强直性脊柱炎患者的外周血维生素D水平：一项系统评价与荟萃分析。

Peripheral vitamin D levels in ankylosing spondylitis: A systematic review and meta-analysis.

作者信息

Diao Maohui, Peng Jun, Wang Daidong, Wang Hongbo

机构信息

Department of Spine Surgery, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, China.

出版信息

Front Med (Lausanne). 2022 Aug 26;9:972586. doi: 10.3389/fmed.2022.972586. eCollection 2022.

DOI:10.3389/fmed.2022.972586

PMID:36091702

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9458854/

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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)].

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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）]。