目的 系统评价抽动障碍(TD)与维生素A(VitA)水平的临床关系,为该病的预防提供新思路。方法 检索中国知网、维普、万方、PubMed、Cochrane Library及Web of Science数据库,检索时间从数据库建立至2025年1月12日。由2名研究者独立完成文献筛选、数据提取及文献偏倚风险评价,采用RevMan5.3软件进行Meta分析。结果 最终纳入文献7篇,样本总量1 401例,其中TD组901例,对照组500例。荟萃分析显示,TD组儿童血清VitA平均水平显著低于对照组(MD=-0.05,95%CI:-0.08～-0.02,P=0.002)。亚组分析显示:Tourette综合征(TS)组与慢性运动或发声抽动障碍(CTD)组儿童的血清VitA水平差异无统计学意义(MD=0.03,95%CI:-0.00～0.07,P=0.080);相比于TS组,暂时性抽动障碍(PTD)组儿童血清VitA水平更高(MD=0.05,95%CI:-0.00～0.09,P=0.050);PTD组儿童血清VitA水平显著高于CTD组(MD=0.01,95%CI:0.00～0.03,P=0.020)。3篇文献TD轻度组VitA水平显著高于中重度组(MD=0.08,95%CI:0.05～0.11,P<0.001)。结论 TD儿童的血清维生素A水平低于健康儿童,较低的维生素A水平可能与TD的发生及严重程度相关,但由于纳入研究数量有限且异质性较高,仍需更高质量研究进一步验证。
Abstract
Objective To systematically evaluate the association between vitamin A (VitA) levels and tic disorders (TD) in children, in order to provide new ideas for the prevention of TD. Methods CNKI, VIP, Wanfang, PubMed, Cochrane Library, and Web of Science were searched from inception to January 12, 2025. Two researchers independently screened the literature, extracted data, and assessed study quality. Meta-analysis was performed using RevMan 5.3. Results A total of 7 case-control studies involving 1 401 participants were included, including 901 children in the TD group and 500 in the control group. The pooled results showed that serum VitA levels in children with TD were significantly lower than those in healthy controls (MD=-0.05, 95%CI: -0.08 to -0.02, P=0.002). Subgroup analysis showed no significant difference in serum VitA levels between the Tourette syndrome (TS) group and the chronic motor or vocal tic disorder (CTD) group (MD=0.03, 95%CI:-0.00 to 0.07, P=0.080). Serum VitA levels in the provisional tic disorder (PTD) group tended to be higher than those in the TS group, with borderline significant difference (MD=0.05, 95%CI:-0.00 to 0.09, P=0.050). Serum VitA levels in PTD group were higher than those in CTD group(MD=0.01,95%CI:0.00 to 0.03,P=0.020). In 3 studies, VitA levels in children with mild TD were higher than those in children with moderate-to-severe TD (MD=0.08, 95%CI: 0.05 to 0.11, P<0.001). Conclusions Serum VitA levels are lower in children with TD than in healthy children, and lower VitA levels may be associated with the presence and severity of TD. However, given the limited number of included studies and the substantial heterogeneity, further high-quality studies are needed to confirm these findings.
关键词
抽动障碍 /
维生素A /
Meta分析 /
儿童
Key words
tic disorders /
vitamin A /
Meta-analysis /
children
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基金
河北省医学科学研究课题计划项目(20211432);河北医科大学大学生创新性实验计划项目(USIP2024363)
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