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哮喘患者维生素 D 缺乏:维生素 D 补充剂有作用吗?

Asthmatic patients with vitamin D deficiency: Can vitamin D supplementation make a difference.

机构信息

Department of Pulmonary Medicine, The First Affiliated Hospital of Baotou Medical College, Baotou, China.

Department of Teaching, The First Affiliated Hospital of Baotou Medical College, Baotou, China.

出版信息

Technol Health Care. 2024;32(6):3985-4008. doi: 10.3233/THC-231462.

DOI:10.3233/THC-231462
PMID:39031398
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11612934/
Abstract

BACKGROUND

Asthma is a major public health concern due to its persistent inflammation of the airways. The intricate and widely variable epidemiology of asthma among nations and populations is a result of the interplay between genetic, environmental, and socioeconomic factors.

OBJECTIVE

This study aims to investigate whether VitD supplementation can reduce the frequency of exacerbations (including the frequency of exacerbations requiring systemic corticosteroids and the frequency of exacerbations necessitating trips to the hospital or emergency room, or both) and improve pulmonary function (clinical indicators such as the FEV1% predicted value).

METHODS

Computers were used to search Pubmed, Medline, ISI Web of Science, Embase, Cachrane Library, CNKI, CBM, VIP, and the Wanfang Database. Asthma/asthma, VitD/VitD, lung function/lung function, retrieval time is from database setup to October 8, 2021, to search all randomized controlled trials (RCTs) on the effect of VitD on human asthma and to retroactively incorporate references to literature were all included in the search criteria. After rigorous screening, quality evaluation, and data extraction of the included literature by two reviewers independently, heterogeneity tests and sensitivity analyses were performed.

RESULTS

The findings show that a total of 12 relevant studies meeting the inclusion criteria were finally included, including 649 cases in the experimental group and 646 cases in the control group. VitD intervention reduced the number of asthma exacerbations, including the rate of exacerbations requiring systemic corticosteroid therapy and the rate of acute exacerbations requiring emergency department or hospital visits or both.

CONCLUSIONS

In the outcome of lung function (FEV1% predicted value), it was shown that VitD supplementation improved lung function; in the outcome of serum 25-hydroxyVitD levels, it was shown that VitD supplementation increased serum 25-hydroxyVitD levels.

摘要

背景

哮喘是一个主要的公共卫生关注点,因为它会导致气道持续炎症。由于遗传、环境和社会经济因素的相互作用,不同国家和人群的哮喘流行病学情况复杂且差异很大。

目的

本研究旨在探讨维生素 D 补充是否可以减少哮喘恶化的频率(包括需要全身皮质激素治疗的恶化频率和需要去医院或急诊室就诊或两者兼有的恶化频率)和改善肺功能(如 FEV1%预计值等临床指标)。

方法

计算机检索 Pubmed、Medline、ISI Web of Science、Embase、Cochrane 图书馆、中国知网、中国生物医学文献数据库、维普数据库和万方数据库,检索时间均从数据库建立至 2021 年 10 月 8 日,检索 VitD 对人类哮喘影响的所有随机对照试验(RCT),并追溯纳入文献的参考文献。纳入的文献由 2 名研究者独立进行严格筛选、质量评价和数据提取,然后进行异质性检验和敏感性分析。

结果

最终纳入 12 项符合纳入标准的相关研究,实验组 649 例,对照组 646 例。VitD 干预可减少哮喘恶化的次数,包括需要全身皮质激素治疗的恶化率和需要急诊或住院就诊或两者兼有的急性恶化率。

结论

在肺功能(FEV1%预计值)方面,补充 VitD 可改善肺功能;在血清 25-羟 VitD 水平方面,补充 VitD 可提高血清 25-羟 VitD 水平。

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Recent advances in vitamin D implications in chronic respiratory diseases.维生素 D 在慢性呼吸系统疾病中的作用的最新进展。
Respir Res. 2022 Sep 19;23(1):252. doi: 10.1186/s12931-022-02147-x.
3
The Effect of Vitamin D Supplementation in Children With Asthma: A Meta-Analysis.补充维生素D对哮喘儿童的影响:一项荟萃分析。
Front Pediatr. 2022 Jun 29;10:840617. doi: 10.3389/fped.2022.840617. eCollection 2022.
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Vitamin D supplementation in childhood asthma: a systematic review and meta-analysis of randomised controlled trials.儿童哮喘补充维生素D:随机对照试验的系统评价和荟萃分析
ERJ Open Res. 2021 Feb 7;8(1). doi: 10.1183/23120541.00662-2021. eCollection 2022 Jan.
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Effect of vitamin D supplementation on asthma control in patients with vitamin D deficiency: the ACVID randomised clinical trial.维生素 D 补充对维生素 D 缺乏症患者哮喘控制的影响:ACVID 随机临床试验。
Thorax. 2021 Feb;76(2):126-133. doi: 10.1136/thoraxjnl-2019-213936. Epub 2020 Nov 5.
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Effect of Vitamin D3 Supplementation on Severe Asthma Exacerbations in Children With Asthma and Low Vitamin D Levels: The VDKA Randomized Clinical Trial.维生素 D3 补充对维生素 D 水平低的哮喘儿童重度哮喘发作的影响:VDKA 随机临床试验。
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Pathogenesis, Infection Prevention and Treatment.发病机制、感染预防与治疗。
Pathogens. 2020 May 18;9(5):385. doi: 10.3390/pathogens9050385.
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The role of nutrition in asthma prevention and treatment.营养在哮喘预防和治疗中的作用。
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N Engl J Med. 2020 Feb 6;382(6):525-533. doi: 10.1056/NEJMoa1906137.
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