Abstract
Abstract.Aim: In the present study, the evidence about the association between vitamin D deficiency and Behcet’s disease activity was systematically reviewed and meta-analyzed.
Method: We searched the English and Persian databases of Medline (Ovid), CINHAL, Scopus, Proquest, the Cochrane library and SID, IranDoc, Magiran, Iran Medex for articles published up until May 2018 with the keywords were related to serum vitamin D and active and inactive Behcet’s disease in adults. Meta-analysis was done using the CMA software.
Results: A total of 138 titles were retrieved and reduced to 80 titles after deletion of duplicates and finally after close assessing of titles and abstracts eight eligible studies including a total of 939 participants were identified for systematic review and meta-analysis. According to the results of the meta-analysis, the pooled effect size of the differences in the serum level of vitamin D in patients with inactive Behçet’s Disease and healthy controls was [OR:−0.05; 95% CI:−2.05, 1.94; p = 0.95]. The serum vitamin D level was significantly lower in active patients compared with healthy controls [OR:1.21; 95%CI: −0.12, 2.31; p = 0.03]. The pooled effect size of the differences in the serum level of vitamin D in active and inactive Behçet’s Disease was [OR:−0.71; 95%CI: −1.41, −0.007; p = 0.04]
Conclusion: There is an association between vitamin D deficiency and active Behçet’s Disease. Future studies investigating the association of vitamin D deficiency and Behçet’s Disease needs to involve following information: dietary intake of calcium and vitamin D, measuring of sun exposure, report of drug consumption and physical activity level.
References
1 (2016) Behçet disease. Uveitis: An Update (pp. 17–31). Springer.
2 (2007) Vitamin levels in Behçet’s disease. J Dermatolog Treat. 18(2), 69–75.
3 (2001) Behcet’s disease: an update on the pathogenesis. Clin Exp Rheumato. 19(5; SUPP/24), S6–00.
4 (2007) Interrelated modulation of endothelial function in Behcet’s disease by clinical activity and corticosteroid treatment. Arthritis Res Ther. 9(5), R90.
5 (2003) Pathogenesis of Adamantiades-Behçet’s disease. Med Microbiol Immunol. 192(3), 149–155.
6 (2002) Cytokine profile in Behçet’s disease patients. Scand J Rheumatol. 31(4), 205–210.
7 (1993) Overproduction of monocyte derived tumor necrosis factor alpha, interleukin (IL) 6, IL-8 and increased neutrophil superoxide generation in Behcet’s disease. A comparative study with familial Mediterranean fever and healthy subjects. J Rheumatol. 20(9), 1544–1549.
8 (2005) Involvement of Th1 cells and heat shock protein 60 in the pathogenesis of intestinal Behcet’s disease. Clin Exp Immunol. 139(2), 371–378.
9 (2007) Contribution of selected vitamins and trace elements to immune function. Ann Nutr Metab. 51(4), 301–323.
10 (2017) The Role of Vitamins and Minerals on the Immune System. Home Health Care Manag Pract. 29(3), 199–202.
11 (2001) Effects of vitamin D receptor inactivation on the expression of calbindins and calcium metabolism. Am J Physiol Endocrinol Metab. 281(3), E558–E564.
12 (1992) Immunomodulatory role of 1, 25‐dihydroxyvitamin D3. J Cell Biochem. 49(1), 26–31.
13 (2000) Expression of 1, 25-dihydroxyvitamin D3 receptor in the immune system. Arch Biochem Biophys. 374(2), 334–338.
14 (2000) Vitamin D and autoimmunity: is vitamin D status an environmental factor affecting autoimmune disease prevalence? Proc Soc Exp Biol Med. 223(3), 230–2333.
15 (2013) Blood 25-hydroxy vitamin D levels and incident type 2 diabetes. Diabetes Care. 36(5), 1422–1428.
16 (2015) Association between inflammatory bowel disease and vitamin D deficiency: a systematic review and meta-analysis. Inflamm Bowel Dis. 21(11), 2708.
17 (2015) Vitamin D status and its association with quality of life, physical activity, and disease activity in rheumatoid arthritis patients. J Clin Rheumatol. 21(3), 126–130.
18 (2014) AB0582 Effect of Vitamin D Deficiency and Replacement on Endothelial Functions in Familial Mediterranean Fever. Ann Rheum Dis. 73(Suppl 2), 998.
19 (2008) Effects of vitamin D on expression of Toll-like receptors of monocytes from patients with Behcet’s disease. Rheumatology. 47(6), 840–848.
20 (2014) Vitamin D deficiency in patients with Behcet’s disease. J Diabetes Metab Disord. 13(1), 18.
21 (2013) Vitamin D levels in patients with Behçet’s disease: Significance and impact on disease measures. Egypt Rheumatol. 35(3), 151–157.
22 (2011) Vitamin D status in patients with Behcet’s Disease. Clinics. 66(5), 721–723.
23 (2015) Vitamin D Status of Behcet’s Patients. Analysis of Correlation with Activity and Severity of the Disease as well as with the Quality of Life of Patients. Int Arch Med. 8, 1–7.
24 (2014) The status of serum vitamin D in patients with active Behcet’s disease compared with controls. Int J Rheum Dis. 17(4), 430–434.
25 (2010) Vitamin D modulates peripheral immunity in patients with Behcet’s disease. Clin Exp Rheumato. 28(4), S50.
26 (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 151(4), W65–94.
27 (2014) Cochrane handbook for systematic reviews of interventions version 5.1. 0. 2011. Oxford, UK: The Cochrane Collaboration.
28 (2003) Measuring inconsistency in meta-analyses. Bmj. 327(7414), 557–560.
29 (2017) Vitamin D status in Algerian Behçet’s disease patients: an immunomodulatory effect on NO pathway. Immunopharmacol Immunotoxicol. 39(4), 243–250.
30 (2017) The effect of vitamin D on clinical manifestations and activity of Behçet’s disease. Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 34(1), 15.
31 (2017) High Vitamin D Levels May Downregulate Inflammation in Patients with Behçet’s Disease. Int J Inflam. 2017.
32 (2011) Vitamin D insufficiency. In Mayo Clin Proc. Elsevier.
33 (2007) Vitamin D and autoimmunity: new aetiological and therapeutic considerations. Ann Rheum Dis. 66(9), 1137–1142.
34 (2012) Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinol. 4(2), 158–166.