Association between circulating 25-hydroxyvitamin D and systemic lupus erythematosus: A systematic review and meta-analysis
Guan SY, Cai HY, Wang P, Lv TT, Liu LN, Mao YM, Zhao CN, Wu Q, Dan YL, Sam NB, Wang DG, Pan HF
International journal of rheumatic diseases · 34 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- National Natural Science Foundation of China
- Grants
- National Natural Science Foundation of China (81872687); National Natural Science Foundation of China (81573222, 81872687); National Natural Science Foundation of China (81573222)
Based on 1 listed funder(s).
Publication
- Published
- 2019-08-30 · Int J Rheum Dis · vol. 22 · issue 10 · pp. 1803–1813
- Publisher
- Wiley
- Cited
- 55 citations · more than 79% of similar papers · 1.4× the field average
- References
- 54 works
- Access
- Paywalled
- Research areas
- Vitamin D Research Studies · Bone health and osteoporosis research · Thyroid Disorders and Treatments
- Keywords
- Medicine, Vitamin D and neurology, Publication bias, Internal medicine, Meta-analysis, Funnel plot, Confidence interval, Cochrane Library, Odds ratio, Subgroup analysis, Systemic lupus erythematosus, Lupus erythematosus, Gastroenterology, Strictly standardized mean difference, Immunology, Disease, Antibody
- MeSH
- humans, lupus erythematosus, systemic, vitamin d deficiency, vitamin d, severity of illness index, biomarkers
12 authors
From CN
- Shi‐Yang GuanAnhui Medical University
- Hongyan CaiAnhui Medical University; Second Affiliated Hospital of Anhui Medical University
- Peng WangAnhui Medical University
- Tiantian LvChaohu Hospital of Anhui Medical University
- Lina LiuAnhui Medical University
- Yan‐Mei MaoAnhui Medical University
Abstract
Aim
The indicators for measuring vitamin D are various, and 25-hydroxyvitamin D (25(OH)D) is considered as the optimal indicator of total vitamin D levels. In this study, we aim to deeply explore the 25(OH)D status in systemic lupus erythematosus (SLE) patients, and evaluate its relation to SLE risk and disease severity.
Methods
Literature about 25(OH)D status and its associations with SLE were searched in Pubmed, Embase and Cochrane Library databases. Standardized mean difference (SMD), odds ratio (OR) and corresponding 95% confidence interval (95% CI) were illustrated by forest plots, and correlation coefficients (r) were combined by generic inverse variance method. Heterogeneity and publication bias were quantified by I-squared (I2 ) test, funnel plot and Egger's test, respectively. Sensitivity analyses were further examined by leave-one-out method.
Results
Nineteen articles were included into our meta-analysis. The overall results showed that compared with the healthy controls, the circulating 25(OH)D levels were significantly lower in SLE patients (pooled SMD = -1.63, 95% CI: -2.51 to -0.76). Subgroup analysis revealed that compared with the healthy controls, SLE patients of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) ≥ 10, Arab and European ethnicity, all 4 seasons, no vitamin D supplement, had significantly lower circulating 25(OH)D levels; no significant differences were observed in SLE patients of SLEDAI < 10, mixed ethnicity, spring, summer, vitamin D supplement, respectively; no matter the changes of age, disease duration, and the therapy of corticosteroid or immunosuppressive or neither, circulating 25(OH)D levels were significantly reduced in SLE patients. The deficiency, insufficiency and sufficiency of vitamin D could significantly elevate, slightly decrease (not significantly), significantly decrease SLE risk, respectively (pooled OR = 4.37, 95% CI: 1.49 to 12.84; pooled OR = 0.52, 95% CI: 0.22 to 1.26; pooled OR = 0.31, 95% CI: 0.15 to 0.63). Circulating 25(OH)D levels were inversely associated with SLEDAI (pooled correlation coefficient = -0.50, 95% CI: -0.8278 to -0.1689).
Conclusions
Compared with healthy controls, 25(OH)D levels are significantly lower in SLE patients, which is influenced by disease activity, ethnicity, seasons and vitamin D supplement; no matter the change of age, diseases duration and therapy of corticosteroid or immunosuppressive or neither, 25(OH)D levels are significantly decreased in SLE patients; the deficiency, insufficiency and sufficiency of vitamin D could significantly elevate, slightly decrease, and significantly decrease SLE risk, respectively; and 25(OH)D levels inversely correlate with SLEDAI.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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