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维生素、抗氧化剂及微量营养素补充与新发自身免疫性疾病风险:一项系统评价与荟萃分析

Vitamin, antioxidant and micronutrient supplementation and the risk of developing incident autoimmune diseases: a systematic review and meta-analysis.

作者信息

Low Chen Ee, Loke Sean, Chew Nicole Shi Min, Lee Ainsley Ryan Yan Bin, Tay Sen Hee

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Division of Rheumatology and Allergy, Department of Medicine, National University Hospital, Singapore, Singapore.

出版信息

Front Immunol. 2024 Dec 9;15:1453703. doi: 10.3389/fimmu.2024.1453703. eCollection 2024.

Abstract

BACKGROUND

Autoimmune diseases pose significant health challenges worldwide and affect millions. In recent years, there has been growing interest in exploring preventive strategies through nutritional interventions using vitamins, antioxidants, and micronutrients to reduce the risk of developing autoimmune diseases. However, excessive supplementation has also been associated with toxicity.

OBJECTIVE

We aim to assess how the intake of vitamins, antioxidants and micronutrients affect the risk of developing autoimmune diseases.

METHODS

This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase and Cochrane for controlled studies that evaluated the risk of incident autoimmune diseases after supplementation. Random effects meta-analyses were used for primary analysis.

RESULTS

18 studies were included. Overall meta-analyses observed that vitamin D did not influence the risk of autoimmune diseases (RR=0.99, 95%CI: 0.81-1.20). However, among the different vitamin D dosages, subgroup analysis demonstrated that those who were supplemented with 600-800IU/day may have a statistically significant reduction in risk (RR=0.55, 95%CI: 0.38; 0.82). Systematic review suggested that consumption of most vitamins, micronutrients and antioxidants may not have any effect on the risk of autoimmune diseases. Smoking, age, physical or outdoor activity and diet were significant confounding factors that affected the efficacy of such interventions.

CONCLUSION

We studied the effect of various vitamins, micronutrients and antioxidants on the risk of developing autoimmune diseases. Our study contributes to the evolving landscape of nutritional immunology, providing a foundation for future research to unravel more definite relationships with supplementation and the development of incident autoimmune diseases.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42024504796.

摘要

背景

自身免疫性疾病在全球范围内对健康构成重大挑战,影响着数百万人。近年来,人们越来越有兴趣探索通过使用维生素、抗氧化剂和微量营养素进行营养干预来降低自身免疫性疾病发病风险的预防策略。然而,过量补充也与毒性有关。

目的

我们旨在评估维生素、抗氧化剂和微量营养素的摄入如何影响自身免疫性疾病的发病风险。

方法

本遵循PRISMA的系统评价对PubMed、Embase和Cochrane进行了系统检索,以查找评估补充后发生自身免疫性疾病风险的对照研究。采用随机效应荟萃分析进行初步分析。

结果

纳入18项研究。总体荟萃分析观察到维生素D不会影响自身免疫性疾病的风险(风险比=0.99,95%置信区间:0.81-1.20)。然而,在不同的维生素D剂量中,亚组分析表明,每天补充600-800国际单位的人群发病风险可能有统计学意义的降低(风险比=0.55,95%置信区间:0.38;0.82)。系统评价表明,大多数维生素、微量营养素和抗氧化剂的摄入可能对自身免疫性疾病的风险没有任何影响。吸烟、年龄、身体活动或户外活动以及饮食是影响此类干预效果的重要混杂因素。

结论

我们研究了各种维生素、微量营养素和抗氧化剂对自身免疫性疾病发病风险的影响。我们的研究为营养免疫学的不断发展做出了贡献,为未来研究揭示补充与新发自身免疫性疾病发展之间更明确的关系奠定了基础。

系统评价注册

https://www.crd.york.ac.uk/prospero/,标识符CRD42024504796。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ab5/11663920/3d3f7ef7eaa2/fimmu-15-1453703-g001.jpg

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