Efficacy of vitamin D in treatment of inflammatory bowel disease: A meta-analysis.
Efficacy of vitamin D in treatment of inflammatory bowel disease: A meta-analysis.
复制标题
维生素 D 治疗炎症性肠病 A 疗效的荟萃分析
DOI：
10.1097/md.0000000000012662
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发表时间：
2018-11
期刊：
影响因子：
1.6
通讯作者：
Gong X
中科院分区：
文献类型：
--
作者：
Li J;Chen N;Wang D;Zhang J;Gong X
炎症性肠病（IBD）患者普遍缺乏维生素D （VitD）。近期研究发现，VitD可通过抗菌、抗炎、修复肠黏膜屏障等作用诱导和维持IBD缓解，从而改善患者的疾病活动性和生活质量。本荟萃分析的目的是评价维生素d治疗IBD的疗效和安全性。已发表的随机对照试验（rct）包括电子数据库（PubMed, Embase， Cochrane图书馆，Web of Science等）。采用Cochrane手册评价方法学质量。比较实验组与对照组（安慰剂组）25(OH)D3水平、复发率、炎症指数、不良事件。所有统计分析均采用Revman 5.3软件指导，统计学意义定义为P < 0.05。共纳入18项随机对照试验，共908例患者。meta分析显示，与对照组相比，VitD可显著提高25(OH)D3水平（ng/mL），加权平均偏差[WMD] = 7.85, 95% CI (5.52, 10.18), P <。000001)，与低剂量组相比，25(OH)D3水平升高有显著差异(WMD = 11.19, 95% CI [4.73, 17.65], P =。两组患者不良事件发生率比较差异无统计学意义（WMD = 1.56, 95% CI [0.74, 3.29], P = 0.24）。与对照组相比，VitD治疗更显著地降低了复发率，但低剂量和高剂量维生素D治疗之间没有显著差异。VitD组与对照组的红细胞沉降率（ESR）和高敏c反应蛋白（hsCRP）差异无统计学意义（ESR [mm/h]: WMD = -0.22, 95% CI [-5.73, 5.29], P = 0.94; hsCRP (mg/dL): WMD = - 0.53, 95% CI [-1.68, 0.62], P = 0.37）。IBD患者采用VitD治疗可提高25(OH)D3水平，控制疾病复发率，临床疗效更为准确。因此，维生素d应该被推荐用于IBD的治疗，至少作为一种辅助治疗。
Vitamin D (VitD) deficiency is prevalent in patient with inflammatory bowel disease (IBD). Recent studies have found that VitD can induce and maintain IBD remission through antibiosis, anti-inflammatory, and repair of intestinal mucosal barriers, thus improving the patient's disease activity and quality-of-life. The purpose of this meta-analysis is to evaluate the therapeutic effect and safety of VitD in the treatment of IBD. Published randomized controlled trials (RCTs) were included from electronic databases (PubMed, Embase, Cochrane library, Web of Science, and so forth). Cochrane handbook was applied to evaluate the methodological quality. The levels of 25(OH)D3, relapse rate, inflammation index, and adverse events were compared between the experimental group and the control group (placebo group). All statistical analyses were directed by Revman 5.3 software and statistical significance was defined as P < .05. Eighteen RCTs involved 908 patients were included. Meta-analysis showed that VitD improved the 25(OH)D3 levels more significantly than the control group (ng/mL, weighted mean deviation [WMD] = 7.85, 95% CI (5.52, 10.18), P < .000001), and compared with lower doses, there were significant differences increasing 25(OH)D3 levels (WMD = 11.19, 95% CI [4.73, 17.65], P = .0007) in high-dose VitD treatment while there was no significant difference in the adverse events between 2 groups (WMD = 1.56, 95% CI [0.74, 3.29], P = .24). VitD reduced the relapse rate more significantly than the control group, but there were no significant differences between the low-dose and high-dose vitamin D treatment. The erythrocyte sedimentation rate (ESR) and high-sensitivity C-reactive protein (hsCRP) of the VitD and the control group showed no statistically significant difference (ESR [mm/h]: WMD = –0.22, 95% CI [–5.73, 5.29], P = .94; hsCRP (mg/dL): WMD = −0.53, 95% CI [–1.68, 0.62], P = .37). The treatment of VitD in patients with IBD can improve the level of 25(OH)D3 and control the relapse rate of the disease, whose clinical curative effect is more accurate. Thus VitD should be recommended for the treatment of IBD, at least as an adjunctive treatment.