Meta-analysis of the relationship between low vitamin D levels and risk of Graves' disease / 中华地方病学杂志

ABSTRACT

Objective:To investigate the relationship between low vitamin D levels and the risk of Graves' disease.Methods:Computer was used to search PubMed, EMbase, China National Knowledge Infrastructure (CNKI), Wanfang Database (Wanfang Data) and China Biomedical Database (CBM). Relevant Chinese and English literatures were collected, including literatures of vitamin D, Graves' disease and autoimmune thyroid disease from the earliest publication time of the literature in the database to September 2019. Statistical software Stata 12.0 was used for Meta-analysis of the data. Heterogeneity test was conducted on the literature that met the inclusion criteria. According to the results, a random-effect model fixed-effect model was selected for comprehensive quantitative analysis. Standardized mean difference ( SMD) and 95% confidence interval ( CI) were calculated, and Egger's test was used to evaluate publication bias and sensitivity analysis. Results:A total of 29 literatures were included in the study, covering 2 281 patients with Graves' disease and 4 200 control population. Meta-analysis results showed after the data were combined using a random-effects model, vitamin D levels in patients with Graves' disease were significantly lower than that in the control population ( SMD = - 0.90, 95% CI - 1.14, - 0.66, P < 0.01﹚; heterogeneity analysis and Meta-regression analysis showed that the four factors of national development degree, geographical location, indicator measurement method and whether Graves' disease was primary were not the main source of heterogeneity. However, in developing countries or Asian, the vitamin D levels of patients with Graves' disease were significantly lower than that of the control population ( P < 0.01). In developed countries or Europe, the difference was not statistically significant ( P > 0.05). Sensitivity analysis and publication bias analysis showed that the results of this study had certain stability and reliability. Conclusion:Low vitamin D levels may increase the risk of Graves' disease.