维生素D治疗多囊卵巢综合征有效性的Meta分析

Efficacy of vitamin D supplementation on polycystic ovary syndrome:a meta-analysis

目的系统评价维生素D治疗多囊卵巢综合征(PCOS)的有效性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、EBSCO、CBM、WanFang Data、CNKI和VIP数据库,搜集有关维生素D治疗PCOS的随机对照试验(RCT),检索时限均为建库至2019年7月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入11个RCT,包括692例患者。Meta分析结果显示:与安慰剂相比,维生素D能降低超敏C反应蛋白(hs-CRP)[MD=-0.54,95%CI(-1.00,-0.08),P=0.02]和总睾酮[MD=-0.17,95%CI(-0.29,-0.05),P=0.004]水平,增加子宫内膜厚度[MD=1.78,95%CI(0.49,3.06),P=0.007]。但两组在性激素结合球蛋白(SHBG)水平、多毛症评分(mF-G)变化方面的差异均无统计学意义(P>0.05)。结论当前证据表明,补充维生素D能显著降低PCOS的总睾酮和hs-CRP水平,增加子宫内膜厚度。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Objective To systematically review the efficacy of vitamin D supplementation on patients with polycystic ovary syndrome(PCOS).Methods PubMed,EMbase,The Cochrane Library,Web of Science,EBSCO,CBM,WanFang Data,CNKI and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on the efficacy of vitamin D supplementation for PCOS from inception to July 2019.Two reviewers independently screened literature,extracted data and assessed risk of bias of included studies,then,meta-analysis was performed by using RevMan5.3 software.Results A total of 11 RCTs involving 692 patients were included.The results of meta-analysis showed that compared with placebo,vitamin D could reduce the level of hypersensitive C-reactive protein(hs-CRP)(MD=-0.54,95%CI-1.00 to-0.08,P=0.02)and total testosterone(MD=-0.17,95%CI-0.29 to-0.05,P=0.004),and increase endometrial thickness(MD=1.78,95%CI 0.49 to 3.06,P=0.007).However,there were no significant differences between two groups in the incidence of sex hormone binding globulin(SHBG)level and hypertrichosis’s score(mF-G)(P>0.05).Conclusions Current evidence indicates that vitamin D supplementation can significantly reduce the level of total testosterone and hs-CRP,and increase endometrial thickness of PCOS.Due to the limited quality and quantity of the included studies,more high quality studies are required to verify the above conclusions.