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Vitamin D levels do not predict the stage of hepatic fibrosis in patients with non-alcoholic fatty liver disease: A PRISMA compliant systematic review and meta-analysis of pooled data

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World Journal of Hepatology 2018年第1期10卷 142-154页

作者： Behnam Saberi Alia S Dadabhai julie nanavati Lin Wang Russell T Shinohara Gerard E Mullin Division of Gastroenterology and Hepatology The Johns Hopkins University School of Medicine Division of Liver Diseases Icahn School of Medicine at Mount Sinai Welch Medical Library The Johns Hopkins University School of Medicine Department of Epidemiology Johns Hopkins-Bloomberg School of Public Health Department of Biostatistics Epidemiology and Informatics Perelman School of Medicine University of Pennsylvania

AIM To investigate the relationship between 25-hydroxyvitamin D [25(OH)D] levels and fibrosis stage in patients with non-alcoholic fatty liver disease(NAFLD).METHODS Two individual reviewers identified relevant studies using the Pub Med, EMBASE, Cochrane, and Scopus databases. Inclusion criteria were as follows:(1) Studies that evaluated adults with NAFLD and serum or plasma 25(OH)D levels; and(2) assessed fibrosis stage using liver biopsy. A rigorous analysis yielded six articles as having sufficient data to employ in evaluating the association of serum vitamin D levels in patients with NAFLD based on their liver fibrosis stage by histopathological analysis. The lead investigators of each of the six studies were contacted and the data were collected. To meta-analyze vitamin D levels in F0-F2 vs F3-F4 fibrosis, a random-effects meta-analysis fit using restricted maximum likelihood was applied. To examine trends across each stage of fibrosis with respect to vitamin D levels, a meta-regression was performed. P < 0.05 was considered statistically significant. RESULTS A total of 937 subjects from six studies were included in the final analysis to evaluate the association of serum vitamin D levels in patients with NAFLD based on their liver fibrosis stage by histopathological analysis. The lead investigators of each of the six studies were contacted and the data were collected. First, the investigators performed a meta-analysis to compare serum vitamin D levels in patients with NAFLD with stage F0-F2 compared to F3-F4, which did not show significance [meta-estimate of the pooled mean difference =-0.86, P = 0.08(-4.17, 2.46)]. A metaregression evaluation of serum vitamin 25(OH)D levels across the individual stages(F0-F4) of fibrosis did not show an association for the six included *** Low vitamin D status is not associated with higher stages of liver fibrosis in patients with NAFLD.

关键词： Vitamin D 25-hydroxyvitamin D Liver fibrosis Meta-analysis Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis

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