Serum Vitamin D Level and Rheumatoid Arthritis Disease Activity: Review and Meta-Analysis.
Serum Vitamin D Level and Rheumatoid Arthritis Disease Activity: Review and Meta-Analysis.
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DOI：
10.1371/journal.pone.0146351
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Chen W
中科院分区：
文献类型：
--
作者：
Lin J;Liu J;Davies ML;Chen W
关于血清维生素D浓度与类风湿性关节炎（RA）之间关系的流行病学研究证据不一致。这项荟萃分析旨在确定这种常见的自身免疫性疾病与维生素D之间的相关性，维生素D是一种重要的营养素，已知可以抑制适应性免疫反应。通过多种检索策略，在2015年5月16日之前识别并评价了相关文献的质量。从合格的研究中提取的数据进行综合，以计算合并的相关系数（r），平均差异（MD）和比值比（OR）。应用威尼斯标准评估每个统计学显著关联的证据可信度。共选择24份报告（涉及3489例患者）进行分析。RA患者的维生素D水平低于健康对照组（MD：-16.52 nmol/L，95%置信区间[CI]：-18.85至-14.19 nmol/L）。血清25-羟维生素D（25 OHD）水平与疾病活动指数呈负相关，如25 OHD与28个关节疾病活动评分（DAS 28）：r =-0.13，95% CI-0.16至-0.09; 25 OHD与C反应蛋白：r =-0.12，95% CI-0.23至-0.00。此外，纬度分层的亚组分析得到了一个相对较强的负相关25 OHD和DAS 28在低纬度地区。这种反向关系在发展中国家也比在发达国家更为显著。未发现发表偏倚。RA患者的维生素D值低于健康对照组。血清维生素D与RA疾病活动度呈负相关。然而，需要更严格的对照研究来验证这些发现。
The evidence from epidemiological studies concerning the relationship between serum vitamin D concentrations and rheumatoid arthritis (RA) is inconsistent. This meta-analysis is aimed at determining the magnitude of the correlation between this common autoimmune disease and vitamin D, an important nutrient known to dampen adaptive immune responses. Through multiple search strategies, relevant literature was identified and evaluated for quality before May 16 2015. Data extracted from eligible studies was synthesized to calculate pooled correlation coefficient (r), mean difference (MD) and odds ratio (OR). The Venice criteria were applied to assess the credibility of the evidence for each statistically significant association. A total of 24 reports involving 3489 patients were selected for analysis. RA patients had lower vitamin D levels than healthy controls (MD:-16.52 nmol/L, 95% confidence intervals [CI]:-18.85 to -14.19 nmol/L). There existed a negative relationship between serum 25-hydroxyvitamin D (25OHD) level and disease activity index, e.g. 25OHD vs. Disease Activity Score in 28 joints (DAS28): r = -0.13, 95% CI -0.16 to -0.09; 25OHD vs. C-reactive protein: r = -0.12, 95% CI -0.23 to -0.00. Additionally, latitude-stratified subgroup analysis yielded a relatively stronger negative correlation between 25OHD and DAS28 in low-latitude areas. This inverse relationship also appeared more significant in developing countries than in developed countries. No publication bias was detected. RA patients had lower vitamin D values than healthy controls. There was a negative association between serum vitamin D and RA disease activity. However, more strictly controlled studies are needed to validate these findings.