Vitamin D therapy in pediatric patients with inflammatory bowel disease:a systematic review and meta-analysis

Background There is some evidence for the role of vitamin D deficiency in the pathogenesis of inflammatory bowel disease(IBD)in the pediatric population.However,the results are contradictory.Therefore,we have conducted a systematic review and meta-analysis to evaluated the effect of vitamin D on pediatric patients with IBD.Methods We carried out a systematic search in databases from inception until 20 January 2022.We included all relevant articles that evaluate the efficacy and safety of vitamin D on disease activity,inflammatory factors,and vitamin D and calcium levels in pediatric patients with IBD.Random effects models were used to combine the data.The main outcomes were then analyzed using weight mean difference(WMD)and respective 95%confidence interval(CI).Results Fifteen treatment arms met the eligibility criteria and were included.Pooled estimates indicated that intervention with vitamin D has a significantly beneficial effect on 25-hydroxy vitamin D3[25(OH)D3](pooled WMD of 17.662 ng/mL;CI 9.77-25.46;P<0.001),calcium(pooled WMD of 0.17 mg/dL;CI 0.04-0.30;P=0.009),and inflammatory factors including C-reactive protein(CRP)(pooled WMD of-6.57 mg/L;CI-11.47 to-1.67;P=0.009)and erythrocyte sedimentation rate(ESR)(pooled WMD of-7.94 mm/h;CI-12.65 to-3.22;P=0.001)levels.In addition,this effect was greater for vitamin D levels at doses greater than 2000 IU,and when follow-up duration was more than 12 weeks.Conclusion This study showed that vitamin D therapy can have a significant and beneficial effect on 25(OH)D3,calcium,and inflammatory factors in children and adolescents with IBD.