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解析维生素D与非传染性疾病之间的关系:一项系统评价与荟萃分析

Unraveling the Relationship Between Vitamin D and Noncommunicable Diseases: A Systemic Review and Meta-Analysis.

作者信息

Dumbre Dipali, Upendra Sheela, Zacharias Betsy Sara

机构信息

Symbiosis College of Nursing, Symbiosis International (Deemed University), Pune, India.

出版信息

Public Health Nurs. 2025 May-Jun;42(3):1302-1314. doi: 10.1111/phn.13521. Epub 2025 Jan 7.

Abstract

BACKGROUND

Subclinical vitamin D insufficiency is frequent in both developing and developed countries. Even after rickets was eliminated in the 1930s by fortifying milk, up to 1 billion people worldwide suffer from subclinical vitamin D deficiency (VDD). Numerous noncommunicable diseases (NCDs), including depression, autoimmune illnesses, diabetes, osteoporosis, and cardiovascular disease, are linked to this deficiency.

METHODOLOGY

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was applied when conducting a systematic review. Relevant studies published between 2010 and 2023 were found by searching databases such as Web of Science, Scopus, and PubMed. To find correlations between deficiency of vitamin D and NCDs, data was extracted from the studies and analyzed using the Mixed Method Appraisal Tools (MMAT). In meta-analysis data combined from multiple observational Unraveling the Relationship Between Vitamin D and Noncommunicable Diseases-A Systemic Review and Meta-Analysis studies to evaluate the relationship between vitamin D insufficiency and health outcomes. Statistical techniques, such as calculating effect sizes and constructing confidence ranges, are employed to determine combined outcomes and investigate possible causal connections.

RESULTS

Fourteen studies-including cross-sectional studies, prospective cohorts, randomized controlled trials, and longitudinal studies-met the inclusion criteria. Significant correlations among deficiency of vitamin D and a number of NCDs, including anemia, diabetes, hypertension, rheumatoid arthritis (RA), mental health issues, and autoimmune hypothyroidism, were found in the review. The results highlight the prevalence of deficiency of vitamin D worldwide and its detrimental impact on health. In order to lower the risk of numerous NCDs, this review emphasizes the need for greater awareness and possible interventions to maintain appropriate vitamin D levels. A meta-analysis was conducted to investigate the potential causal connections between vitamin D insufficiency and different health disorders. It elucidates the connections between deficient levels of vitamin D and conditions such as mental health disorders, anemia, diabetes, hypertension, and autoimmune diseases. The study prioritizes the examination of temporal correlations, biological plausibility, and the removal of confounding factors to provide support for these associations. While the text acknowledges that experimental data, such as randomized controlled trials, would enhance the argument for causation, it mostly depends on observational studies.

摘要

背景

亚临床维生素D不足在发展中国家和发达国家都很常见。即使在20世纪30年代通过强化牛奶消除佝偻病之后,全球仍有多达10亿人患有亚临床维生素D缺乏症(VDD)。许多非传染性疾病(NCDs),包括抑郁症、自身免疫性疾病、糖尿病、骨质疏松症和心血管疾病,都与这种缺乏有关。

方法

在进行系统评价时采用了系统评价和荟萃分析的首选报告项目(PRISMA)方案。通过搜索科学网、Scopus和PubMed等数据库,找到了2010年至2023年期间发表的相关研究。为了找出维生素D缺乏与非传染性疾病之间的相关性,从研究中提取数据,并使用混合方法评估工具(MMAT)进行分析。在荟萃分析中,将多个观察性研究的数据合并起来,以评估维生素D不足与健康结果之间的关系。采用计算效应大小和构建置信区间等统计技术来确定合并结果,并研究可能的因果关系。

结果

14项研究——包括横断面研究、前瞻性队列研究、随机对照试验和纵向研究——符合纳入标准。该评价发现维生素D缺乏与多种非传染性疾病之间存在显著相关性,包括贫血、糖尿病、高血压、类风湿性关节炎(RA)、心理健康问题和自身免疫性甲状腺功能减退症。结果突出了全球维生素D缺乏的普遍性及其对健康的有害影响。为了降低多种非传染性疾病的风险,本评价强调需要提高认识,并可能采取干预措施来维持适当的维生素D水平。进行了一项荟萃分析,以研究维生素D不足与不同健康障碍之间的潜在因果关系。它阐明了维生素D水平不足与心理健康障碍、贫血、糖尿病、高血压和自身免疫性疾病等状况之间的联系。该研究优先考虑对时间相关性、生物学合理性和混杂因素的排除进行检验,以支持这些关联。虽然文本承认随机对照试验等实验数据会加强因果关系的论据,但它主要依赖于观察性研究。

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