Ismail Nor Hayati, Mussa Ali, Al-Khreisat Mutaz Jamal, Mohamed Yusoff Shafini, Husin Azlan, Johan Muhammad Farid, Islam Md Asiful
Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia.
Department of Biology, Faculty of Education, Omdurman Islamic University, Omdurman P.O. Box 382, Sudan.
Nutrients. 2023 Jul 20;15(14):3227. doi: 10.3390/nu15143227.
Multiple myeloma (MM) is a hematological malignancy characterized by the exponential growth of malignant plasma cells. Individuals diagnosed with MM exhibit a deficiency in vitamin D and may suffer fatigue, a loss of muscular strength, persistent musculoskeletal aches, and pain. The objective of this systematic review and meta-analysis is to determine the prevalence of vitamin D insufficiency and deficiency in individuals diagnosed with MM.
We searched five electronic databases using relevant keywords. The quality of the included studies was evaluated using the critical appraisal tool developed by the Joanna Briggs Institute. We employed a random-effects model and presented the findings in the form of percentages accompanied by 95% confidence intervals (CI). This protocol has been officially registered in PROSPERO under the registration number CRD42021248710.
The meta-analysis comprised a total of eighteen studies and found that, among patients with MM, the occurrence of serum vitamin D deficiency and insufficiency was 39.4% (95% CI: 25.8 to 52.9, n = 3746) and 34.1% (95% CI: 20.9 to 47.2, n = 3559), respectively. The findings indicate that a greater proportion of newly diagnosed patients exhibited vitamin D deficiency and insufficiency, with rates of 43.0% and 41.6%, respectively, compared to those receiving treatment (rates of 41.6% and 32.3%, respectively). The findings of the sensitivity analyses were consistent, and most of the studies (72.2%) were deemed to be of high quality. The results of Egger's test indicated the absence of publication bias.
Patients diagnosed with MM have been found to exhibit significantly elevated levels of both vitamin D deficiency and insufficiency. Therefore, it is recommended to consider vitamin D testing as an additional parameter in the current criteria for the clinical evaluation of MM.
多发性骨髓瘤(MM)是一种血液系统恶性肿瘤,其特征为恶性浆细胞呈指数增长。被诊断为MM的个体存在维生素D缺乏,可能会出现疲劳、肌肉力量丧失、持续性肌肉骨骼疼痛等症状。本系统评价和荟萃分析的目的是确定被诊断为MM的个体中维生素D不足和缺乏的患病率。
我们使用相关关键词搜索了五个电子数据库。采用乔安娜·布里格斯研究所开发的批判性评价工具对纳入研究的质量进行评估。我们采用随机效应模型,并以百分比形式呈现结果,同时给出95%置信区间(CI)。本方案已在国际前瞻性系统评价注册库(PROSPERO)正式注册,注册号为CRD42021248710。
荟萃分析共纳入18项研究,发现MM患者中血清维生素D缺乏和不足的发生率分别为39.4%(95%CI:25.8至52.9,n = 3746)和34.1%(95%CI:20.9至47.2,n = 3559)。研究结果表明,与接受治疗的患者(发生率分别为41.6%和32.3%)相比,更多新诊断患者存在维生素D缺乏和不足,发生率分别为43.0%和41.6%。敏感性分析结果一致,大多数研究(72.2%)被认为质量较高。Egger检验结果表明不存在发表偏倚。
已发现被诊断为MM的患者维生素D缺乏和不足水平显著升高。因此,建议在MM临床评估的现行标准中,将维生素D检测作为一项附加参数加以考虑。