补充维生素D对认知功能影响的Meta分析

Effect of oral vitamin D on cognitive function:a meta-analysis

目的系统评价补充维生素D(Vit D)对认知障碍和非认知障碍人群认知功能的影响。方法计算机检索Pub Med、Web of Science、Cochrane Library、EMbase、CNKI、CBM、Wan Fang Data和VIP数据库,搜集有关补充Vit D对认知障碍患者或非认知障碍人群认知功能影响的随机对照试验,检索时限均为建库至2022年3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Rev Man 5.4软件进行Meta分析。结果共纳入19个研究,包括8684例研究对象。Meta分析结果显示:在整体认知功能和工作记忆方面,认知障碍患者Vit D组的简易精神状态量表(MMSE)评分[MD=1.70,95%CI(1.20,2.21),P<0.01]、蒙特利尔认知评估量表(Mo CA)评分[MD=1.51,95%CI(1.00,2.02),P<0.01]、中国修订版韦氏成人智力量表(WAIS-RC)评分[MD=9.12,95%CI(7.77,10.47),P<0.01]和工作记忆[SMD=1.87,95%CI(1.07,2.67),P<0.01]均优于对照组,但非认知障碍人群Vit D组的整体认知功能和工作记忆与对照组相比差异无统计学意义;在语言流畅性和语言记忆方面,Vit D组与对照组差异均无统计学意义;在执行功能方面,干预时间>6个月时,Vit D组优于对照组[SMD=0.15,95%CI(0.01,0.28),P=0.03]。结论当前证据表明,补充Vit D可有效改善认知障碍患者的整体认知功能和工作记忆,在干预时间>6个月时,对执行功能也有积极影响。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 effect of vitamin D(VitD)supplementation on cognitive function in people with cognitive impairment and non-cognitive disorders.Methods The PubMed,Web of Science,Cochrane Library,EMbase,CBM,CNKI,WanFang Data and VIP databases were searched to collect randomized controlled trials(RCTs)about the effect of VitD supplementation on cognitive function of patients with cognitive impairment or noncognitive disorders from inception to March,2022.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.4 software.ResultsA total of 19 articles including 8684 cases were included.The results of meta-analysis showed that mini-mental state examination(MMSE)score(MD=1.70,95%CI 1.20 to 2.21,P<0.01),Montreal cognitive assessment(MoCA)score(MD=1.51,95%CI 1.00 to 2.02,P<0.01),Wechsler Adult Intelligence Scale-Revised(WAIS-RC)score(MD=9.12,95%CI 7.77 to 10.47,P<0.01)and working memory(SMD-1.87,95%CI 1.07 to 2.67,P<0.01)in the VitD group of patients with cognitive impairment were all better than those in the control group.However,the overall cognitive function and working memory of the non-cognitive impairment population were not significantly different compared with the control group.In terms of language fluency and language memory,there was no significant difference between the VitD group and the control group.In terms of the executive functions,at the intervention time of>6 months,the VitD and control groups were statistically significant(SMD=0.15,95%CI 0.01 to 0.28,P=0.03).Conclusion Current evidence suggests that VitD supplementation can effectively improve the overall cognitive function and working memory of patients with cognitive impairment,and has a positive effect on executive function at an intervention time of>6 months.Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.