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维生素 D 在性早熟中是否具有潜在作用?一项荟萃分析。

Does vitamin D have a potential role in precocious puberty? A meta-analysis.

机构信息

Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China.

Department of Gynaecology and Obstetrics, Jilin Women and Children Health Hospital, Changchun, China.

出版信息

Food Funct. 2023 Jun 6;14(11):5301-5310. doi: 10.1039/d3fo00665d.

Abstract

: Precocious puberty, one of the common pediatric endocrine system diseases, has been related to reduced adult height, adverse psychological outcomes and long-term health consequences. Previous findings have found that low levels of vitamin D appear to be associated with the characteristics of precocious puberty such as early menarche. However, the effect of vitamin D on precocious puberty remains controversial. : The published literature was searched from PubMed, Web of Science, Cochrane Library, MEDLINE, EMBASE, CNKI, Wan Fang and VIP databases up to October 2022. A randomized effect model was used to perform a meta-analysis to evaluate differences in vitamin D concentration between precocious puberty subjects and normal subjects, the risk of precocious puberty in subjects with low vitamin D levels, and the effect of supplementation of vitamin D on subjects with precocious puberty on medication. : Our study found that precocious puberty subjects had lower serum vitamin D levels than the normal population (standardized mean difference (SMD) = -1.16 ng ml and 95% confidence interval (CI) = -1.41 and -0.91 ng ml). Meanwhile, the lower level of vitamin D was associated with the risk of precocious puberty (odd ratio (OR) = 2.25 and 95% CI = 1.66 and 3.04). Moreover, compared with gonadotropin-releasing hormone analogue (GnRHa) intervention alone, subjects receiving GnRHa + vitamin D intervention had significantly lower luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol levels and bone age, and higher predicted adult height (PAH). : Vitamin D may have a potential role in precocious puberty and more data from large clinical trials are needed to confirm the findings.

摘要

性早熟是常见的小儿内分泌系统疾病之一,与成人身高降低、不良心理结局和长期健康后果有关。先前的研究发现,维生素 D 水平较低似乎与性早熟的特征有关,如早初潮。然而,维生素 D 对性早熟的影响仍存在争议。

我们检索了 PubMed、Web of Science、Cochrane 图书馆、MEDLINE、EMBASE、CNKI、万方和 VIP 数据库,截至 2022 年 10 月的发表文献。采用随机效应模型进行荟萃分析,评估性早熟患者与正常人群之间维生素 D 浓度的差异、维生素 D 水平较低患者发生性早熟的风险,以及补充维生素 D 对接受药物治疗的性早熟患者的影响。

我们的研究发现,性早熟患者的血清维生素 D 水平低于正常人群(标准化均数差(SMD)=-1.16ng/ml,95%置信区间(CI)=-1.41 至-0.91ng/ml)。同时,维生素 D 水平较低与性早熟风险相关(比值比(OR)=2.25,95%CI=1.66 至 3.04)。此外,与单独使用促性腺激素释放激素类似物(GnRHa)干预相比,接受 GnRHa+维生素 D 干预的患者黄体生成素(LH)、卵泡刺激素(FSH)和雌二醇水平以及骨龄明显降低,而预测成人身高(PAH)明显升高。

维生素 D 可能在性早熟中发挥潜在作用,需要更多来自大型临床试验的数据来证实这一发现。

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