维生素D与系统性硬化症的关联及其临床特征:系统性审查,元分析和元回归
Tarak Dhaouadi1, Awatef Riahi1, Taïeb Ben Abdallah1
1Research Laboratory in Immunology of Renal Transplantation and Immunopathology (LR03SP01), Charles Nicolle Hospital, Tunis El Manar University, Tunis, Tunisia.
Journal of scleroderma and related disorders
|November 15, 2024
概括
低维生素D水平与全身性硬化易感性和疾病严重程度有关,包括间歇性肺病和肺动脉压力. 然而,较高的维生素D水平与患者的结症有关.
科学领域:
- 风湿病学和免疫学
- 内分泌学和新陈代谢学
- 皮肤病学 皮肤病学
背景情况:
- 系统性硬化症 (SSc) 是一种复杂的自身免疫性疾病,其特征是纤维化,血管异常和免疫失调.
- 维生素D的作用,一个关键的调节平衡和免疫功能的激素,在SSc的发病和临床表现仍然是一个活跃的研究领域.
研究的目的:
- 系统地审查和元分析有关维生素D水平 (包括缺乏和不足) 与对全身性硬化症的易感性之间的相关性现有证据.
- 评估维生素D状况与系统性硬化症的关键临床特征的相关性,例如间歇性肺病,肺动脉压,皮肤干扰和.
主要方法:
- 在PubMed,EMBASE,Web of Science和Scopus数据库中对2024年6月30日之前发表的研究进行了全面的文献搜索.
- 进行了元分析,以估计聚合平均差异,赔率比率和维生素D水平的相关系数,与SSc易感性和临床结果相关.
- 用子组分析和元回归来进一步调查这些关联.
主要成果:
- 与健康对照组相比,系统性硬化症患者的维生素D水平显著降低 (平均差异 = -11.68 ng/mL).
- 维生素D不足和缺乏与患全身性硬化症的风险增加显著相关 (分别为OR=3.58和7.67).
- 较低的维生素D水平与间歇性肺病 (平均差异 = -3.61 ng/mL) 和较高的缩性肺动脉压 (平均差异 = 4.17 ng/mL) 相相关,并且与修改的罗丹皮肤评分 (r = -0.26) 相负相关. 相反,在皮肤结症患者中观察到更高的维生素D水平 (平均差异=4.18 ng/mL).
结论:
- 这一元分析证实了维生素D水平降低与对系统性硬化症敏感性增加之间的显著关联.
- 低维生素D状态与更严重的临床表现有关,包括间歇性肺病,肺动脉高血压和较大的皮肤纤维化.
- 有趣的是,系统性硬化症患者的皮肤结与维生素D水平升高有关,这表明维生素D在疾病表现中具有复杂,潜在的双重作用.
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