基于综合性Meta分析的血清VD水平与精神分裂症关系的研究

RELATIONSHIP BETWEEN SERUM VITAMIN D AND SCHIZOPHRENIA: A COMPREHENSIVE META-ANALYSIS

目的探讨血清VD水平与精神分裂症的关系。方法检索收集国内外发表的关于VD水平与精神分裂症关系的观察性研究,基于综合性Meta分析进行系统评价。采用Stata12.0软件进行效应值的合并、异质性和偏倚检验。结果纳入27项流行病学实验,包括2208例精神分裂症患者和5771例对照参与者。Meta分析结果显示精神分裂症患者和对照参与者之间血清VD水平的总体平均差异为-5.51 ng/ml[95%可信区间(confidence interval,CI):-8.56^-2.47,P=0.0004],有统计学显著性;不同研究设计、生物标志物、住院状态、研究位置、质量评分、对照参与者的亚组分析及精确值、放射免疫、化学发光免疫、蛋白液相色谱和未定义研究,表明精神分裂症患者血清VD的平均水平显著低于对照组(P<0.05)。精神分裂症患者VD缺乏的总体患病率为69.1%(95%CI:59.2%~79.0%,P<0.0001),VD缺乏者患精神分裂症的风险是充足者的2.00倍(95%CI:1.67~2.40,P<0.0001),两者均有统计学意义。结论 VD缺乏和精神分裂症之间存在联系。

Objective To investigate the relationship between serum vitamin D and schizophrenia. Methods All observational studies that had measured serum vitamin D level in schizophrenic patients were collected, and a comprehensive meta-analysis was conducted to systematically evaluate their relationship. The merging effect value, heterogeneity and bias test were analyzed by using the Stata12.0 software. Results Twenty-seven epidemiological trials consisting of 2208 schizophrenic patients and 5771 control participants were screened through a defined search strategy. Meta-analysis showed that the overall mean difference in serum vitamin D level between schizophrenic patients and control participants was-5.51 ng/ml [95% confidence interval（CI）：-8.56 to-2.47, P=0.0004]. The difference was statistically significant. Subgroup analyses of different study designs, biomarkers, hospitalization status, study locations, quality scores and control participants, and exact value, radioimmunoassay, chemiluminescence immunoassay, protein liquid chromato-graphy and undefined studies showed that the average level of serum vitamin D in patients with schizophrenia was significantly lower than that in the control group（P〈0.05）. The overall prevalence of vitamin D deficiency in schizophrenic patients was 69.1%（95% CI： 59.2%-79.0%, P 〈0.0001）, and the risk of schizophrenia in vitamin D deficiency persons was 2.00 times for those with vitamin D sufficiency（95% CI： 1.67-2.40, P〈0.0001）, both of which were statistically significant. Conclusion There is a link between vitamin D deficiency and schizophrenia.