Vitamin D Deficiency Increases the Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies.
Vitamin D Deficiency Increases the Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies.
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维生素 D 缺乏会增加妊娠期糖尿病的风险：观察性研究的荟萃分析
DOI：
10.3390/nu7105398
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发表时间：
2015-10-01
期刊：
影响因子：
5.9
通讯作者：
Zhang ZL
中科院分区：
文献类型：
--
作者：
Zhang MX;Pan GT;Guo JF;Li BY;Qin LQ;Zhang ZL
维生素D水平与妊娠期糖尿病（GDM）之间关系的研究结果不一致。因此，我们通过对观察到的研究进行荟萃分析，重点评估维生素D缺乏与GDM的关联。通过PubMed、MEDLINE和科克伦图书馆进行系统性文献检索，以识别2015年8月之前的合格研究。对20项研究（包括9209名参与者）的荟萃分析显示，维生素D缺乏的女性发生GDM的风险显著增加（比值比（OR）= 1.53; 95%置信区间（CI），1.33，1.75），具有少许异质性（I2 = 16.20%，p = 0.252）。GDM参与者血清25（OH）D显著降低4.93 nmol/L（95% CI，−6.73，−3.14），观察到中度异质性（I2 = 61.40%，p = 0.001）。采用研究设计的亚组分析显示，巢式病例对照研究存在明显的异质性（I2 > 52.5%，p < 0.07）。敏感性分析表明，排除任何单一研究不会实质性改变整体综合效应。总之，这项荟萃分析的证据表明，维生素D缺乏与GDM风险增加之间存在一致的关联。然而，需要设计良好的随机对照试验来得出维生素D补充剂对预防GDM的明显效果。
The results investigating the relationship between vitamin D levels and gestational diabetes mellitus (GDM) are inconsistent. Thus, we focused on evaluating the association of vitamin D deficiency with GDM by conducting a meta-analysis of observed studies. A systematic literature search was conducted via PubMed, MEDLINE, and Cochrane library to identify eligible studies before August 2015. The meta-analysis of 20 studies including 9209 participants showed that women with vitamin D deficiency experienced a significantly increased risk for developing GDM (odds ratio (OR) = 1.53; 95% confidence intervals (CI), 1.33, 1.75) with a little heterogeneity (I2 = 16.20%, p = 0.252). A noteworthy decrease of 4.93 nmol/L (95% CI, −6.73, −3.14) in serum 25(OH)D was demonstrated in the participants with GDM, and moderate heterogeneity was observed (I2 = 61.40%, p = 0.001). Subgroup analysis with study design showed that there were obvious heterogeneities in nested case–control studies (I2 > 52.5%, p < 0.07). Sensitivity analysis showed that exclusion of any single study did not materially alter the overall combined effect. In summary, the evidence from this meta-analysis indicates a consistent association between vitamin D deficiency and an increased risk of GDM. However, well-designed randomized controlled trials are needed to elicit the clear effect of vitamin D supplementation on prevention of GDM.