血清25(OH)D水平与痴呆发病风险的剂量—反应Meta分析

A dose-response meta-analysis of serum 25(OH)D levels and the risk of dementia

目的系统分析血清25羟基维生素D[25(OH)D]与痴呆发病风险的剂量—反应关系。方法检索中国学术期刊全文数据库(CNKI)、万方数据知识服务平台、PubMed、Embase、Cochrane Library、Web of Science数据库中研究血清25(OH)D与痴呆发病风险的剂量—反应关系的相关文献,检索时限从数据库创建到2021年9月,采用Stata 16.0软件使用广义最小二乘估计方法(GLST)分析血清25(OH)D与痴呆发病风险的剂量—反应关系。结果共纳入9篇文献,含11项研究,包括42054例研究对象,其中发生痴呆3480例。基于随机效应模型对各原始研究最高剂量组相对于最低剂量组的RR值及95%CI进行合并,Meta分析结果显示,血清25(OH)D水平与痴呆发病风险呈负相关[RR(95%CI)=0.751(0.615~0.916),P=0.005]。剂量—反应Meta分析显示,随着血清维生素D水平升高,痴呆发病风险逐渐降低;血清维生素D水平每增加1 nmol/L,痴呆发病风险降低0.3%(OR=0.997,95%CI 0.996~0.999,P<0.001),血清维生素D水平与痴呆发病风险相关,且可能存在线性负相关(RR=-0.003,P<0.001)。结论血清25(OH)D水平与痴呆发病风险呈线性负相关。

Objective To systematic analysis of the dose-response relationship between serum 25(OH)D and the risk of dementia.Methods Relevant literatures on the dose-response relationship between serum 25(OH)D and the risk of dementia were searched in CNKI,Wanfang Data Knowledge Service Platform,PubMed,Embase,Cochrane Library,and Web of Science databases.The time frame was from database creation to September 2021,and Stata 16.0 software was used to analyze the dose-response relationship between serum 25(OH)D and the risk of dementia using generalized least squares estimation method(GLST).Results A total of 9 articles were included,including 11 studies,including 42054 subjects,of which 3480 had dementia.Based on the random effects model,the RR values and 95%CI of the highest dose group relative to the lowest dose group in each original study were combined.Meta-analysis results showed that serum 25(OH)D levels were negatively correlated with the risk of dementia[RR(95%)CI)=0.751(0.615-0.916),P=0.005].The dose-response Meta-analysis showed that with the increase of serum vitamin D level,the risk of dementia gradually decreased;for every 1 nmol/L increase of serum vitamin D level,the risk of dementia decreased by 0.3%(OR=0.997,95%CI 0.996-0.999),P<0.001),serum vitamin D level was associated with the risk of dementia,and there may be a linear negative correlation(RR=-0.003,P<0.001).Conclusion Serum 25(OH)D levels were linearly inversely related to the risk of dementia.