维生素D缺乏与老年人群直立性低血压:系统综述与meta分析

doi:10.3969/j.issn.1004-583X.2024.10.001

摘要/Abstract

摘要：

目的研究老年人群中维生素D缺乏[定义为25(OH)D3缺乏]与直立性低血压发生风险之间的关系。方法自数据库建立至2023年6月,对Pubmed、Embase、Web of Science、Scopus、Cochrane多个数据库进行了系统的文献检索。由两名研究员独立筛查纳入文献、提取资料并评价纳入研究偏倚风险,采用Stata软件(版本17.0)和RevMan5.4软件进行meta分析。结果使用随机效应模型对来自9项横断面研究包括9 155名参与者进行荟萃分析,通过放射免疫分析法(radioimmunoassay, RIA)和液相色谱-质谱法(liquid chromatography mass spectrometry,LC-MS)测定患者血清25羟维生素D含量。总体分析结果表明,在老年群体中,维生素D缺乏和直立性低血压具有直接相关性。与维生素D水平正常的个体相比,血清维生素D水平降低会显著增加老年人直立性低血压发生风险(OR=1.22,95%CI=1.12-1.33,P<0.05)。结论老年人维生素D水平缺乏与直立性低血压的发生风险具有明确相关性。

关键词: 低血压, 直立性, 老年人, 25-羟维生素D, Meta分析

Abstract:

Objective To study the relationship between vitamin D deficiency, defined as 25-hydroxyvitamin D3 (25 (OH) D3) deficiency and the risk of orthostatic hypotension (OH) in the elderly population. Methods From the establishment of the database to June 2023, a systematic literature search was conducted on Pubmed, Embase, Web of Science, Scopus, and Cochrane databases. Two researchers independently screened the included literatures, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was performed using Stata software (version 17.0) and RevMan5.4 software. Results A meta-analysis was conducted using the random-effect model involving 9,155 participants from 9 cross-sectional studies. Serum 25-hydroxyvitamin D levels were measured by radioimmunoassay (RIA) and liquid chromatography mass spectrometry (LC-MS). The overall analysis results showed that vitamin D deficiency was directly correlated with OH in the elderly population. Compared with individuals with normal vitamin D levels, low serum vitamin D levels significantly increased the risk of OH in the elderly (OR=1.22, 95%CI=1.12-1.33,P<0.05). Conclusion There is a clear correlation between vitamin D deficiency and the risk of OH in the elderly.

Key words: hypotension, orthostatic, elderly, 25-hydroxyvitamin D, meta-analysis

中图分类号:

R544.2

赵家华, 马庆华, 于江华. 维生素D缺乏与老年人群直立性低血压:系统综述与meta分析[J]. 临床荟萃, 2024, 39(10): 869-876.

Zhao Jiahua, Ma Qinghua, Yu Jianghua. Vitamin D deficiency and orthostatic hypotension in the elderly: A systematic review and meta-analysis[J]. Clinical Focus, 2024, 39(10): 869-876.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.10.001

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I10/869

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参考文献 39

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第一作者	年份	国家	样本量	性别(女) /人	25(OH)D 检测方法	中位年龄 (岁)	维生素D 缺乏组发生 OH的OR值	OR_LL	OR_UL	NOS评分
Gilani^[13]	2021	英国	3620	0(均为男性)	液相色谱-质谱法	68.6	1.31	0.96	1.78	7
Laird^[14]	2019	爱尔兰	4186	2219	液相色谱-质谱法	61.58	1.17	0.81	1.68	8
Veronese^[15]	2016	意大利	1308	781	放射免疫分析法	70	1.18	1.06	1.31	8
Veronese^[16]	2014	意大利	2640	1558	放射免疫分析法	73.8	1.08	0.77	1.51	7
Soysal^[17]	2014	土耳其	546	333	放射免疫分析法	73.4	1.47	0.931	2.322	6
McCarroll^[18]	2012	爱尔兰	76	76	放射免疫分析法	78-79	1.392	1.06	1.827	6
Duval^[19]	2016	法国	216	95	放射免疫分析法	84.9	1.644	0.533	5.072	7
Duval^[20]	2015	法国	51	25	放射免疫分析法	82	18.2	1.12	294.9	6
Annweiler^[21]	2014	法国	329	329	放射免疫分析法	83.3	1.41	0.733	2.686	7

第一作者	年份	国家	样本量	性别(女) /人	25(OH)D 检测方法	中位年龄 (岁)	维生素D 缺乏组发生 OH的OR值	OR_LL	OR_UL	NOS评分
Gilani^[13]	2021	英国	3620	0(均为男性)	液相色谱-质谱法	68.6	1.31	0.96	1.78	7
Laird^[14]	2019	爱尔兰	4186	2219	液相色谱-质谱法	61.58	1.17	0.81	1.68	8
Veronese^[15]	2016	意大利	1308	781	放射免疫分析法	70	1.18	1.06	1.31	8
Veronese^[16]	2014	意大利	2640	1558	放射免疫分析法	73.8	1.08	0.77	1.51	7
Soysal^[17]	2014	土耳其	546	333	放射免疫分析法	73.4	1.47	0.931	2.322	6
McCarroll^[18]	2012	爱尔兰	76	76	放射免疫分析法	78-79	1.392	1.06	1.827	6
Duval^[19]	2016	法国	216	95	放射免疫分析法	84.9	1.644	0.533	5.072	7
Duval^[20]	2015	法国	51	25	放射免疫分析法	82	18.2	1.12	294.9	6
Annweiler^[21]	2014	法国	329	329	放射免疫分析法	83.3	1.41	0.733	2.686	7