Sumayah Abdul-Jabbar, Chukwuebuka Nebechi, Graham R McClelland, Anthony Lockett, Abdel Douiri, David Morgan, Stuart A Jones
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The change in 25(OH)D3 blood levels (95% CI) and P values were extracted, and grouped according to ethnicity, then subjected to random-effects meta-analysis. The primary outcome measurement was mean serum 25(OH)D3 levels and the secondary outcome was dose-adjusted mean serum 25(OH)D3 levels, both compared with baseline.</p><p><strong>Data analysis: </strong>A total of 18 studies were identified, and data from 1131 participants were extracted. Body mass index (BMI) and dose were significant covariates (Pearson correlation coefficient, P = .016 and .017) and were normalized in the meta-analysis to minimize heterogeneity, but latitude was not (P = .66). Meta-analysis showed an effect of ethnicity on dose and BMI-adjusted mean serum 25(OH)D3 levels compared with baseline (P < .00001, I2 = 98%). Asian and White study participants demonstrated a statistically higher increase in dose and BMI-adjusted 25(OH)D3 blood levels (183 nmol/L [95% CI, 163-203] and 173 nmol/L [95% CI, 152-194], respectively), compared with Arab and Black study participants (37 nmol/L [95% CI, 35-39] and 99 nmol/L [95% CI, 90-108]) using repeated t tests. Sensitivity analysis demonstrated that these findings were not impacted by potential study bias or the inclusion of immigrant populations.</p><p><strong>Conclusion: </strong>Ethnicity had an impact on oral vitamin D response. Further prospective studies should examine if ethnicity-based dose stratification in both clinical practice and clinical trials is warranted.</p><p><strong>Systematic review registration: </strong>PROSPERO registration no. 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引用次数: 0
摘要
背景：口服维生素 D 补充剂反应的个体差异阻碍了人们对其临床影响的理解，虽然种族问题与这种差异有关，但尚未得到很好的描述：目的：系统评估种族对口服维生素 D 补充剂反应的影响：数据来源： 在 Web of Science 和 PubMed 数据库中搜索了 1960 年至 2020 年底发表的文章。数据提取：两名审稿人独立提取了符合条件的研究数据。提取25（OH）D3血液水平的变化（95% CI）和P值，并根据种族进行分组，然后进行随机效应荟萃分析。主要结果测量是平均血清 25（OH）D3 水平，次要结果是剂量调整后的平均血清 25（OH）D3 水平，两者均与基线进行比较：共确定了 18 项研究，提取了 1131 名参与者的数据。体重指数（BMI）和剂量是重要的协变量（皮尔逊相关系数，P = 0.016 和 0.017），并在荟萃分析中进行了归一化处理，以尽量减少异质性，但纬度没有进行归一化处理（P = 0.66）。荟萃分析表明，与基线相比，种族对剂量和体重指数调整后的平均血清 25（OH）D3 水平有影响（P 结论：种族对口服维生素 D3 有影响：种族对口服维生素 D 的反应有影响。进一步的前瞻性研究应探讨在临床实践和临床试验中是否需要基于种族进行剂量分层：系统综述注册：PROSPERO 注册号CRD42023410076。
Ethnic Differences in Response to Oral Vitamin D Supplementation: A Systematic Review and Meta-analysis.
Context: Individual variability in oral vitamin D supplement response hinders the understanding of its clinical impact, and while ethnicity has been implicated in this variability it has not been well described.
Objective: The aim was to systematically assess the impact of ethnicity on response to oral vitamin D supplementation.
Data source: The Web of Science and PubMed databases were searched for articles published from 1960 to the end of 2020. All trials in adults measuring 25(OH)D3 blood levels were included.
Data extraction: Two reviewers independently extracted the data from the eligible studies. The change in 25(OH)D3 blood levels (95% CI) and P values were extracted, and grouped according to ethnicity, then subjected to random-effects meta-analysis. The primary outcome measurement was mean serum 25(OH)D3 levels and the secondary outcome was dose-adjusted mean serum 25(OH)D3 levels, both compared with baseline.
Data analysis: A total of 18 studies were identified, and data from 1131 participants were extracted. Body mass index (BMI) and dose were significant covariates (Pearson correlation coefficient, P = .016 and .017) and were normalized in the meta-analysis to minimize heterogeneity, but latitude was not (P = .66). Meta-analysis showed an effect of ethnicity on dose and BMI-adjusted mean serum 25(OH)D3 levels compared with baseline (P < .00001, I2 = 98%). Asian and White study participants demonstrated a statistically higher increase in dose and BMI-adjusted 25(OH)D3 blood levels (183 nmol/L [95% CI, 163-203] and 173 nmol/L [95% CI, 152-194], respectively), compared with Arab and Black study participants (37 nmol/L [95% CI, 35-39] and 99 nmol/L [95% CI, 90-108]) using repeated t tests. Sensitivity analysis demonstrated that these findings were not impacted by potential study bias or the inclusion of immigrant populations.
Conclusion: Ethnicity had an impact on oral vitamin D response. Further prospective studies should examine if ethnicity-based dose stratification in both clinical practice and clinical trials is warranted.
期刊介绍：
Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
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