Radić Mislav, Đogaš Hana, Kolak Ela, Gelemanović Andrea, Nenadić Dora Bučan, Vučković Marijana, Radić Josipa
Internal Medicine Department, Rheumatology, Allergology, and Clinical Immunology Division, University Hospital of Split, Split, Croatia; Department of Internal Medicine, University of Split School of Medicine, Split, Croatia.
Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, Split, Croatia.
Semin Arthritis Rheum. 2023 Jun;60:152200. doi: 10.1016/j.semarthrit.2023.152200. Epub 2023 Apr 1.
This systematic review and meta-analysis aimed to summarize current evidence on vitamin D status in patients with psoriatic arthritis (PsA) with a particular focus on disease activity.
PubMed, Web of Science, Scopus and Cochrane Library databases were searched for studies that investigated vitamin D levels in PsA. The search was conducted on 12 October 2022. Included studies were cohorts, RCTs or observational studies, those assessing the level of 25(OH)D with control group consisting of healthy or psoriasis (Pso) patients. Nottingham-Ottawa Quality Scale was used to assess methodological quality. Random effects meta-analysis model was applied with inverse variance weighting and mean difference with 95% CI was calculated.
Of 356 retrieved studies, 76 duplicates and 270 studies were excluded according to the exclusion criteria with one study unavailable. Four studies including 264 PsA patients and 287 healthy controls and five studies including 225 PsA patients and 391 Pso patients assessing vitamin D levels were eligible for meta-analysis. Vitamin D levels were lower in PsA patients compared to the healthy group (MD = -6.42; 95 % CI -8.31, -4.53; P < 0.01), while higher compared to Pso patients (MD = 2.37; 95 % CI 0.97, 3.78; P < 0.01). Included studies had moderate to low risk of bias.
In conclusion, PsA patients have lower vitamin D levels than the general population. However, further studies are essential to understand the role of vitamin D in the development and treatment of PsA and the differences in vitamin D metabolism in PsA and Pso.
本系统评价和荟萃分析旨在总结银屑病关节炎（PsA）患者维生素D状态的现有证据，特别关注疾病活动情况。
在PubMed、Web of Science、Scopus和Cochrane图书馆数据库中检索调查PsA患者维生素D水平的研究。检索于2022年10月12日进行。纳入的研究为队列研究、随机对照试验或观察性研究，那些评估25(OH)D水平且对照组为健康或银屑病（Pso）患者的研究。采用诺丁汉-渥太华质量量表评估方法学质量。应用随机效应荟萃分析模型，采用逆方差加权法，计算95%置信区间的平均差。
在检索到的356项研究中，根据排除标准排除了76项重复研究和270项研究，其中一项研究无法获取。四项纳入研究包括264例PsA患者和287例健康对照，五项纳入研究包括225例PsA患者和391例Pso患者，评估维生素D水平，符合荟萃分析条件。与健康组相比，PsA患者的维生素D水平较低（MD = -6.42；95%CI -8.31，-4.53；P < 0.01），而与Pso患者相比则较高（MD = 2.37；95%CI 0.97，3.78；P < 0.01）。纳入研究的偏倚风险为中度至低度。
总之，PsA患者的维生素D水平低于一般人群。然而，进一步的研究对于了解维生素D在PsA的发生和治疗中的作用以及PsA和Pso中维生素D代谢的差异至关重要。
