Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China.
Department of Neurology, Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei 230011, China.
Clin Neurol Neurosurg. 2024 Apr;239:108190. doi: 10.1016/j.clineuro.2024.108190. Epub 2024 Mar 8.
There's an increasing body of evidence on vitamin D deficiency and the risk of neuromyelitis optica spectrum disorder (NMOSD). The aim of this meta-analysis was to assess serum vitamin D levels in patients with NMOSD versus healthy controls.
We searched PubMed, EMBASE, Cochrane Library, Web of Science and CNKI for publications up to November 2022 and explored the relationship between NMOSD and serum vitamin D levels. The standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random-effects model. Subgroup analysis and sensitivity analysis were applied to explore the sources of heterogeneity. Begg's test, Egger's test, and Egger's funnel plot were adopted to evaluate publication bias.
6 studies (including 319 patients and 595 healthy controls) met the inclusion criteria and all compared vitamin D levels in patients with NMOSD versus healthy controls. Levels of serum vitamin D detected in NMOSD patients were significantly lower than those in healthy controls (SMD=-1.57, 95% CI=-2.27 ∼ -0.87, P<0.001, I = 94.6%). The results of the different sensitivity analysis remained statistically significant, which demonstrated the robustness of the meta-analysis. There was no significant publication bias in our meta-analysis (P>0.05).
Patients with NMOSD showed significantly reduced vitamin D levels compared with healthy controls. Our findings highlighted the importance of measuring vitamin D levels in patients with NMOSD. Multi-center randomized controlled trials with large samples will further confirm whether the association is casual and modifiable.
越来越多的证据表明维生素 D 缺乏与视神经脊髓炎谱系疾病（NMOSD）的风险有关。本荟萃分析旨在评估 NMOSD 患者与健康对照者的血清维生素 D 水平。
我们检索了 PubMed、EMBASE、Cochrane 图书馆、Web of Science 和中国知网（CNKI）截至 2022 年 11 月的文献，并探讨了 NMOSD 与血清维生素 D 水平之间的关系。使用随机效应模型计算标准化均数差（SMD）和 95%置信区间（CI）。进行亚组分析和敏感性分析以探索异质性的来源。采用 Begg 检验、Egger 检验和 Egger 漏斗图评估发表偏倚。
6 项研究（包括 319 名患者和 595 名健康对照者）符合纳入标准，所有研究均比较了 NMOSD 患者与健康对照者的维生素 D 水平。NMOSD 患者的血清维生素 D 水平明显低于健康对照组（SMD=-1.57，95%CI=-2.27~-0.87，P<0.001，I = 94.6%）。不同敏感性分析的结果仍具有统计学意义，表明荟萃分析的稳健性。我们的荟萃分析不存在显著的发表偏倚（P>0.05）。
与健康对照组相比，NMOSD 患者的维生素 D 水平明显降低。我们的研究结果强调了在 NMOSD 患者中测量维生素 D 水平的重要性。多中心随机对照试验和大样本量的研究将进一步证实这种关联是否具有因果关系和可调节性。
