Previous studies have failed to draw a consistent conclusion over the effect of vitamin D administration on asthma. We hypothesized that vitamin D supplementation could improve the clinical efficacy of corticosteroids in patients with asthma as measured by exacerbations, Asthma Control Test (ACT) score, and lung function in order to maintain asthma control. We searched Web of Science, PubMed, the Cochrane Library, and ScienceDirect up through January 20, 2021 for randomized controlled trials analyzing the effect of vitamin D supplementation on asthma exacerbation. Studies were limited to patients with moderate to severe asthma who were treated with corticosteroids. We identified 12 studies involving 1,543 participants in this meta-analysis. Vitamin D supplementation significantly reduced the risk of asthma exacerbation (pooled risk ratio (RR) 0.70, 95% confidence interval (CI), 0.59, 0.83; P < .05). The pooled RR of the ACT score was 0.04 (95% CI, −0.19, 0.27; P > .05). The pooled standardized mean difference in vitamin D levels was 1.07 (95% CI, 0.77, 1.38; P < .05), and in the percentage of forced expiratory volume in one second was −0.02 (95% CI, −0.13, 0.09; P > .05). The pooled RR of adverse events was 1.06 (95% CI, 0.89, 1.25; P > .05). We performed subgroup analysis and meta-regression of serum vitamin D levels but found no source of heterogeneity. Vitamin D supplementation safely reduced the rate of asthma exacerbation but did not improve ACT score or lung function among patients with asthma treated with corticosteroids.

以前的研究未能就维生素 D 给药对哮喘的影响得出一致的结论。我们假设补充维生素 D 可以提高皮质类固醇对哮喘患者的临床疗效，如哮喘发作、哮喘控制测试 (ACT) 评分和肺功能，以维持哮喘控制。我们在科学网、PubMed、Cochrane 图书馆和 ScienceDirect 中检索了截至 2021 年 1 月 20 日的随机对照试验，这些试验分析了补充维生素 D 对哮喘恶化的影响。研究仅限于接受皮质类固醇治疗的中度至重度哮喘患者。我们在这项荟萃分析中确定了 12 项研究，涉及 1,543 名参与者。补充维生素 D 显着降低了哮喘恶化的风险（汇总风险比 (RR) 0.70，P < .05）。ACT 评分的汇总 RR 为 0.04（95% CI，-0.19，0.27；P > .05）。维生素 D 水平的合并标准化平均差异为 1.07（95% CI，0.77，1.38；P < .05），一秒内用力呼气量的百分比为 -0.02（95% CI，-0.13，0.09；P > .05）。不良事件的汇总 RR 为 1.06（95% CI，0.89，1.25；P > .05）。我们对血清维生素 D 水平进行了亚组分析和荟萃回归，但没有发现异质性来源。在接受皮质类固醇治疗的哮喘患者中，补充维生素 D 可以安全地降低哮喘恶化率，但并未改善 ACT 评分或肺功能。