血清25(OH)D3水平与慢性丙型肝炎相关性的Meta分析

摘要

目的 评价血清25羟维生素D3[25(OH)D3]水平与慢性丙型肝炎(CHC)的关系.方法 计算机检索Cochrane Library、Medline、Pubmed、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP)、中国期刊全文数据库(CNKI)、万方数字化期刊全文数据库收录的文献,检索年限均为建库至2017年3月1日,检索所有评价人体血清25(OH)D3水平与慢性丙型肝炎关系的中英文文献.采用 RevMan 5.2软件和Stata12.0软件进行数据分析.结果 最终纳入12篇文献1 144例患者,Mate分析结果显示,CHC组患者体内25(OH)D3水平较对照组低1.59 ng/ml(SMD =-1.59,95％CI -2.37～-0.80,P <0.01).按种族进行分析,黄种人和埃及人CHC组患者25(OH)D均较对照组低(SMD =-2.48,95％CI -3.58～-1.38,P <0.01; SMD =-2.10,95％CI -3.23～-0.96,P <0.01),而白种人差异无统计学意义(SMD =-0.20,95％CI -1.42～-1.03,P =0.75).根据维生素D检测方法进行分析,在酶联免疫法(ELISA)亚组和色谱法亚组中,CHC组患者的血清25(OH)D3均较对照组低(SMD =-2.39,95％CI -3.22～-1.56,P <0.01; SMD =-1.75l,95％CI -2.06～-1.44,P <0.01).结论 慢性丙型肝炎患者25(OH)D3水平较正常人低.%Objective To review the relationships between 25 hydroxyvitamin D3[25(OH)D3]levels and chronic hepatitis C.Methods We searched Cochrane Library,Medline,PubMed,Chinese Biomedical Literature Database(CBM),VIP,CNKI,and Wanfang database of English and Chinese studies reporting the relationship between 25 hydroxyvitamin D levels and chronic hepatitis D form establish of the database to March 1,2017.Results Twelve studies(n=1 144)were finally included,737 cases in CHC group and 407 in control group.The results of meta-analysis showed that 25(OH)D3 in patients with CHC was lower than the control group individuals(SMD=-1.59,95％CI-2.37～-0.80,P<0.01).The subgroup analysis of ethnicity,the CHC group was lower than the control group in the serum 25(OH)D3 levels for both Asian and Egyptian(SMD=-2.48,95％CI-3.58～-1.38,P<0.01;SMD=-2.10,95％CI-3.23～-0.96,P<0.01),while there was no statistical difference for White(SMD=-0.20,95％CI-1.42～-1.03,P=0.75).In the subgroup analysis of detection method for 25(OH)D3,both of ELISA and chromatography showed that the serum 25(OH)D3 levels in CHC group was lower than the control group(SMD=-2.39,95％CI-3.22～-1.56,P<0.01;SMD=-1.75,95％CI-2.06～-1.44,P<0.01).The result of the study showed no bias and reliable according to publication bias analysis and sensitivity analysis.Conclusion The 25 hydroxyvitamin D level was lower in chronic hepatitis C patients than health control.Due to the small of sample sizes,more high quality,large sample studies are needed to verify the results.