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中国循证儿科杂志

中国循证儿科杂志 ›› 2018, Vol. 13 ›› Issue (4): 248-252.

• 论著 • 上一篇    下一篇

儿童25羟维生素D水平与注意缺陷多动障碍关系的系统评价和Meta分析

王媛媛1,崔俊岭2,张会丰2   

  1. 1 河北省儿童医院 石家庄，050000；2 河北医科大学第二医院 石家庄，050000
  • 收稿日期:2018-06-28 修回日期:2018-07-29 出版日期:2018-08-25 发布日期:2018-08-25
  • 通讯作者: 张会丰

Meta-analysis on association of 25(OH)D3 with attention deficit and hyperactivity disorder

WANG Yuan-yuan1, CUI Jun-ling2, ZHANG Hui-feng2   

  1. 1 The Children's Hospital of Hebei Province, Shijiazhuang 050000,China; 2 The Second Hospital of Hebei Medical University, Shijiazhuang 050000,China
  • Received:2018-06-28 Revised:2018-07-29 Online:2018-08-25 Published:2018-08-25
  • Contact: ZHANG Hui-feng

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摘要： 目的 分析25羟维生素D与注意力缺陷多动障碍的关系，进一步证实维生素D影响神经系统的发生和发展。方法 通过对Pubmed，EMbase，Cochrane，万方数据库，CNKI数据库从建库至2018年3月以前发表的关于维生素D和注意力缺陷多动障碍（Attention Deficit Hyperactivity Disorder, ADHD）的文献进行检索和筛选。采用纽卡斯尔-渥太华量表进行质量评估，应用 RevMan 5.3统计学软件进行 Meta分析。结果 最终纳入14篇研究，对其中9篇维生素D状态与ADHD关系的横断面病例对照研究进行Meta分析，注意缺陷多动障碍组2709 例， 健康对照组 12024 例。根据异质性结果采用随机效应模型进行计算，ADHD组血清25(OH)D3水平低于正常对照组（WMD=-6.03，95%CI：-8.26～-3.79）；5篇孕母/脐血维生素D水平与ADHD的关系的前瞻性队列研究显示,随着孕13周母亲的25(OH)D3血清浓度的升高其后代ADHD患病率明显下降，孕30周母亲及脐血25(OH)D3水平与ADHD关系不明确。结论 怀孕早期及发育过程的维生素D水平影响ADHD的发病。

Abstract: Objective To analyze the relationship between 25 hydroxyvitamin D and attention deficit and hyperactivity disorder by Meta-analysis. Methods Pubmed, EMbase, Cochrane Library, Wanfang and CNKI database were searched up to March 2018, references related to vitamin D and ADHD were retrieved and collected. Using the Newcastle - Ottawa scale for quality assessment, a meta-analysis was performed by RevMan 5.3 statistical software. Results 14 articles were included in this study. 9 case-control studies which included 2709 cases in ADEM group and 12024 cases in control group were analyzed by Meta-analysis. The results shows that the serum 25(OH)D levels were found to be significant lower in the ADHD group compared to health controls (WMD=-6.03, 95%CI: -8.26~-3.79). 5 prospective cohort studies related to the vitamin D levels of pregnant mother / cord blood and ADHD showed that higher serum concentrations of 25(OH)D3 in the 13 weeks of pregnant significantly decrease the risk of ADHD in offspring, and the relationship between 25(OH)D3 levels of 30 weeks of pregnant/cord blood and ADHD was not clear. Conclusion The higher serum 25(OH)D3 levels of early pregnancy and children were decrease the risk of ADHD.

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