炎症性肠病患儿维生素D营养状况的meta分析

Nutritional status of vitamin D in children patients with inflammatory bowel disease:a meta analysis

目的通过meta分析探讨儿童炎症性肠病(IBD)血清25-羟维生素D[25(OH)D]的表达及其临床意义。方法检索中国知网、万方、PubMed、Embase和Cochrane Library自建库至2024年4月22日发表的研究对象为IBD患儿血清25(OH)D的相关文献,并进行质量评价。对符合条件的文献应用RevMan5.4进行meta分析,分析IBD患儿与对照组、活动期/缓解期IBD患儿与对照组、活动期与缓解期IBD患儿血清25(OH)D的差异。结果共纳入10项研究,总计902例IBD患儿,893例健康儿童。meta分析结果显示,与年龄匹配的健康儿童比较,IBD患儿血清25(OH)D缺乏率差异无统计学意义(RR=1.28,95%CI:0.71~2.33,P=0.41),水平更低(MD=-2.88,95%CI:-5.69~-0.07,P=0.04);无论是活动期还是缓解期,IBD患儿25(OH)D水平更低(活动期:MD=-7.40,95%CI:-11.25~-3.55,P<0.001;缓解期:MD=-2.59,95%CI:-3.17~-2.01,P<0.001);且与IBD缓解期比较,IBD活动期患儿血清25(OH)D水平明显降低(MD=-4.11,95%CI:-5.56~-2.67,P<0.001)。结论临床上应高度重视IBD患儿的维生素D缺乏的综合防治。

Objective To explore the expression and clinical significance of 25-hydroxyvitamin D[25(OH)D]in children patients with inflammatory bowel disease(IBD).Methods The relevant articles on serum 25(OH)D in children patients with IBD as the study subjects in the databases of CNKI,Wanfang,PubMed,Embase and Cochrane Library were retrieved from the database establishment to April 22,2024.The RevMan 5.4 software was used to conduct the meta analysis on the literatures meeting the conditions.The differences in serum 25(OH)D levels between children with IBD and control group,children patients with active/remission stage and control group,children patients with active stage and remission stage were analyzed.Results Ten studies were included with a total of 902 children patients with IBD and 893 healthy children.The meta analysis results showed that compared with the age-matched healthy children,the deficiency rate of serum 25(OH)D in children patients with IBD had no significant difference(RR=1.28,95%CI:0.71-2.33,P=0.41),but serum 25(OH)D level was significantly lower(MD=-2.88,95%CI:-5.69 to-0.07,P=0.04),both in the active stage and remission stage(active stage:MD=-7.40,95%CI:-11.25 to-3.55,P<0.001;remission stage:MD=-2.59,95%CI:-3.17 to-2.01,P<0.001).Moreover,compared with the IBD remission stage,the serum 25(OH)D level in active stage of the children patients with IBD was significantly decreased(MD=-4.11,95%CI:-5.56 to-2.67,P<0.001).Conclusion Clinic should pay high attention to the comprehensive prevention and treatment of vitamin D deficiency in children patients with IBD.