut-09-860628-g001.jpg

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