血清25(OH)D3水平与肝细胞癌相关性的Meta分析

摘要

目的 探讨血清25羟维生素D3[25(OH)D3]水平与肝细胞癌(hepatocellular carcinoma,HCC)的关系.方法 计算机检索Cochrane Library、PubMed、Web of Science、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),查找所有评价人体血清25(OH)D3水平与HCC关系的中英文文献,检索时限均为建库至2017年3月.同时人工检索纳入文献的参考文献.对符合入选标准的7篇文献进行Meta分析.结果 共有1 009例患者(HCC组346例,对照组663例)被纳入本次研究. Meta分析结果显示:HCC组患者体内25(OH)D3的水平较健康对照组低(SMD= -2. 78,95% CI:-4. 08~ -1. 48,P<0.0001).按HCC基础病因进行亚组分析发现,HBV亚组和HCV亚组HCC患者体内25(OH)D3 的水平均较对照组低(SMD=-1. 02,95% CI:-1. 86~ -0. 18,P=0. 02;SMD= -4. 46,95% CI:-5. 58~ -3. 34,P<0. 00001).按HCC患者种族进行亚组分析,发现不管是亚洲人还是埃及人,HCC患者体内25(OH)D3的水平均较对照组低(SMD= -0. 88,95% CI:-1. 05~ -0. 71,P<0. 00001;SMD= -4. 44,95% CI:-5. 09~ -3. 80,P<0. 00001).结论 HCC患者25(OH)D3水平较正常人低.但由于文献样本量较少,需要更多高质量、大样本研究证实.%Objective To explore the relationship between 25-hydroxyvitamin D3 [25(OH)D3] levels and hepato-cellular carcinoma ( HCC) . Methods Cochrane Library, PubMed, Web of Science, CBM, VIP, CNKI were searched (the duration of search was from the building of databases to Mar. 2017), and both Chinese and English trials about the relationships between 25(OH)D3 levels and HCC were searched, and the references of those studies were also searched by hand. A Meta-analysis of 7 studies was performed which met the inclusion criteria. Results Seven studies ( n=1 009) were finally included (346 cases in HCC group and 663 cases in control group). The results of Meta-analysis showed that 25(OH)D3 levels in patients with HCC were lower than those in the control group individuals (SMD =-2. 78, 95% CI: -4. 08 - -1. 48, P <0. 0001). The subgroup analysis of the different basic diseases of HCC showed that the patients in both HBV subgroup and HCV group had lower 25(OH)D3 levels in comparison with control group individuals (SMD= -1. 02, 95% CI: -1. 86 - -0. 18, P =0. 02; SMD = -4. 46, 95% CI: -5. 58 --3. 34, P<0. 00001). The subgroup analysis, according to the different races of patients, showed that both Asian and Egyptian HCC patients had lower 25(OH)D3 levels in comparison with control group individuals (SMD= -0. 88, 95% CI: -1. 05- -0. 71, P<0. 00001; SMD= -4. 44, 95% CI: -5. 09- -3. 80, P<0. 00001). Conclusion The 25(OH)D3 levels are lower in HCC patients than those in health controls. Due to the small sizes of sample, more high-quality and large sample studies are needed to verify.