儿童和青少年非酒精性脂肪性肝病与维生素D水平关系的Meta分析
DOI: 10.3969/j.issn.1001-5256.2021.03.024
利益冲突声明:本研究不存在研究者、伦理委员会成员、受试者监护人以及与公开研究成果有关的利益冲突,特此声明。
作者贡献声明:胡庭鹏负责课题设计,资料分析,撰写论文;唐苏丹参与收集数据,修改论文;余泽波负责拟定写作思路,指导撰写文章并最后定稿。
Relationship between vitamin D level in children and adolescents with nonalcoholic fatty liver disease: A Meta-analysis
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摘要:
目的 系统评价儿童和青少年维生素D水平和非酒精性脂肪性肝病(NAFLD)的相关性。 方法 计算机检索PubMed、Cochrane Library、Embase数据库以及CNKI、中国生物医学文献数据库、万方和维普数据库,收集有关儿童及青少年维生素D水平与NAFLD之间关系的研究,检索时限从建库到2020年8月。按照纽卡斯尔-渥太华量表(NOS)进行文献质量评价,采用RevMan 5.3软件进行数据分析。 结果 Meta分析最终纳入10篇文献,NAFLD组共622例,健康对照组共1608例。10篇纳入研究的NOS评分均≥6分。10篇文献采用随机效应模型合并(I2=97%, P<0.05),NAFLD组血清25(OH)D水平显著低于对照组,差异有统计学意义(SMD=-1.40, 95%CI: -2.07~-0.72)。 结论 儿童和青少年NAFLD患者血清中25(OH)D水平显著降低,其可能与NAFLD的进展和严重程度有关。 -
关键词:
- 非酒精性脂肪性肝病 /
- 维生素D /
- Meta分析(主题)
Abstract:Objective To systematically evaluate the association between vitamin D level and nonalcoholic fatty liver disease (NAFLD) in children and adolescents. Methods Related English and Chinese databases, including PubMed, Cochrane Library, Embase, CNKI, CBM, Wanfang Data, and VIP, were searched for studies on the association between vitamin D level and NAFLD in children and adolescents published up to August 2020. Newcastle-Ottawa Scale (NOS) was used to evaluate quality of studies, and RevMan 5.3 software was used for data analysis. Results A total of 10 articles were included in the meta-analysis, with 622 patients in the NAFLD group and 1608 in the healthy control group. All 10 articles had an NOS score of ≥6. A pooled analysis of the 10 articles was performed using a random effects model (I2=97%, P < 0.05). The NAFLD group had a significantly lower serum 25(OH) D level than the healthy control group (standardized mean difference=-1.40, 95% confidence interval: -2.07 to -0.72). Conclusion There is a significant reduction in serum vitamin D level in children and adolescents with NAFLD, which may be associated with the progression and severity of NAFLD. -
Key words:
- Non-Alcoholic Fatty Liver Disease /
- Vitamin D /
- Meta-Analysis As Topic
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表 1 纳入研究的基本特征及质量评价
第一作者 发表年份 国家 研究类型 NAFLD诊断方法 BMI(kg/m2) 年龄(岁) NOS评分 NAFLD组(n=622) 对照组(n=1608) Sezer[12] 2016 土耳其 横断面研究 超声 28.7±4.3 27.3±3.3 12.6±3.1 6 Chang [14] 2015 韩国 病例对照 UPLC-MS/MS 25.89±4.13 23.70±2.63 8.70±3.87 6 Yildiz[15] 2014 土耳其 病例对照 超声 30.9±3.9 29.3±4.4 11.0±2.8 8 Pirgon[16] 2013 土耳其 病例对照 超声 28.7±4.7 28.4±3.6 12.48±1.60 6 Mohamed[17] 2016 埃及 横断面研究 超声 10.6±3.1 8 Malespin[18] 2015 美国 横断面研究 升高的ALT 12.9±2.9 6 Black[19] 2014 澳大利亚 横断面研究 超声 27.0±7.4 22.0±3.0 17 7 Nobili[20] 2014 意大利 横断面研究 超声 31.3±4.37 12.24±7.23 6 胡颖[21] 2018 中国 病例对照 超声 17.2±2.5 10.1±3.6 7 张兰华[22] 2019 中国 病例对照 超声 27.2±3.6 17.2±2.6 11.2±2.5 6 注:UPLC-MS/MS,超高效液相色谱串联质谱。 表 2 纳入研究的25(OH)D水平
第一作者 发表年份 NAFLD组(n=622) 对照组(n=1608) 例数(女/男) 25(OH)D(ng/ml) 例数(女/男) 25(OH)D(ng/ml) Sezer[12] 2016 58(26/32) 16.60±6.20 53(38/15) 14.60±7.00 Chang[14] 2015 62(无分类) 17.90±6.84 32(无分类) 17.70±5.05 Yildiz[15] 2014 58(22/36) 12.60±6.52 43(24/19) 16.40±9.19 Pirgon[16] 2013 45(无分类) 29.50±18.40 72(无分类) 43.96±19.97 Mohamed[17] 2016 47(28/19) 20.89±16.56 23(14/9) 41.98±14.52 Malespin[18] 2015 25(6/19) 16.50±6.40 382(193/189) 20.80±7.10 Black[19] 2014 156(96/60) 26.84±8.81 838(381/457) 30.85±9.62 Nobili[20] 2014 73(无分类) 19.30±6.70 85(32/53) 29.04±5.81 胡颖[21] 2018 62(25/37) 15.20±2.06 50(11/39) 26.26±2.25 张兰华[22] 2019 36(15/21) 15.20±2.10 30(12/18) 26.30±2.30 -
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