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Vitamin D status and tic disorder: a systematic review and meta-analysis of observational studies
Lin Xiaoxia1, Jiang Jilong1, Chen Xianrui2
1Department of Pediatrics, Fujian Medical University Union Hospital, Fuzhou, China.
Insights
Children with tic disorders (TD) have lower vitamin D levels than healthy children. Further research is needed to confirm findings across TD subtypes like Tourette syndrome (TS).
Area of Science:
- Neuroscience
- Pediatrics
- Nutritional Science
Background:
- Tic disorders (TD) are common neurodevelopmental conditions affecting children.
- TD encompasses transient tic disorder (TTD), chronic motor or vocal tic disorder (CTD), and Tourette syndrome (TS).
- The relationship between vitamin D levels and TD in pediatric populations requires further investigation.
Purpose of the Study:
- To evaluate the clinical association between vitamin D levels and tic disorders in children.
- To compare serum vitamin D levels between children diagnosed with TD and healthy controls (HC).
- To analyze vitamin D levels across different TD subtypes (TTD, CTD, TS).
Main Methods:
- A systematic review and meta-analysis of observational studies were conducted.
- Searched major databases (CNKI, Wanfang, VIP, Cochrane, PubMed, Embase) up to June 2022.
- Included 13 studies comparing serum vitamin D levels in children with TD versus HC, analyzing TD subtypes.
Main Results:
- Children with TD exhibited significantly lower serum vitamin D levels compared to HC (MD = -6.64, P < 0.001).
- No significant differences in vitamin D levels were found between TTD and CTD, or between CTD and TS groups.
- A significant difference was observed between TTD and TS groups (MD = 5.24, P = 0.02).
- A higher ratio of males was noted in the TD group compared to HC (OR = 1.48, P = 0.02).
Conclusions:
- The meta-analysis indicates lower vitamin D levels in children with TD compared to healthy children.
- Subgroup analyses did not reveal significant differences in vitamin D levels among TD subtypes.
- High-quality, large-scale, multi-center studies are recommended to validate these findings due to study limitations.
Objective:
Tic disorders (TD) are a common neurodevelopmental disorder, it can be divided into transient tic disorder (TTD), chronic motor or vocal tic disorder (CTD), and Tourette syndrome (TS). Our research is to evaluate the clinical relationship between tic disorders and vitamin D level in children.
Methods:
Online databases, including CNKI, Wanfang, VIP, Cochrane Library, PubMed and Embase digital knowledge service platform, were checked up to June 2022 for relevant observational studies published in Chinese and English. A random-effects model was incorporated to summarize the study results. The RevMan5.3 software was used for meta-analysis.
Results:
Out of 132 retrieved articles, 13 observational studies were eligible for inclusion in the systematic review and meta-analysis, comparing serum Vitamin D levels between children with TD and HC (healthy controls), including different subtypes of TD (TTD, CTD and TS). The results showed that the serum vitamin D levels in the TD group were lower than those in the HC group (MD = -6.64, 95% CI: -9.36 to -3.93, P < 0.001, Heterogeneity test: P < 0.001, I2 = 94%). There were no statistically significant differences in serum vitamin D levels between the TTD group and the CTD group (MD = 3.84, 95% CI: -0.59 to 8.26, P = 0.09, Heterogeneity test: P < 0.001, I2 = 90%), or between the CTD group and the TS group (MD = 1.06, 95% CI: -0.04 to 2.16, P = 0.0, Heterogeneity test: P = 0.54, I2 = 0%). However, there was a statistically significant difference in serum vitamin D levels between the TTD group and the TS group (MD = 5.24, 95% CI: 0.68-9.80, P = 0.02, Heterogeneity test: P < 0.001, I2 = 92%). The study also found a statistically significant difference in the ratio of male children between the TD group and the HC group (OR = 1.48, 95% CI: 1.07-2.03, P = 0.02, Heterogeneity test: P < 0.001, I2 = 74%), but no statistically significant difference in the age of children between the TD group and the HC group (OR = 0.46, 95% CI: -0.33 to 1.24, P = 0.25, Heterogeneity test: P < 0.001, I2 = 96%).
Conclusions:
Our meta-analysis showed that the vitamin D level of children with TD was lower than that of healthy children. However, there was no difference between the subgroup. Due to the limitations of included studies in research design and diagnostic criteria, large samples, multi-center and high-quality studies are still needed for further analysis and confirmation.
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