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维生素D补充剂治疗多囊卵巢综合征:随机对照试验的荟萃分析

Vitamin D supplementation in the treatment of polycystic ovary syndrome: A meta-analysis of randomized controlled trials.

作者信息

Zhang Biyun, Yao Xiuhua, Zhong Xingming, Hu Yang, Xu Jianying

机构信息

Reproductive Immunization Center,Guangdong Provincial Reproductive Science Institute(Guangdong Provincial Fertility Hospital), NHC Key Laboratory of Male Reproduction and Genetics, Guangzhou, Guangdong 510660, China.

Gynecology Department, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, 518000, China.

出版信息

Heliyon. 2023 Mar 8;9(3):e14291. doi: 10.1016/j.heliyon.2023.e14291. eCollection 2023 Mar.

Abstract

BACKGROUND

Vitamin D level is closely associated with the development of polycystic ovary syndrome (PCOS). We aimed to systematically evaluate the effects of vitamin D supplementation on patients with PCOS, to provide reliable evidence to the clinical treatment of PCOS.

METHODS

We searched PubMed, Medline, EMbase, Cochrane Library, Web of Science, WanFang, China national knowledge infrastructure(CNKI) and Weipu databases for randomized controlled trials (RCTs) on vitamin D supplementation for the treatment of PCOS. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included RCTs. RevMan 5.3 software was used for meta-analysis.

RESULTS

13 RCTs with 840 PCOS patients were included finally. Meta-analyses indicated that vitamin D supplementation increase the serum vitamin D level[mean difference(MD) = 17.81, 95% confidence interval(CI) (10.65, 24.97)] and endometrial thickness [MD = 1.78, 95%CI (0.49, 3.06), P = 0.007], reduce the serum hs-CRP [MD = -0.54, 95%CI (-1.00, -0.08)], parathyroid hormone[MD = -14.76, 95%CI (-28.32, -1.19)], total cholesterol[MD = -12.00, 95%CI (-18.36, -5.56)] and total testosterone level [MD = -0.17, 95%CI (-0.29, -0.05)] (all p < 0.05). No significant differences in the SHBG level [MD = 1.33, 95%CI (-2.70, 5.36)] and mF-G score [MD = 0.04, 95%CI (-0.79, 0.86)] between vitamin D and control group were found (all p > 0.05). Egger's tests showed that there were no publication biases in every synthesized result (all P > 0.05).

CONCLUSION

Vitamin D may be helpful to improve the endocrine and metabolism-related indexes in patients with PCOS. More high-quality studies with larger sample size are warranted to further evaluate the role of vitamin D supplementation in patients with PCOS.

摘要

背景

维生素D水平与多囊卵巢综合征(PCOS)的发生密切相关。我们旨在系统评价补充维生素D对PCOS患者的影响,为PCOS的临床治疗提供可靠依据。

方法

我们检索了PubMed、Medline、EMbase、Cochrane图书馆、Web of Science、万方、中国知网(CNKI)和维普数据库,以查找关于补充维生素D治疗PCOS的随机对照试验(RCT)。两名研究者独立筛选文献、提取数据并评估纳入RCT的偏倚风险。使用RevMan 5.3软件进行荟萃分析。

结果

最终纳入13项RCT,共840例PCOS患者。荟萃分析表明,补充维生素D可提高血清维生素D水平[平均差(MD)=17.81,95%置信区间(CI)(10.65,24.97)]和子宫内膜厚度[MD = 1.78,95%CI(0.49,3.06),P = 0.007],降低血清超敏C反应蛋白[MD = -0.54,95%CI(-1.00,-0.08)]、甲状旁腺激素[MD = -14.76,95%CI(-28.32,-1.19)]、总胆固醇[MD = -12.00,95%CI(-18.36,-5.56)]和总睾酮水平[MD = -0.17,95%CI(-0.29,-0.05)](均P < 0.05)。维生素D组与对照组之间的性激素结合球蛋白水平[MD = 1.33,95%CI(-2.70,5.36)]和改良F-G评分[MD = 0.04,95%CI(-0.79,0.86)]无显著差异(均P > 0.05)。Egger检验显示各综合结果均无发表偏倚(均P > 0.05)。

结论

维生素D可能有助于改善PCOS患者的内分泌和代谢相关指标。需要更多样本量更大的高质量研究来进一步评估补充维生素D在PCOS患者中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e157/10023924/cdd96256b69b/gr1.jpg

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