Abstract：Objective To conduct a systematic review of the correlation between vitamin D and immunity in patients with recurrent miscarriage (URSA).Methods PubMed, EBSCO, CNKI, CBM, VIP, and WanFang Data databases were searched for control studies related to vitamin D and immunity in patients with URSA.The search time limit was from the establishment of the database to January 2021.In the case control study, patients with URSA were as the experimental group and normal pregnant women as the control group.In the randomized controlled trial, patients with URSA were divided into experimental group and control group.The case control study had no intervention.In the randomized controlled trial, both the experimental group and the control group were given routine treatment, and the experimental group was given vitamin D in addition to the intervention of the control group.The studies were screened by two independent researchers and data were extracted.After quality evaluation of included studies, RevMan 5.3 software was used for meta-analysis.Results A total of 12 literatures were included, including 2114 subjects.Meta-analysis results showed that the level of 25-hydroxyvitamin D (25[OH]D) in experimental group was lower than that in control group, the difference was statistically significant (SMD=-1.46, 95%CI[-2.08, -0.84], P＜0.000 01).The positive rates of anti-thyroid peroxidase antibody (TPOAb), anticardiolipin antibody (ACA) and antinuclear antibody (ANA) in URSA patients of 25(OH)D＜30 ng/ml group were higher than those in URSA patients of 25(OH)D≥30 ng/ml group, and the differences were statistically significant (OR=3.87, 95%CI[2.27, 6.60], P＜0.000 01; OR=2.96, 95%CI [1.53, 5.75],P=0.001; OR=2.54, 95%CI[1.54, 4.17], P=0.0002).CD4+T and CD56+NK cell counts in URSA patients of 25(OH)D＜30 ng/ml group were higher than those in URSA patients of 25(OH)D≥30 ng/ml group, the differences were statistically significant (SMD=1.65, 95%CI[1.29, 2.01], P＜0.000 01; SMD=0.83, 95%CI[0.35, 1.31], P=0.0008).There was no significant difference in CD19+B cell count between the URSA patients of 25(OH)D＜30 ng/ml group and the URSA patients of 25(OH)D≥30 ng/ml group (SMD=1.74, 95%CI[-1.07, 4.56], P=0.22).The abortion rate of URSA patients in experimental group was lower than that of URSA patients in control group, and the difference was statistically significant(RR=0.53, 95%CI[0.31, 0.89], P=0.02).Conclusion Deficiency of 25(OH)D is associated with increased CD4+T CD56+NK cell counts and autoimmune antibody, and adequate vitamin D supplementation may prevent URSA.However, this study was limited by the number and quality of subjects included in the study, and the conclusion needs to be verified by more high-quality studies.
吴运燕；秦霞；邱峰▲. 维生素D与原因不明复发性流产患者免疫相关性的系统评价[J]. 中国当代医药, 2021, 28(29): 30-34转38.
WU Yun-yan；QIN Xia；QIU Feng. Systematic review of correlation between vitamin D and immunity in patients with unexplained recurrent spontaneous abortion. 中国当代医药, 2021, 28(29): 30-34转38.
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