Diao Maohui, Peng Jun, Wang Daidong, Wang Hongbo
Department of Spine Surgery, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, China.
Front Med (Lausanne). 2022 Aug 26;9:972586. doi: 10.3389/fmed.2022.972586. eCollection 2022.
Previous studies showed conflicting results regarding peripheral vitamin D levels in ankylosing spondylitis (AS). We performed this systemic review and meta-analysis to explore whether vitamin D may influence AS process.
Articles published until March 2022 were searched in databases as follows: PubMed, Web of Science, and Google Scholar. The present study included cross-sectional and case-control studies regarding vitamin D levels in patients with AS. Studies were excluded according to the following exclusion criteria: (1) we excluded studies which did not provide sufficient information regarding the comparison of vitamin D levels in AS patients and healthy controls (HC). Vitamin D levels in the two group studies should be reported or could be calculated in included studies; (2) meta-analysis, reviews and case reports. STATA 12.0 software was used to make a meta-analysis. Standard mean differences (SMDs) and 95% confidence intervals (CIs) were computed as effect size.
The present meta-analysis showed no significant difference in peripheral 1,25-dihydroxyvitamin D3 (1,25OHD) levels between AS and healthy controls (HCs) in Caucasians with a random effects model [SMD: -0.68, 95% CI (-1.90, 0.54)]. Patients with AS had lower peripheral 25-hydroxyvitamin D (25OHD) levels compared with HC with a random effects model [SMD: -0.45, 95% CI: (-0.70, -0.20)]. Patients with AS had higher peripheral C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels compared with HC in Caucasian population with random effects models [CRP: SMD: 1.08, 95% CI: (0.78, 1.37); ESR: SMD: 0.86, 95% CI: (0.39, 1.34)]. However, no significant difference in alkaline phosphatase (ALP), parathyroid hormone (PTH) or calcium levels were indicated between AS and HC in Caucasian with random effects models [ALP: SMD: 0.07, 95% CI: (-0.41, 0.55); PTH: SMD: -0.15, 95% CI: (-0.56, 0.26); calcium: SMD: -0.06, 95% CI: (-0.39, 0.26)].
In conclusion, the study showed an inverse association between 25OHD and AS, which suggests that vitamin D may have a protective effect on AS. ESR and C-reactive protein (CRP) are important biomarkers for AS.
既往研究关于强直性脊柱炎（AS）患者外周血维生素D水平的结果相互矛盾。我们进行了这项系统评价和荟萃分析，以探讨维生素D是否会影响AS的病情发展。
在以下数据库中检索截至2022年3月发表的文章：PubMed、科学网和谷歌学术。本研究纳入了关于AS患者维生素D水平的横断面研究和病例对照研究。根据以下排除标准排除研究：（1）排除未提供足够信息以比较AS患者和健康对照（HC）维生素D水平的研究。纳入研究应报告或可计算两组研究中的维生素D水平；（2）荟萃分析、综述和病例报告。使用STATA 12.0软件进行荟萃分析。计算标准平均差（SMD）和95%置信区间（CI）作为效应量。
本荟萃分析显示，在采用随机效应模型的白种人中，AS患者与健康对照（HC）在外周血1,25-二羟维生素D3（1,25OHD）水平上无显著差异[SMD：-0.68，95%CI（-1.90，0.54）]。采用随机效应模型时，与HC相比，AS患者外周血25-羟维生素D（25OHD）水平较低[SMD：-0.45，95%CI：（-0.70，-0.20）]。在白种人群中，采用随机效应模型时，与HC相比，AS患者外周血C反应蛋白（CRP）和红细胞沉降率（ESR）水平较高[CRP：SMD：1.08，95%CI：（0.78，1.37）；ESR：SMD：0.86，95%CI：（0.39，1.34）]。然而，在采用随机效应模型的白种人中，AS与HC在碱性磷酸酶（ALP）、甲状旁腺激素（PTH）或钙水平上无显著差异[ALP：SMD：0.07，95%CI：（-0.41，0.55）；PTH：SMD：-0.15，95%CI：（-0.56，0.26）；钙：SMD：-0.06，95%CI：（-0.39，0.26）]。
总之，该研究显示25OHD与AS之间存在负相关，这表明维生素D可能对AS具有保护作用。ESR和C反应蛋白（CRP）是AS的重要生物标志物。
