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特发性炎性肌病患者的维生素 D 水平:一项荟萃分析。

Vitamin D levels in idiopathic inflammatory myopathy patients: a meta-analysis.

机构信息

Department of Rheumatology and Immunology, Nanchong Central Hospital, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong Hospital of Beijing Anzhen Hospital Capital Medical University, Nanchong, China.

Inflammation and Immunology Key Laboratory of Nanchong City, Nanchong, Sichuan, China.

出版信息

Postgrad Med. 2024 Mar;136(2):141-149. doi: 10.1080/00325481.2024.2325335. Epub 2024 Mar 4.

Abstract

PURPOSE

This meta-analysis aimed to explore correlations between vitamin D and idiopathic inflammatory myopathy (IIM).

METHODS

A comprehensive database search was conducted on 13 October 2020. Mean differences (MDs) and aggregated risk ratios (RR) with 95% confidence intervals (CIs) were used to determine the correlation between vitamin D deficiency (VDD) and IIM. Statistical analysis was performed with RevMan 5.4 and Stata15, statistical significance was set at  < 0.05.

RESULTS

Search revealed five studies with 286 IIM patients and 480 healthy controls. Results with random-effects modeling indicated that serum vitamin D levels were significantly lower in IIM patients than in healthy controls (MD = -13.10 ng/mL; 95% CI: -16.51 to -9.68;  < 0.00001). No differences were found between patients with IIM and other autoimmune diseases on vitamin D levels (MD =-2.65 ng/mL; 95% CI: -11.31-6.01;  = 0.55). In two studies with 185 IIM patients, those with low vitamin D levels exhibited higher creatine kinase levels (MD = 85.20 IU/L; 95% CI: 72.67-97.73;  < 0.00001) than those with normal vitamin D levels. VDD was correlated with an increased risk of IIM (RR = 3.24, 95% CI: 1.81-5.79;  < 0.0001).

CONCLUSION

This meta-analysis showed correlations between vitamin D level and IIM. The results indicated, VDD may be a risk factor for IIM, a determinant of immune dysregulation in IIM, or a consequence of IIM. Also, it implied further research to determine whether vitamin D supplementation is beneficial for patients with IIM.

摘要

目的

本荟萃分析旨在探讨维生素 D 与特发性炎性肌病(IIM)之间的相关性。

方法

于 2020 年 10 月 13 日进行全面的数据库检索。使用均数差(MD)和汇总风险比(RR)及其 95%置信区间(CI)来确定维生素 D 缺乏(VDD)与 IIM 之间的相关性。采用 RevMan 5.4 和 Stata15 进行统计分析,以 P 值<0.05 为具有统计学意义。

结果

检索到五项研究,包含 286 例 IIM 患者和 480 例健康对照者。采用随机效应模型的结果表明,IIM 患者的血清维生素 D 水平明显低于健康对照者(MD=-13.10ng/mL;95%CI:-16.51 至-9.68;P<0.00001)。在维生素 D 水平方面,IIM 患者与其他自身免疫性疾病患者之间无差异(MD=-2.65ng/mL;95%CI:-11.31 至 6.01;P=0.55)。在两项包含 185 例 IIM 患者的研究中,维生素 D 水平较低的患者肌酸激酶水平较高(MD=85.20IU/L;95%CI:72.67 至 97.73;P<0.00001)。VDD 与 IIM 的发病风险增加相关(RR=3.24,95%CI:1.81-5.79;P<0.0001)。

结论

本荟萃分析表明维生素 D 水平与 IIM 之间存在相关性。结果表明,VDD 可能是 IIM 的危险因素、IM 免疫失调的决定因素,或是 IIM 的结果。同时,还需要进一步研究以确定维生素 D 补充是否对 IIM 患者有益。

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