维生素D补充对妊娠期糖尿病血脂水平及新生儿结局影响Meta分析  

Effects of Vitamin D Supplementation on Serum Lipid Profiles and Neonatal Outcomes in Gestational Diabetes Mellitus:a Meta-analysis

作　　者：王朦朦 陈赵静 王颖 徐贤荣 李红娟[1] 杨军[1,2] WANG Mengmeng;CHEN Zhaojing;WANG Ying;XU Xianrong;LI Hongjuan;YANG Jun(Department of Public Health,Hangzhou Normal University School of Medicine,Hangzhou 311121,China;Center for Uterine Cancer Diagnosis and Therapy Research of Zhejiang Province,Women’s Hospital,School of Medicine,Zhejiang University,Hangzhou 310006,China)

机构地区：[1]杭州师范大学医学部公共卫生学院,杭州311121 [2]浙江大学医学院附属妇产科医院浙江省子宫恶性肿瘤诊治技术研究中心,杭州310006

出　　处：《中国医学科学院学报》2021年第1期82-91,共10页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(31971138);浙江省自然科学基金(LZ19H260001);杭州师范大学医学院教改项目(YXYJG2020012)。

摘　　要：目的评价维生素D补充对妊娠期糖尿病患者血脂及新生儿预后影响。方法检索PubMed、Web of Science、Embase、中国知网和万方等数据库,收集以维生素D为干预措施治疗妊娠期糖尿病的随机对照试验(RCT),检索时间为建库开始至2020年2月1日。由2位研究者独立筛选符合纳入标准的试验,提取数据并进行Meta分析和敏感性分析。采用Cochrane偏倚风险评估工具对文章进行质量评价,采用RevMan 5.3和Stata 12.0软件进行Meta分析。结果最终纳入17个RCT共1432例患者,其中,试验组704例,对照组728例。Meta分析结果表明,维生素D补充能够显著降低患者血清总胆固醇[MD=-6.11,95%CI=(-7.17,-5.04)]、低密度脂蛋白胆固醇[MD=-10.80,95%CI=(-14.72,-6.89)]、三酰甘油[MD=-8.11,95%CI=(-10.09,-6.13)]水平,显著升高患者血清25-羟维生素D3[MD=45.45,95%CI=(41.98,48.92)]和血清高密度脂蛋白胆固醇水平[MD=2.77,95%CI=(1.59,3.96)]。维生素D补充还可以显著降低高胆红素血症[RR=0.49,95%CI=(0.35,0.68)]、早产[RR=0.44,95%CI=(0.27,0.72)]和新生儿住院[RR=0.44,95%CI=(0.29,0.67)]发生率。结论维生素D补充可以改善妊娠期糖尿病患者的血脂水平,减少新生儿不良结局的发生。但仍需更多高质量的RCT加以验证。Objective To evaluate the effects of vitamin D supplementation on serum lipid profiles and neonatal prognosis in gestational diabetes mellitus(GDM)patients.Methods The electronic databases including PubMed,Web of Science,Embase,CNKI,and Wanfang Data were searched from inception to February 1,2020.All randomized controlled trials that compared vitamin D supplementation with placebo or without supplementation for GDM women were included.Paper selection,data extraction,meta-analysis and sensitivity analysis were conducted independently by two authors.Risk of bias was assessed using the Cochrane Risk of Bias Tool.The data were analyzed in RevMan 5.3 software and Stata 12.0.Results Totally 17 randomized controlled trials involving 1432 patients(704 in the intervention group and 728 in the control group)were included in the meta-analysis.The results showed that vitamin D supplementation significantly reduced serum total cholesterol[MD=-6.11,95%CI=(-7.17,-5.04)],low-density lipoprotein cholesterol[MD=-10.80,95%CI=(-14.72,-6.89)],and triglyceride[MD=-8.11,95%CI=(-10.09,-6.13)],while significantly increased serum 25-hydroxyvitamin D3 level[MD=45.45,95%CI=(41.98,48.92)]and high-density lipoprotein cholesterol[MD=2.77,95%CI=(1.59,3.96)].In addition,vitamin D supplementation significantly reduced the incidence rate of hyperbilirubinemia[RR=0.49,95%CI=(0.35,0.68)],premature birth[RR=0.44,95%CI=(0.27,0.72)],and neonatal hospitalization[RR=0.44,95%CI=(0.29,0.67)].Conclusions Vitamin D supplementation may regulate the serum lipid profiles in patients with GDM and reduce the incidence of adverse neonatal outcomes.More high-quality RCTs are needed to confirm the findings in our study.

关 键 词：维生素D 妊娠期糖尿病 META分析 

分 类 号：R714.256[医药卫生—妇产科学]