Insulin resistance inobata basa rinokosha pathogenesis ye nonalcoholic fatty chiropa chirwere (NAFLD) .Zvidzidzo zvakawanda zvakaongorora kushamwaridzana kwevitamini Dkuwedzera ne insulin resistance kune varwere vane NAFLD.Zvigumisiro zvakawanikwa zvichiri kuuya nemigumisiro inopesana.Chinangwa chechidzidzo ichi chaiva chekuongorora kushanda kwekuwedzera kwevhitamini D therapy pakuvandudza insulin resistance kune varwere vane NAFLD.Mabhuku akakodzera akawanikwa kubva kuPubMed, Google Nyanzvi, COCHRANE neScience Direct dhatabhesi.Zvidzidzo zvakawanikwa zvakaongororwa pachishandiswa zvigadziriswa-zvakagadziriswa kana kuti zvigadziriswe zvisingatarisirwi.Zvidzidzo zvinomwe zvinokodzera nehuwandu hwevatori vechikamu 735 zvakabatanidzwa.Vitamin Dkuwedzeredza kwakavandudza insulin kusagadzikana kune varwere vane NAFLD, yakaratidzwa nekuderedzwa kweHomeostatic Model Assessment yeInsulin Resistance (HOMA-IR), ine mutsauko wakabatanidzwa we -1.06 (p = 0.0006; 95% CI -1.66 kusvika -0.45). Vitamin D supplementation yakawedzera serum vitamin D mazinga ane zvinoreva kusiyana kwe17.45 (p = 0.0002; 95% CI 8.33 kusvika 26.56).Vitamin Dkuwedzeredza kwakaderedza mazinga eAlT ane mutsauko wakabatanidzwa we -4.44 (p = 0.02; 95% CI -8.24 kusvika -0.65) .Hapana chiitiko chakaonekwa paAST mazinga.Vitamin D supplementation ine migumisiro inobatsira pakuvandudza insulin kudzivisa mu NAFLD varwere. kuwedzera kwekuwedzera kunogona kuderedza HOMA-IR muvarwere vakadaro.Inogona kushandiswa sechinhu chinogona kurapa adjuvant kuvarwere veNAFLD.
Nonalcoholic fatty chiropa chirwere (NAFLD) iboka rezvirwere zvechiropa zvine chokuita nemafuta1.Inoratidzirwa nekuunganidza kukuru kwe triglycerides muhepatocytes, kazhinji necroinflammatory activity uye fibrosis (steatohepatitis) 2.Inogona kufambira mberi kune nonalcoholic steatohepatitis (NASH), fibrosis uye cirrhosis.NAFLD inoonekwa sechikonzero chikuru chechirwere chisingaperi chisingaperi uye kuwanda kwayo kuri kuwedzera, inofungidzirwa pa25% kusvika ku30% yevanhu vakuru munyika dzakabudirira3,4.Insulin resistance, kuzvimba, uye oxidative stress inofungidzirwa kuti ndiyo zvikonzero zvikuru kuvandudzwa kweNAFLD1.
Iyo pathogenesis yeNAFLD yakanyatsobatana ne insulin resistance.Kubva pane yakanyanya kupararira "two-hit hypothesis" muenzaniso, insulin resistance inobatanidzwa mu "first-hit" maitiro.Muchiito ichi chekutanga, chinosanganisira kuunganidza lipids iri mukati. hepatocytes, apo insulin resistance inofungidzirwa kuti ndiyo inonyanya kukonzera mukugadzirwa kwehepatic steatosis.Iyo "yekutanga hit" inowedzera kukanganisa kwechiropa kune zvinhu zvinoumba "second hit".Inogona kukonzera kukanganisa kwechiropa, kuzvimba uye fibrosis.Kugadzirwa kweproinflammatory cytokines, mitochondrial dysfunction, oxidative stress, uye lipid peroxidation zvakare zvinhu zvinogona kukonzera kukura kwekukuvara kwechiropa, chinoumbwa neadipokines.
Vitamin D ine mafuta-soluble vitamin inogadzirisa bone homeostasis.Basa rayo rave richiongororwa zvakanyanya muhutano hwehutano husina-skeletal hwakadai se metabolic syndrome, insulin resistance, kuneta, chirwere cheshuga chechipiri uye zvirwere zvine chokuita nemoyo.Recently, a a. hukuru hwehupupu hwesainzi hwakaongorora hukama huripo pakati pevhitamini D neNAFLD.Vitamin D inozivikanwa kuti inodzora insulin kushorwa, kusingaperi kuzvimba uye fibrosis.Naizvozvo, vitamini D inogona kubatsira kudzivirira kufambira mberi kweNAFLD6.
Miedzo yakawanda yakarongeka (RCTs) yakaongorora mhedzisiro yevhitamini D yekuwedzera pane insulin kushorwa.Zvisinei, mhedzisiro yakawanikwa ichiri kusiyana;kana kuratidza kunobatsira kwe insulin kudzivisa kana kusaratidza chero rubatsiro7,8,9,10,11,12,13.Pasinei nemigumisiro inopesana, meta-analysis inodiwa kuti iongorore maitiro ose ekuwedzera kwevhitamini D.Several meta-analysis. zvakaitwa kare14,15,16.A meta-analysis naGuo et al.Kusanganisira zvidzidzo zvitanhatu zvinoongorora kushanda kwevhitamini D pakudzivirira insulin kunopa uchapupu hukuru hwokuti vhitamini D inogona kuva nemigumisiro inobatsira pa insulin senitivity14.Zvisinei, imwe meta- kuongororwa kwakaunza migumisiro yakasiyana.Pramono et al15 vakawana kuti kuwedzera kwevhitamini D kurapwa kwakanga kusina simba pa insulin senitivity.Vanhu vaibatanidzwa muchidzidzo vaiva zvidzidzo kana kuti pangozi yekudzivirira insulini, kwete avo vakanyatsotarirwa NAFLD.Imwe tsvakurudzo yaWei et al. ., kusanganisira zvidzidzo zvina, zvakawanikwa zvakafanana.Vitamin D supplementation haina kuderera HOMA IR16.Kufunga nezvese zvakapfuura meta-analysis pamusoro pekushandiswa kwevhitamini D yekuwedzera insulin resistance, an upda.ted meta-analysis inodiwa pamwe chete nemamwe mabhuku akagadziridzwa.Chinangwa chechidzidzo ichi chaiva chekuongorora mhedzisiro yevhitamini D yekuwedzera pane insulin kuramba.
Nekushandisa nzira yekutsvaga yepamusoro, takawana zvidzidzo zve 207, uye mushure mokubvisa, takawana zvinyorwa 199. Takabvisa zvinyorwa zve 182 nekuongorora mazita uye zvinyorwa, zvichisiya zvidzidzo zvakakosha zve 17. Zvidzidzo zvisina kupa ruzivo rwese. inodiwa kune iyi meta-analysis kana kuti iyo yakazara zvinyorwa zvakanga zvisipo zvakanga zvisingabatanidzwi.Mushure mekuongorora uye kuongororwa kwehutano, takawana zvinyorwa zvinomwe zvemazuva ano kuongorora kwakarongeka uye meta-analysis.Kuyerera kwechidzidzo chePRISMA chinoratidzwa muMufananidzo 1. .
Takabatanidza zvinyorwa zvizere zvezvinomwe zvinomwe zvisingatarisirwi (RCTs) .Makore ekubudiswa kwezvinyorwa izvi zvakabva ku2012 kusvika ku2020, pamwe chete nemasampuli e423 muboka rekupindira uye 312 muboka re placebo.Boka rekuedza rakagamuchira zvakasiyana-siyana. madhasi uye nguva yevhitamini D yekuwedzera, nepo boka rekutonga rakagamuchira placebo. Pfupiso yemhedzisiro yezvidzidzo uye maitiro ekudzidza anoratidzwa muTafura 1.
Njodzi yekurerekera yakaongororwa pachishandiswa nzira yeCochrane Collaboration yenjodzi yekurerekera divi rimwe chete.Zvinyorwa zvinomwe zvese zvakabatanidzwa muchidzidzo ichi zvakapfuura kuongororwa kwemhando.Mibairo yakazara yengozi yekurerekera kune zvese zvinosanganisirwa zvinyorwa zvinoratidzwa muFigure 2.
Vitamin D supplementation inovandudza insulin kudzivirira kune varwere vane NAFLD, inoratidzirwa nekuderera kweHOMA-IR.Kubva pane imwe nzira yemigumisiro yemuenzaniso (I2 = 67%; χ2 = 18.46; p = 0.005), iyo yakasanganiswa inoreva kusiyana pakati pevhitamini D yekuwedzera uye pasina vhitamini. D kuwedzera kwaiva -1.06 (p = 0.0006; 95% CI -1.66 kusvika -0.45) (mufananidzo 3).
Kubva pamuenzaniso wemaitiro-maitiro (Mufananidzo 4), iyo yakasanganiswa inoreva kusiyana muvhitamini D serum mushure mekuwedzera kwevhitamini D yaiva 17.45 (p = 0.0002; 95% CI 8.33 kusvika 26.56) . Maererano nekuongorora, vitamin D kuwedzera kunogona kuwedzera serum vitamin D level ne 17.5 ng / mL. Zvichakadaro, mhedzisiro yevhitamini D yekuwedzera pane enzymes yechiropa ALT uye AST yakaratidza mhedzisiro dzakasiyana. Vitamin D supplementation yakaderera ALT mazinga ane pooled zvinoreva musiyano we -4.44 (p = 0.02; 95% CI -8.24 kusvika -0.65) (Mufananidzo 5) .Zvisinei, hapana chiitiko chakaonekwa kune AST mazinga, ane pooled zvinoreva musiyano we -5.28 (p = 0.14; 95% CI - 12.34 kusvika 1.79) zvichienderana nemuenzaniso wemigumisiro ( Mufananidzo 6).
Kuchinja kweHOMA-IR mushure mekuwedzera kwevhitamini D kwakaratidza huterogeneity yakawanda (I2 = 67%).Meta-regression inoongorora nzira yehutungamiri (muromo kana intramuscular), kudya (zuva nezuva kana kuti kwete zuva nezuva), kana nguva yekuwedzera vitamin D (≤ Masvondo e12 uye > mavhiki e12) anoratidza kuti kushandiswa kwehuwandu kunogona kutsanangura heterogeneity (Table Table 2) .Zvose asi chidzidzo chimwe chete naSakpal et al.11 yakashandisa nzira yemuromo yehutungamiri.Kudya kwezuva nezuva kwevhitamini D kunowedzera kushandiswa muzvidzidzo zvitatu7,8,13.Kuwedzera kunzwisiswa kwekuongorora nekusiya-imwe-kunze kwekuongorora kwekuchinja kweHOMA-IR mushure mekuwedzera kwevhitamini D kwakaratidza kuti hapana chidzidzo chakanga chinokonzera. iyo heterogeneity yekuchinja muHOMA-IR (Fig. 7).
Migumisiro yakabatanidzwa yezvino meta-analysis yakawana kuti kuwedzera kwevhitamini D kurapwa kunogona kuvandudza insulin kudzivisa, chiratidzo cheiyo yakaderedzwa HOMA-IR kune varwere vane NAFLD. Nzira yehutungamiri yevhitamini D inogona kusiyana, nejekiseni remumuscular kana nemuromo. .Kuwedzera kuongororwa kwemigumisiro yaro pakuvandudza insulin kudzivisa kuti unzwisise kuchinja kweserum ALT uye AST mazinga.
Chiitiko cheNAFLD chakanyatsobatana ne insulin resistance.Kuwedzera pasina mafuta acids (FFA), adipose tissue inflammation, uye kuderera kweadiponectin inokonzera kukura kwe insulin resistance mu NAFLD17.Serum FFA inonyanya kukwidziridzwa mu NAFLD varwere, iyo inozoshandurwa. kune triacylglycerols kuburikidza ne glycerol-3-phosphate pathway.Chimwe chigadzirwa chenzira iyi ceramide uye diacylglycerol (DAG) .DAG inozivikanwa kuti inobatanidzwa mukushandiswa kweprotein kinase C (PKC), iyo inogona kudzivisa insulin receptor threonine 1160, iyo inobatanidza nekuderedza insulin kusagadzikana.Kuvhiringidza kweadipose tissue uye kuwedzera mu proinflammatory cytokines yakadai se interleukin-6 (IL-6) uye tumor necrosis factor alpha (TNF-alpha) inobatsirawo ku insulin resistance. Kana iri adiponectin, inogona kukurudzira. iyo inhibition ye fatty acid beta-oxidation (FAO), kushandiswa kweglucose uye fatty acid synthesis.Mazinga ayo anoderedzwa mu NAFLD varwere, nokudaro vachikurudziralopment ye insulin resistance.Inoenderana ne vitamin D, vitamin D receptor (VDR) iripo mumasero echiropa uye yakave yakabatanidzwa mukuderedza maitiro ekuputika muchirwere chisingaperi chechiropa.Basa reVDR rinowedzera insulin senitivity nekugadzirisa FFA.Kuwedzera, vitamini D ine anti-inflammatory uye anti-fibrotic properties muchiropa19.
Uchapupu huripo hunoratidza kuti kushayikwa kwevhitamini D kunogona kubatanidzwa muhutachiona hwezvirwere zvakawanda.Iyi pfungwa inobata chokwadi chekubatana pakati pekushayikwa kwevhitamini D uye insulin resistance20,21.Vitamin D inoita basa rayo rinogona kuita kuburikidza nekubatana neVDR uye vitamin D metabolizing enzymes. Izvi zvinogona kunge zviripo mumhando dzakasiyana-siyana dzemasero, kusanganisira pancreatic beta masero uye insulin-inopindura masero akadai seadipocytes.Kunyange zvazvo nzira chaiyo pakati pevhitamini D uye insulin kushorwa inoramba isingazivikanwi, yakave yakataurwa kuti adipose tissue inogona kubatanidzwa mukugadzirisa kwayo. chitoro chikuru chevhitamini D mumuviri is adipose tissue.Inoitawo sechinhu chinokosha cheadipokines uye cytokines uye inobatanidzwa mukugadzirwa kwemaitiro ehutachiona.Uchapupu huripo hunoratidza kuti vitamini D inogadzirisa zviitiko zvine chokuita ne insulin secretion kubva pancreatic beta cells.
Zvichipa uchapupu uhwu, vitamini D kuwedzera kwekuvandudza insulin kusagadzikana muvarwere veNAFLD inonzwisisika.Mishumo yemazuva ano inoratidza kushanda kunobatsira kwevhitamini D kuwedzera pakuvandudza insulin kushorwa.RCTs dzakawanda dzakapa migumisiro inopesana, inoda kuwedzera kuongororwa nemeta-analyses.A ichangobva kuitika. meta-analysis by Guo et al. Kuongorora kushanda kwevhitamini D pakurwisa insulin kunopa humbowo hukuru hwekuti vhitamini D inogona kuva nemhedzisiro inobatsira pakunzwa kwe insulin.Vakawana kuderedzwa kweHOMA-IR kwe - 1.32;95% CI - 2.30, - 0.34.Zvidzidzo zvakabatanidzwa kuongorora HOMA-IR zvaive zvidzidzo zvitanhatu14.Zvisinei, uchapupu hunopesana huripo.Kuongorora kwakarongeka uye meta-analysis inosanganisira 18 RCTs naPramono et al evaluating the effect of vitamin D supplementation on. insulin senitivity mune zvidzidzo ne insulin kushorwa kana njodzi ye insulin kushorwa kwakaratidza kuti yakawedzera vhitamini D Insulin senitivity yakanga isina mhedzisiro, yakaenzana inoreva musiyano -0.01, 95% CI -0.12, 0.10;p = 0.87, I2 = 0% 15.Zvisinei, zvinofanira kucherechedzwa kuti vanhu vakaongororwa mumeta-analysis vaiva vanhu vane kana kuti vari pangozi ye insulin resistance (kurema, kufutisa, prediabetes, polycystic ovary syndrome [PCOS] uye rudzi rusina kuoma. 2 chirwere cheshuga), pane NAFLD varwere15. Imwe meta-analysis na Wei et al. Zvakafanana zvakawanikwa zvakawanikwawo.Mukuongororwa kwevhitamini D kuwedzera muHOMA-IR, kusanganisira zvidzidzo zvina, vitamin D supplementation haina kuderedza HOMA IR (WMD). = 0.380, 95% CI - 0.162, 0.923; p = 0.169) 16.Kuenzanisa data yose iripo, ikozvino yakarongeka yakarongeka uye meta-analysis inopa mamwe mimwe mishumo yevhitamini D yekuwedzera kuvandudza insulin kushorwa muvarwere veNAFLD, yakafanana nemeta-analysis. naGuo et al.Kunyange zvazvo meta-analysis yakafanana yakaitwa, ikozvino meta-analysis inopa zvinyorwa zvakagadziridzwa zvinosanganisira miedzo yakawanda inodzorwa uye nokudaro inopa uchapupu hwakasimba hwekuita kwevhitamini D kuwedzera pa insulin r.kusistance.
Mhedzisiro yevhitamini D pakudzivirira kwe insulini inogona kutsanangurwa nebasa rayo semugadziri we insulin secretion uye Ca2 + mazinga.Calcitriol inogona kukonzera zvakananga insulin secretion nokuti vitamin D response element (VDRE) iripo mune insulin gene inokurudzira iri mupancreatic. beta masero.Kwete chete kunyorwa kwejene re insulin, asiwo VDRE inozivikanwa kuti inokurudzira majini akasiyana-siyana ane chokuita ne cytoskeleton formation, intracellular junctions, uye kukura kwesero yepancreatic cβ cells.Vitamin D yakaratidzawo kuti inokanganisa insulini kusagadzikana nekugadzirisa Ca2 + flux.Sezvo calcium inokosha kune dzakawanda insulin-mediated intracellular process in muscle and adipose tissue, vitamini D inogona kubatanidzwa mukuita kwayo pa insulin resistance.Optimal intracellular Ca2 + mazinga anodiwa kuti insulini iite.Zvidzidzo zvakawana kuti kushayikwa kwevhitamini D kunotungamirira yakawedzera Ca2 + kuwedzera, zvichiita kuti kuderera kweGLUT-4 basa, iyo inokanganisa insulin resistance26,27.
Mhedzisiro yevhitamini D yekuwedzera pakuvandudza insulin kusagadzikana yakawedzera kuongororwa kuratidza mhedzisiro yayo pachiropa chinoshanda, iyo yakaratidzwa mukushandurwa kweALT uye AST mazinga. supplementation.A meta-analysis naGuo et al.yakaratidza kuderedzwa kwemuganhu mumazinga eALT, pasina mhedzisiro pamazinga eAST, akafanana neaya ekudzidza14.Imwe meta-analysis yekuongorora naWei et al.2020 yakawanawo mutsauko muserum alanine aminotransferase. uye aspartate aminotransferase mazinga pakati pevhitamini D yekuwedzera uye mapoka e placebo.
Ikozvino kuongororwa kwakarongeka uye meta-analysis inopesanawo nemiganhu.The heterogeneity yezvino meta-analysis inogona kunge yakakonzera migumisiro yakawanikwa muchidzidzo ichi.Maonero emangwana anofanira kutarisa nhamba yezvidzidzo uye zvidzidzo zvinobatanidzwa mukuongorora vitamin D kuwedzera kwe insulin resistance, zvakanangana nenhamba yeNAFLD, uye homogeneity yezvidzidzo.Chimwe chikamu chekufunga ndechekudzidza mamwe maitiro muNAFLD, semugumisiro wevhitamini D kuwedzera mu NAFLD varwere pazvipembenene zvinopisa, NAFLD basa rekuita (NAS) uye kuoma kwechiropa. Mukupedzisa, vhitamini D yekuwedzera yakavandudza insulin kudzivirira kune varwere vane NAFLD, chiratidzo cheiyo yakaderedzwa HOMA-IR.Iyo inogona kushandiswa seyanogona kushandiswa adjuvant therapy kune NAFLD varwere.
Nzira dzekukodzera dzinotarwa nekushandisa pfungwa yePICO.Iyo hurongwa hunotsanangurwa muTebhu 3.
Ikozvino yakarongeka yekuongorora uye meta-analysis inosanganisira zvidzidzo zvose kusvika March 28, 2021, uye inopa zvinyorwa zvizere, kuongorora humwe vhitamini D kutonga kune varwere vane NAFLD. Zvinyorwa zvine nyaya dzenyaya, zvidzidzo zvehutano uye zvehupfumi, ongororo, cadavers uye anatomy types. zvakabviswa kubva pane zvidzidzo zvemazuva ano.Nyaya dzose dzisina kupa dhiyabhorosi yaidiwa kuti iite meta-analysis yemazuva ano yakanga isingabatanidzwiwo.Kudzivirira kudzokorora kwemuenzaniso, sampuli dzakaongororwa nokuda kwezvinyorwa zvakanyorwa nemunyori mumwe chete mukati mesangano rimwechete.
Kuongorora kwaisanganisira zvidzidzo zvevanhu vakuru NAFLD varwere vanowana vhitamini D kutonga.Insulin kuramba yakaongororwa uchishandisa Homeostasis Model Assessment yeInsulin Resistance (HOMA-IR).
Kupindira kuri kuongororwa kwaiva kutungamirirwa kwevhitamini D.Taisanganisira zvidzidzo umo vitamini D yaishandiswa chero ipi zvayo, nenzira ipi zvayo yekutonga, uye kwenguva ipi zvayo.Zvisinei, takanyora muyero uye nguva yevhitamini D inoshandiswa muchidzidzo chega chega. .
Mhedzisiro huru yakaongororwa muongororo yezvino yakarongeka uye meta-analysis yaiva insulin resistance.Panyaya iyi, takashandisa HOMA-IR kuti tione insulin resistance muvarwere.Zvigumisiro zvechipiri zvaisanganisira serum vitamin D mazinga (ng / mL), alanine aminotransferase (ALT). ) (IU / l) uye aspartate aminotransferase (AST) (IU / l) mazinga.
Bvisa Mamiriro Ekuita (PICO) mumazwi akakosha uchishandisa Boolean operators (semu OR, UYE, KWETE) uye minda yese kana MeSH (Medical Subject Heading). Muchidzidzo ichi, takashandisa dhatabhesi rePubMed, Google Scholar, COCHRANE neScience Direct sekutsvaga. injini kuwana magazini akakodzera.
Nzira yekusarudza chidzidzo yakaitwa nevanyori vatatu (DAS, IKM, GS) kuderedza mukana wekubvisa zvidzidzo zvingangove zvakakosha.Kana kusawirirana kunomuka, zvisarudzo zvevanyori vekutanga, vechipiri nevechitatu zvinotariswa.Sarudzo yezvidzidzo inotanga nekubata kaviri. zvinyorwa.Musoro uye abstract screening yakaitwa kuti isabatanidze zvidzidzo zvisingabatsiri.Pashure, zvidzidzo zvakapfuura kuongorora kwekutanga zvakazoongororwa zvakare kuti zviongorore kana zvakasangana nemaitiro ekubatanidzwa uye kusaregererwa kwekuongorora uku.Zvose zvinosanganisira zvidzidzo zvakagadzirisa kuongororwa kwehutano kusati kwaiswa kwekupedzisira.
Vese vanyori vakashandisa mafomu ekuunganidza data yemagetsi kuti vatore data inodiwa kubva pane imwe neimwe nyaya.Iyo data yakabva yaunganidzwa uye yakagadziriswa uchishandisa software Yekuongorora Mutariri 5.4.
Zvinyorwa zvinyorwa zvaive zita remunyori, gore rekubudiswa, rudzi rwekudzidza, huwandu hwevanhu, vhitamini D dose, nguva yevhitamini D kutonga, saizi yemuenzaniso, zera, yekutanga HOMA-IR, uye yekutanga vhitamini D mazinga. HOMA-IR pamberi uye shure kwevhitamini D kutonga kwakaitwa pakati pekurapa nemapoka ekutonga.
Kuti ave nechokwadi chehutano hwezvinyorwa zvose zvinosangana nekodzero yekufanirwa kwekuongorora uku, chigadziro chekuongorora chakakosha chakashandiswa.Iyi nzira, yakagadzirirwa kuderedza mikana yekusarura mukusarudzwa kwezvidzidzo, yakaitwa yakazvimiririra nevanyori vaviri (DAS neIKM).
Chishandiso chakakosha chekuongorora chakashandiswa muongororo iyi yaive njodzi yeCochrane Collaboration yenzira yekurerekera.
Kubatanidza uye kuongororwa kwezvinoreva kusiyana muHOMA-IR ine uye isina vitamin D kune varwere vane NAFLD. Maererano naLuo et al., Kana iyo data inoratidzwa seyepakati kana mutsara weQ1 neQ3, shandisa karukureta kuverenga zvinoreva. uye Wan et al.28,29 Effect sizes inoshumwa seyakasiyana-siyana ne95% nguva dzekuvimba (CI) .Kuongorora kwakaitwa uchishandisa zvakagadziriswa kana zvisingatarisirwi maitiro emigumisiro.Heterogeneity yakaongororwa uchishandisa nhamba yeI2, zvichiratidza kuti chiyero chekusiyana kwechiitiko chakaonekwa pane zvidzidzo chaiva nekuda kwekusiyana kwechiitiko chechokwadi, ine hutsika> 60% ichiratidza huterogeneity yakakosha.Kana heterogeneity yaive> 60%, kumwe kuongorora kwakaitwa pachishandiswa meta-regression uye senitivity analyses. (chidzidzo chimwe panguva chakabviswa uye kuongorora kwakadzokororwa) p-values <0.05 yakaonekwa seyakakosha.Meta-analyses yakaitwa uchishandisa software Review Manager 5.4, senitivity kuongorora kwakaitwa uchishandisa statistical software package (Stata 17.0 yeWindows), uye meta-regressions yakaitwa pachishandiswa Integrated Meta-Analysis Software Version 3.
Wang, S. et al. Vitamin D yekuwedzera mukurapa kweasina kudhakwa mafuta ane chiropa chirwere murudzi rwechipiri chirwere cheshuga: Protocols yekuongorora kwakarongeka uye meta-analysis.Medicine 99(19), e20148.https://doi.org/10.1097 /MD.0000000000020148 (2020).
Barchetta, I., Cimini, FA & Cavallo, MG Vitamin D kuwedzera uye nonalcoholic fatty chiropa chirwere: ikozvino uye ramangwana.Nutrients 9 (9), 1015. https://doi.org/10.3390/nu9091015 (2017).
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Nguva yekutumira: May-30-2022