Abstract

Background

There have been various articles reporting relationship between Vitamin D (VitD) and celiac disease (CeD), but results remain controversial. This study aimed to conduct a meta‐analysis to systematically review and quantify the relationship between VitD and CeD. Moreover, difference in Vitamin D Receptor (VDR) genotypes between CeD patients and controls was also analyzed.

Methods

Articles published until July 20, 2019 in the PubMed, MEDLINE, and EMBASE databases were searched. According to the inclusion and exclusion criteria, relevant statistical data were collated and extracted, which were finally analyzed by STATA15.1.

Results

27 articles and 28 sets of data were included. It showed that average 25(OH)D level in CeD patients was 8.36 nmol/L lower than controls (Weighted Mean Difference (WMD) = −8.36, 95% CI = [−14.63, −2.09] nmol/L). After gluten-free diet treatment, we found that average 25(OH)D level in treated patients was 15.6 nmol/L higher than untreated patients (WMD = 15.6, 95% CI = [5.96, 25.23] nmol/L). In addition, 25(OH)D level in treated patients was close to healthy controls (WMD = −2.82, 95% CI = [−6.45, 0.73] nmol/L). However, genetic polymorphism analysis showed that there is no difference in VDR genotypes between CeD and control.

Conclusions

CeD had decreased serum 25(OH)D levels, which returned to normal after treatment, suggesting that VitD may play a role in the development of CeD. The directionality of this association cannot be confirmed from cross-sectional studies. Demonstration of a causal role of VitD deficiency in CeD development in future studies could have important therapeutic implications.

中文翻译：

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乳糜泻中的维生素 D 状态和维生素 D 受体基因型：荟萃分析

摘要

背景

已有多篇文章报道了维生素 D (VitD) 与乳糜泻 (CeD) 之间的关系，但结果仍存在争议。本研究旨在进行一项荟萃分析，以系统地回顾和量化 VitD 和 CeD 之间的关系。此外，还分析了 CeD 患者和对照组之间维生素 D 受体 (VDR) 基因型的差异。

方法

检索了截至 2019 年 7 月 20 日在 PubMed、MEDLINE 和 EMBASE 数据库中发表的文章。根据纳入和排除标准，整理提取相关统计数据，最后通过STATA15.1进行分析。

结果

纳入27篇文章和28组数据。结果表明，CeD 患者的平均 25(OH)D 水平比对照组低 8.36 nmol/L（加权平均差 (WMD) = -8.36, 95% CI = [-14.63, -2.09] nmol/L）。在无麸质饮食治疗后，我们发现接受治疗的患者的平均 25(OH)D 水平比未接受治疗的患者高 15.6 nmol/L（WMD = 15.6, 95% CI = [5.96, 25.23] nmol/L）。此外，接受治疗的患者的 25(OH)D 水平接近健康对照组（WMD = -2.82, 95% CI = [-6.45, 0.73] nmol/L）。然而，遗传多态性分析表明，CeD和对照之间的VDR基因型没有差异。

结论

CeD降低了血清25(OH)D水平，治疗后恢复正常，提示VitD可能在CeD的发生发展中起作用。这种关联的方向性无法从横断面研究中得到证实。在未来的研究中证明 VitD 缺乏在 CeD 发展中的因果作用可能具有重要的治疗意义。