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维生素D治疗对子宫内膜异位症患者妊娠率的影响:一项系统评价与Meta分析

The impact of vitamin D treatment on pregnancy rate among endometriosis patients: a systematic review and meta-analysis.

作者信息

Shrateh Oadi N, Siam Haneen A, Ashhab Yasmeen S, Sweity Raneen R, Naasan Mashhour

机构信息

Faculty of Medicine, Al-Quds University, Jerusalem.

Department of Obstetrics and Gynecology, Al-Istishari Arab Hospital, Ramallah, Palestine.

出版信息

Ann Med Surg (Lond). 2024 May 15;86(7):4098-4111. doi: 10.1097/MS9.0000000000002174. eCollection 2024 Jul.

Abstract

BACKGROUND

Vitamin D supplementation is supposed to have an important role in the management of several endometriosis-related aspects, offering potential relief to affected individuals. Herein, the authors aim to evaluate the impact of vitamin D on pregnancy rates and clinical symptoms in women with endometriosis.

METHODS

The authors extensively searched PubMed, Cochrane Library, EMBASE, Ovid MEDLINE, and CINAHL from their inception to 20 July 2023.

RESULTS

Three randomized controlled trials involving 167 patients were included in this meta-analysis. The findings demonstrated that vitamin D supplementation exhibits efficacy in alleviating dysmenorrhea associated with endometriosis, as evidenced by a meta-analysis showing a significant reduction in dysmenorrhea (mean difference -1.41, 95% CI -2.61 to -0.22, = 0.02). However, the impact on dyspareunia was inconclusive, with a non-significant mean difference of -0.2 (95% CI -1.62 to 1.22, = 0.78). In contrast, dyschezia significantly decreased with vitamin D supplementation (mean difference -1.10, 95% CI -2.22 to 0.02, = 0.05 However, the meta-analysis did not show a significant effect of vitamin D on chronic pelvic pain associated with endometriosis.

CONCLUSION

While antioxidant vitamin D supplementation demonstrates general effectiveness in alleviating endometriosis symptoms, such as dysmenorrhea, dyspareunia, and dyschezia, the existing literature lacks direct investigations into the specific impact of vitamin D on enhancing pregnancy rates among endometriosis patients. This observation prompts various hypotheses, suggesting that the positive effects of vitamin D supplementation on endometriosis-related symptoms may indirectly contribute to improved pregnancy outcomes and enhanced fertility.

摘要

背景

补充维生素D被认为在子宫内膜异位症相关的多个方面的管理中具有重要作用,可能为受影响的个体带来缓解。在此,作者旨在评估维生素D对子宫内膜异位症女性妊娠率和临床症状的影响。

方法

作者全面检索了从创刊至2023年7月20日的PubMed、Cochrane图书馆、EMBASE、Ovid MEDLINE和CINAHL。

结果

本荟萃分析纳入了三项涉及167例患者的随机对照试验。研究结果表明,补充维生素D在减轻与子宫内膜异位症相关的痛经方面具有疗效,荟萃分析显示痛经显著减轻(平均差值-1.41,95%置信区间-2.61至-0.22,P = 0.02)。然而,对性交痛的影响尚无定论,平均差值为-0.2,无统计学意义(95%置信区间-1.62至1.22,P = 0.78)。相比之下,补充维生素D后排便困难显著减轻(平均差值-1.10,95%置信区间-2.22至0.02,P = 0.05)。然而,荟萃分析未显示维生素D对与子宫内膜异位症相关的慢性盆腔疼痛有显著影响。

结论

虽然补充抗氧化维生素D在减轻子宫内膜异位症症状(如痛经、性交痛和排便困难)方面显示出总体有效性,但现有文献缺乏对维生素D对子宫内膜异位症患者提高妊娠率具体影响的直接研究。这一观察结果引发了各种假设,表明补充维生素D对子宫内膜异位症相关症状的积极作用可能间接有助于改善妊娠结局和提高生育能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b02a/11230764/dc6d12668d11/ms9-86-4098-g001.jpg

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