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. 2022 Aug 26:9:972586.
doi: 10.3389/fmed.2022.972586. eCollection 2022.

Peripheral vitamin D levels in ankylosing spondylitis: A systematic review and meta-analysis

Maohui Diao  1 , Jun Peng  1 , Daidong Wang  1 , Hongbo Wang  1
Affiliations

Peripheral vitamin D levels in ankylosing spondylitis: A systematic review and meta-analysis

Maohui Diao et al. Front Med (Lausanne). .

Abstract

Objectives: Previous studies showed conflicting results regarding peripheral vitamin D levels in ankylosing spondylitis (AS). We performed this systemic review and meta-analysis to explore whether vitamin D may influence AS process.

Methods: Articles published until March 2022 were searched in databases as follows: PubMed, Web of Science, and Google Scholar. The present study included cross-sectional and case-control studies regarding vitamin D levels in patients with AS. Studies were excluded according to the following exclusion criteria: (1) we excluded studies which did not provide sufficient information regarding the comparison of vitamin D levels in AS patients and healthy controls (HC). Vitamin D levels in the two group studies should be reported or could be calculated in included studies; (2) meta-analysis, reviews and case reports. STATA 12.0 software was used to make a meta-analysis. Standard mean differences (SMDs) and 95% confidence intervals (CIs) were computed as effect size.

Results: The present meta-analysis showed no significant difference in peripheral 1,25-dihydroxyvitamin D3 (1,25OHD) levels between AS and healthy controls (HCs) in Caucasians with a random effects model [SMD: -0.68, 95% CI (-1.90, 0.54)]. Patients with AS had lower peripheral 25-hydroxyvitamin D (25OHD) levels compared with HC with a random effects model [SMD: -0.45, 95% CI: (-0.70, -0.20)]. Patients with AS had higher peripheral C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels compared with HC in Caucasian population with random effects models [CRP: SMD: 1.08, 95% CI: (0.78, 1.37); ESR: SMD: 0.86, 95% CI: (0.39, 1.34)]. However, no significant difference in alkaline phosphatase (ALP), parathyroid hormone (PTH) or calcium levels were indicated between AS and HC in Caucasian with random effects models [ALP: SMD: 0.07, 95% CI: (-0.41, 0.55); PTH: SMD: -0.15, 95% CI: (-0.56, 0.26); calcium: SMD: -0.06, 95% CI: (-0.39, 0.26)].

Conclusion: In conclusion, the study showed an inverse association between 25OHD and AS, which suggests that vitamin D may have a protective effect on AS. ESR and C-reactive protein (CRP) are important biomarkers for AS.

Keywords: 1; 25-dihydroxyvitamin D3; ankylosing spondylitis; meta-analysis; systematic review; vitamin D.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Forest plot regarding comparison in peripheral 1,25OHD levels between AS and HC. AS, ankylosing spondylitis; HC, healthy controls; 1,25OHD, 1,25-dihydroxyvitamin D3.
Figure 2
Figure 2
Forest plot regarding comparison in peripheral 25OHD levels between AS and HC. AS, ankylosing spondylitis; HC, healthy controls; 25OHD, 25-hydroxyvitamin D.
Figure 3
Figure 3
Forest plot regarding comparison in peripheral ALP levels between AS and HC. ALP, alkaline phosphatase; AS, ankylosing spondylitis; HC, healthy controls.
Figure 4
Figure 4
Forest plot regarding comparison in peripheral CRP levels between AS and HC. AS, ankylosing spondylitis; CRP, C-reactive protein; HC, healthy controls.
Figure 5
Figure 5
Forest plot regarding comparison in peripheral ESR levels between AS and HC. AS, ankylosing spondylitis; ESR, erythrocyte sedimentation rate; HC, healthy controls.
Figure 6
Figure 6
Forest plot regarding comparison in peripheral PTH levels between AS and HC. AS, ankylosing spondylitis; HC, healthy controls; PTH, parathyroid hormone.
Figure 7
Figure 7
Forest plot regarding comparison in peripheral calcium levels between AS and HC. AS, ankylosing spondylitis; HC, healthy controls.
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