Associations between serum vitamin D and the risk of female reproductive tumors: A meta-analysis with trial sequential analysis.
Associations between serum vitamin D and the risk of female reproductive tumors: A meta-analysis with trial sequential analysis.
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血清维生素 D 与女性生殖肿瘤风险之间的关联 试验序贯分析的荟萃分析
DOI：
10.1097/md.0000000000010360
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发表时间：
2018-04
期刊：
影响因子：
1.6
通讯作者：
Zeng X
中科院分区：
文献类型：
--
作者：
Yan L;Gu Y;Luan T;Miao M;Jiang L;Liu Y;Li P;Zeng X
女性生殖系统肿瘤在世界范围内发病率和死亡率都很高;然而，妇科肿瘤与血清维生素D之间的关系存在争议。本荟萃分析的目的是评价血清维生素D不足与妇科良恶性肿瘤发生的关系。由2名研究者独立在电子数据库：国家医学图书馆（PubMed）、Web of Science（Clerivate）和科克伦系统评价数据库（科克伦图书馆，CDSR）中检索从开始到2017年6月的研究。使用随机效应模型计算比值比（OR）和95%置信区间（CI）。数据分析采用STATA 12.0软件和试验序贯分析（TSA）软件。总体而言，8项研究（分别包括2391例和5798例女性生殖系统肿瘤患者和非女性生殖系统肿瘤患者）符合本荟萃分析的条件。在随后的荟萃分析中，病例组和对照组维生素D缺乏的发生率分别为52.36%和48.70%;女性生殖系统良性肿瘤和恶性肿瘤的发生率分别为55.57%和50.59%。虽然维生素D缺乏与女性生殖系统肿瘤之间没有确定的相关性（OR，1.05; 95%CI，0.85-1.31）;但维生素D缺乏可能是女性生殖系统恶性肿瘤的危险因素，如合并OR（95%CI）：1.17（1.02-1.33）所示。此外，基于OR值，观察了维生素D不足与疾病类型、研究地点、患者数量和检测CLA的方法的关联。在敏感性分析中观察到类似结果。TSA表明，累积Z曲线越过传统的边界线，而不是越过试验顺序监测边界。但是，累积信息未能达到所需的信息大小。目前，维生素D缺乏似乎是女性的常见问题，可能迫切需要提高维生素D水平。此外，维生素D缺乏可能是女性生殖系统恶性肿瘤的一个不可忽视的危险因素。毫无疑问，根据TSA的说法，未来需要进行更多的试验。
Supplemental Digital Content is available in the text Female reproductive tumors are common with high morbidity and mortality worldwide; however, the association between gynecological tumors and serum vitamin D is controversial. The aim of this meta-analysis was to evaluate the relationship between insufficiency of serum vitamin D and the occurrence of benign and malignant gynecological tumors. Studies from inception to June 2017 were searched in the electronic databases: National Library of Medicine (PubMed), Web of Science (Clerivate), and Cochrane Database of Systematic Reviews (Cochrane Library, CDSR) by 2 investigators independently. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. STATA 12.0 Software and Trial Sequential Analysis (TSA) software were applied for data analyses. Overall, 8 studies (including 2391 patients and 5798 patients with and without female reproductive tumors, respectively) were eligible for the present meta-analysis. In the subsequent meta-analysis, the occurrence of vitamin D deficiency in the case and control groups were 52.36% and 48.70%, respectively; women with female reproductive benign and malignant tumors were 55.57% and 50.59%, respectively. Although, no conclusive association was found between vitamin D deficiency and female reproductive tumors (OR, 1.05; 95% CI, 0.85–1.31); vitamin D deficiency may be a risk factor of malignant female reproductive neoplasm, as shown by the pooled OR (95% CI):1.17 (1.02–1.33). Furthermore, based on the OR values, association of vitamin D insufficiency with disease type, study location, number of patients, and methods for detecting CLA was observed. Similar results in the sensitivity analysis were observed. TSA showed that the cumulative Z-curve crossed the traditional boundary line, rather than crossing the trial sequential monitoring boundary. However, the cumulative information failed to reach the required information size. Currently, vitamin D deficiency appears to be a common issue in females, and there may be an urgent need to improve the level of vitamin D. Furthermore, vitamin D deficiency may be a non-negligible risk factor of malignant female reproductive neoplasm. Undoubtedly, more trials are required in the future according to TSA.