Cadaadiska insulinku wuxuu door muhiim ah ka ciyaaraa xanuunka beerka dufanka leh ee aan khamriga ahayn (NAFLD) . Daraasado dhowr ah ayaa qiimeeyay ururkafitamiin Dkabista caabbinta insulin ee bukaanka NAFLD.Natiijooyinka la helay ayaa weli la socda natiijooyin iska soo horjeeda. Ujeedada daraasaddan ayaa ahayd in la qiimeeyo saameynta daawaynta fiitamiin D ee dheeraadka ah ee hagaajinta caabbinta insulin ee bukaanka NAFLD. Suugaanta la xidhiidha ayaa laga helay PubMed, Google Aqoonyahanka, COCHRANE iyo xogta Sayniska tooska ah. Daraasadaha la helay waxaa lagu falanqeeyay iyada oo la adeegsanayo saameyn go'an ama moodooyin-saamayn- random.Vitamin Dkabitaanku waxay wanaajisay caabbinta insulin ee bukaanada qaba NAFLD, oo lagu calaamadeeyay hoos u dhigista Qaabka Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), oo leh farqiga celceliska celceliska -1.06 (p = 0.0006; 95% CI -1.66 ilaa -0.45). Kaabista fitamiin D waxay kordhisay heerarka fiitamiin D serum iyadoo celcelis ahaan faraqa u yahay 17.45 (p = 0.0002; 95% CI 8.33 ilaa 26.56).Vitamin Dkabitaanku wuxuu hoos u dhigay heerarka ALT oo leh farqiga celceliska celceliska -4.44 (p = 0.02; 95% CI -8.24 ilaa -0.65) .Wax saameyn ah laguma arag heerarka AST. Kaabista fitamiin D waxay leedahay saameyn faa'iido leh oo lagu hagaajinayo caabbinta insulin ee bukaanka NAFLD. kabitaanku waxa laga yaabaa inay hoos u dhigto HOMA-IR ee bukaankan oo kale.Waxa loo isticmaali karaa daawaynta adjuvant ee suurtogalka ah ee bukaanka NAFLD.
Cudurka beerka dufanka leh ee aan khamriga ahayn (NAFLD) waa koox ka mid ah cudurrada beerka ee la xidhiidha baruurta1. Waxaa lagu gartaa ururinta sare ee triglycerides ee hepatocytes, oo badanaa leh firfircoonida necroinflammatory iyo fibrosis (steatohepatitis) 2. Waxay u gudbi kartaa steatohepatitis aan khamriga ahayn (NASH), fibrosis iyo cirrhosis.NAFLD waxaa loo arkaa inay yihiin sababta ugu weyn ee cudurada joogtada ah ee beerka iyo faafitaankiisa ayaa sii kordhaya, waxaana lagu qiyaasaa 25% ilaa 30% dadka waaweyn ee ku nool wadamada horumaray horumarinta NAFLD1.
Cudurka NAFLD wuxuu si dhow ula xiriiraa iska caabbinta insulin. Iyada oo ku saleysan qaabka ugu badan ee "laba-hit hypothesis", caabbinta insulin waxay ku lug leedahay habka "ugu-horreysa" habkan bilowga ah, waxay ku lug leedahay ururinta dufannada ku yaal Hepatocytes, halkaas oo caabbinta insulin loo maleeyo inay tahay arrin weyn oo sabab u ah horumarinta steatosis hepatic. "First hit" waxay kordhisaa u nuglaanta beerka ee arrimaha ka kooban "garaaca labaad".Waxay u horseedi kartaa dhaawac beerka, caabuqa iyo fibrosis. Soo saarista cytokines proinflammatory, cillad mitochondrial, stress oksaydhiyaha, iyo lipid peroxidation ayaa sidoo kale ah arrimo gacan ka geysan kara horumarinta dhaawaca beerka, oo ka kooban adipokines.
Faytamiin D waa fiitamiin ku milma dufanka kaas oo maamula lafaha homeostasis.Doorkeeda ayaa si weyn loo baaray xaalado caafimaad oo kala duwan sida dheef-shiid kiimikaad, caabbinta insulin, buurnaanta, nooca 2 ee sonkorowga iyo cudurrada wadnaha iyo xididada la xiriira. Dhawaan, a cadaymo badan oo saynis ah ayaa sahamiyay xidhiidhka ka dhexeeya fitamiin D iyo NAFLD.Vitamin D waxa loo yaqaanaa in uu nidaamiyo iska caabbinta insulin, caabuq dabadheeraad ah iyo fibrosis.Sidaas darteed, fitamiin D waxa laga yaabaa in uu ka hortago horumarka NAFLD6.
Dhowr tijaabo oo la kantaroolay (RCTs) ayaa qiimeeyay saameynta fitamiin D-ga ee kaabista caabbinta insulin. Si kastaba ha ahaatee, natiijooyinka la helay ayaa weli kala duwan;ama muujinaya saameyn faa'iido leh oo ku saabsan caabbinta insulin ama aan muujineynin wax faa'iido ah7,8,9,10,11,12,13.In kasta oo ay jiraan natiijooyin is khilaafsan, falanqaynta-meta ayaa loo baahan yahay si loo qiimeeyo saameynta guud ee fitamiin D-ga. ayaa hore loo sameeyay Falanqaynta waxay keentay natiijooyin kala duwan. Pramono et al15 waxay ogaadeen in daaweynta fiitamiin D ee dheeraadka ah aysan wax saameyn ah ku yeelan dareenka insulinta. Dadka ku jira daraasadda waxay ahaayeen maadooyin leh ama halis ugu jira caabbinta insulin, maaha kuwa si gaar ah loogu talagalay NAFLD. Daraasad kale oo ay samaysay Wei et al ., oo ay ku jiraan afar cilmi-baaris, waxay sameeyeen natiijooyin isku mid ah. Kabitaannada fitamiin D-ga ma hoos u dhigin HOMA IR16. Iyadoo la tixgelinayo dhammaan falanqaynta hore ee isticmaalka fitamiin D-ga ee caabbinta insulin, cusbooneysiinted meta-analysis ayaa loo baahan yahay oo ay la socoto suugaan dheeraad ah oo la cusboonaysiiyay. Ujeedada daraasaddan ayaa ahayd in la qiimeeyo saameynta kaabista fitamiin D-ga ee caabbinta insulin.
Adigoo isticmaalaya istaraatiijiyada raadinta ugu sareysa, waxaan helnay wadarta guud ee daraasadaha 207, ka dib markii la soo koobay, waxaan helnay maqaallo 199. Waxaan ka saarnay maqaallada 182 adoo eegaya cinwaannada iyo qoraallada, ka tagista wadarta guud ee daraasadaha 17. Daraasado aan bixin dhammaan macluumaadka Baahida falanqaynta-meta-falanqaynta ama qoraalka buuxa ee aan la heli karin ayaa laga saaray. Ka dib baaritaanka iyo qiimeynta tayada, waxaan helnay todoba maqaal oo loogu talagalay dib-u-eegis nidaamsan oo hadda jira iyo falanqaynta meta. Jaantuska socodka ee daraasadda PRISMA ayaa lagu muujiyay sawirka 1. .
Waxaan ku darnay maqaallada buuxa ee toddobada tijaabo ee la xakameynayo (RCTs) .Sanadihii daabacaadda ee maqaalladani waxay u dhexeeyaan 2012 ilaa 2020, iyada oo wadarta 423 muunadaha ee kooxda faragelinta iyo 312 ee kooxda placebo. Kooxda tijaabada ah waxay heleen noocyo kala duwan. qiyaasaha iyo muddada dheellitirka fitamiin D-ga, halka kooxda xakamaynta ay heleen placebo. Kooban natiijooyinka daraasadda iyo sifooyinka daraasadda ayaa lagu soo bandhigay shaxda 1.
Khatarta eexda ayaa lagu falanqeeyay iyada oo la adeegsanayo khatarta iskaashiga Cochrane ee habka eexda.Dhammaan toddobada qodob ee daraasaddan lagu soo daray waxay dhaafeen qiimaynta tayada. Natiijooyinka buuxa ee khatarta ah eexda dhammaan qodobbada lagu daray ayaa lagu muujiyey Jaantuska 2.
Faytamiin D-ga ayaa wanaajisa iska caabbinta insulin ee bukaanka NAFLD, oo lagu garto hoos u dhaca HOMA-IR. Iyada oo ku saleysan qaabka saameynaha random (I2 = 67%; χ2 = 18.46; p = 0.005), macneheedu waa farqiga u dhexeeya fitamiin D-ga oo aan lahayn fiitamiin D kabitaanku wuxuu ahaa -1.06 (p = 0.0006; 95% CI -1.66 ilaa -0.45) (sawirka 3).
Iyada oo ku saleysan qaabka saamaynta random-ka (Jaantus 4), celceliska celceliska farqiga u dhexeeya fitamiin D serum ka dib fitamiin D-ga ka dib wuxuu ahaa 17.45 (p = 0.0002; 95% CI 8.33 ilaa 26.56) Heerka fitamiin D ee serum by 17.5 ng / mL. Dhanka kale, saamaynta fitamiin D-ga ee enzymes beerka ALT iyo AST ayaa muujiyay natiijooyin kala duwan. CI -8.24 ilaa -0.65) (Jaantus 5) Si kastaba ha ahaatee, wax saameyn ah laguma arag heerarka AST, oo leh farqiga celceliska celceliska -5.28 (p = 0.14; 95% CI - 12.34 ilaa 1.79) oo ku salaysan qaabka saamaynta random sawirka 6).
Isbeddellada HOMA-IR ka dib dheellitirka fitamiin D-ga ayaa muujiyay kala duwanaansho badan (I2 = 67%). Falanqaynta Meta-regression ee dariiqa maamulka (afka ama murqaha), qaadashada (maalin kasta ama aan maalinle ahayn), ama muddada fitamiin D-ga (≤ toddobaadyada 12 iyo> 12 toddobaad) waxay soo jeedinayaan in inta jeer ee isticmaalka ay sharxi karto kala duwanaansho (Shaxda 2) .Dhammaan hal daraasad oo ay sameeyeen Sakpal et al.11 waxay isticmaashay habka afka ah ee maamulka. Qaadashada maalinlaha ah ee fitamiin D-ga oo loo isticmaalo saddex daraasadood7,8,13. Falanqaynta dareenka dheeraadka ah ee falanqaynta ka-baxa ee isbeddelka HOMA-IR ka dib dheellitirka fitamiin D-ga ayaa muujiyay in aysan jirin daraasad mas'uul ka ah kala duwanaanshaha isbeddelada HOMA-IR (Jaantus. 7).
Natiijooyinka la isku daray ee falanqaynta meta-daawaynta ee hadda jirta ayaa lagu ogaaday in daaweynta dheeraadka ah ee fitamiin D ay hagaajin karto caabbinta insulin, calaamad muujinaysa hoos u dhigista HOMA-IR ee bukaannada NAFLD. Waddada maamulka fitamiin D-ga way kala duwanaan kartaa, cirbadeynta muruqyada ama afka. Falanqaynta dheeraadka ah ee saamaynta ay ku leedahay hagaajinta caabbinta insulin si loo fahmo isbeddelada serum ALT iyo heerarka AST. Hoos u dhaca heerarka ALT, laakiin ma aha heerarka AST, ayaa la arkay sababtoo ah fitamiin D dheeraad ah.
Dhacdada NAFLD waxay si dhow ula xiriirtaa iska caabbinta insulin. Kordhinta acids dufanka bilaashka ah (FFA), caabuqa unugyada adipose, iyo hoos u dhaca adiponectin ayaa mas'uul ka ah horumarinta caabbinta insulin ee NAFLD17. Serum FFA waxay si weyn kor ugu kacday bukaannada NAFLD, taas oo markaa la beddelo. si triacylglycerols iyada oo loo marayo jidka glycerol-3-phosphate. Alaabta kale ee waddadani waa ceramide iyo diacylglycerol (DAG) .DAG ayaa la og yahay in ay ku lug leedahay firfircoonida borotiinka kinase C (PKC), taas oo laga yaabo inay joojiso soo-dhoweynta insulin threonine 1160, kaas oo la xidhiidha iska caabbinta insulin-ta oo yaraatay Xakamaynta beta-oxidation fatty acid (FAO), isticmaalka gulukooska iyo isku-darka aashitada dufanka leh. Heerarkeeda waa la dhimay bukaannada NAFLD, taas oo kor u qaadaysa development of insulin resistance.Related to vitamin D, reseptor vitamin D (VDR) ayaa ku jira unugyada beerka waxaana lagu soo daray hoos u dhigista hababka bararka ee cudurada beerka dabadheeraad ah. Dhaqdhaqaaqa VDR wuxuu kordhiyaa dareenka insulinta iyadoo la bedelayo FFA. Intaa waxaa dheer, fitamiin D waxay beerka ku leedahay sifooyin ka-hortagga bararka iyo fibrotic-ka.
Caddaynta hadda waxay soo jeedinaysaa in yaraanta fitamiin D-ga ay ku lug yeelan karto pathogenesis ee cudurro dhowr ah. Fikraddaani waxay run u tahay xiriirka ka dhexeeya yaraanta fitamiin D iyo caabbinta insulin20,21. Vitamin D wuxuu ku shaqeeyaa doorkiisa suurtagalka ah iyada oo la falgalayo VDR iyo fitamiin D-ga enzymes dheef-shiid kiimikaad. Kuwani waxaa laga yaabaa inay ku jiraan dhowr nooc oo unug ah, oo ay ku jiraan unugyada beta ee ganaca iyo unugyada insulin-ka jawaaba sida adipocytes. Inkastoo habka saxda ah ee u dhexeeya fitamiin D iyo caabbinta insulin aan la hubin, ayaa la soo jeediyay in unugyada adipose ay ku lug yeelan karaan farsamadooda. Bakhaarka ugu weyn ee fitamiin D ee jidhku waa unugyada adipose.Waxa kale oo uu u shaqeeyaa sida isha muhiimka ah ee adipokines iyo cytokines wuxuuna ku lug leeyahay soo saarista caabuqa nidaamka. Cadaymaha hadda jira waxay soo jeedinayaan in fitamiin D-gu uu xakameeyo dhacdooyinka la xidhiidha dheecaanka insulin ee unugyada beta ee ganaca.
Marka la eego caddayntan, dheellitirka fitamiin D-ga si loo hagaajiyo caabbinta insulin ee bukaannada NAFLD waa macquul. Warbixinadii ugu dambeeyay waxay tilmaamayaan waxtarka faa'iido leh ee fitamiin D-ga ee hagaajinta caabbinta insulin. Dhowr RCTs ayaa bixiyay natiijooyin isku khilaafsan, taas oo u baahan qiimeyn dheeraad ah oo lagu sameeyay meta-analyses. Dhawaan Meta-analysis by Guo et al95% CI - 2.30, - 0.34. Daraasadaha lagu daray in lagu qiimeeyo HOMA-IR waxay ahaayeen lix daraasadood dareenka insulin ee maadooyinka leh caabbinta insulinta ama halista caabbinta insulin waxay muujisay in fiitamiin D dheeraad ah dareenka Insulinku aanu wax saameyn ah ku yeelan, farqiga celceliska celceliska -0.01, 95% CI -0.12, 0.10;p=0.87, I2 = 0%15 2 diabetes), halkii laga heli lahaa bukaanada NAFLD15. Falanqaynta kale ee Meta-Falanqaynta ee Wei et al. Natiijooyin la mid ah ayaa sidoo kale la helay. Qiimaynta fitamiin D-ga ee HOMA-IR, oo ay ku jiraan afar daraasadood, fitamiin D-ga ma yareynin HOMA IR (WMD) = 0.380, 95% CI - 0.162, 0.923; p = 0.169) 16. Isbarbardhigga dhammaan xogta la heli karo, dib-u-eegis nidaamsan ee hadda jira iyo falanqaynta-meta-falanqaynta waxay bixisaa warbixinno dheeraad ah oo ku saabsan dheellitirka fitamiin D-ga oo hagaajinaya caabbinta insulin ee bukaannada NAFLD, oo la mid ah falanqaynta-meta. Waxaa qoray Guo et al. In kasta oo falanqayn meta-anaaliyadeed oo la mid ah la sameeyay, falanqaynta meta-falanqaynta hadda waxay bixisaa suugaan la cusboonaysiiyay oo ku lug leh tijaabooyin la xakameynayo oo la kala soocay oo sidaas awgeed waxay bixisaa caddayn xooggan oo ku saabsan saamaynta kaabista fitamiin D-ga ee insulin rxaalad
Saamaynta fitamiin D-ga ee caabbinta insulin waxaa lagu sharxi karaa doorka uu ku leeyahay awoodda xakamaynta dheecaanka insulinta iyo heerarka Ca2 +. Calcitriol waxay si toos ah u kicin kartaa dheecaanka insulin sababtoo ah fitamiin D-ga jawaab-celinta (VDRE) ayaa ku jirta dhiirigeliyaha hidde-wadaha insulin ee ku yaala pancreatic. Unugyada beta. Ma aha oo kaliya qoraalka hidda-wadaha insulin, laakiin sidoo kale VDRE ayaa loo yaqaanaa inay kiciso hiddo-wadaha kala duwan ee la xidhiidha samaynta cytoskeleton, isgoysyada unugyada intracellular, iyo korriinka unugyada unugyada cβ ee ganaca. Vitamin D ayaa sidoo kale lagu muujiyay inuu saameyn ku yeesho caabbinta insulin iyadoo la beddelayo Ca2 + flux.Since calcium waa lagama maarmaanka u ah dhowr insulin-dhexdhexaadinta hababka intracellular ee muruqa iyo adipose unug, vitamin D waxaa laga yaabaa in ay ku lug leedahay saamaynta ay insulin caabbinta. Intracellular Ca2 + heerka ugu fiican waa lagama maarmaan u ah fal insulin.Studies ogaaday in vitamin D yaraanta waxay keenaysaa in kordhay Ca2 + uruurinta, taasoo keentay hoos u dhaca dhaqdhaqaaqa GLUT-4, kaas oo saameeya caabbinta insulin26,27.
Saamaynta fitamiin D-ga ee hagaajinta caabbinta insulin-ta ayaa la sii falanqeeyay si ay u muujiso saamaynta ay ku leedahay shaqada beerka, taas oo ka muuqata isbeddelka heerarka ALT iyo AST. Hoos u dhaca heerarka ALT, laakiin ma aha heerarka AST, ayaa la arkay sababtoo ah fitamiin D dheeraad ah. supplementation.A meta-analysis by Guo et al. ayaa muujiyay hoos u dhigista xuduudaha ee heerarka ALT, iyada oo aan wax saameyn ah ku yeelan heerarka AST, oo la mid ah daraasaddan iyo aspartate aminotransferase heerarka u dhexeeya kaabista fitamiin D iyo kooxaha placebo.
Dib-u-eegis nidaamsan ee hadda jira iyo falanqaynta-falanqaynta ayaa sidoo kale ka soo horjeeda xaddidnaanta. Kala duwanaanta falanqaynta falanqaynta hadda jirta ayaa laga yaabaa inay saameyn ku yeelato natiijooyinka laga helay daraasaddan. si gaar ah loo beegsanayo dadka NAFLD, iyo isku midka ah ee daraasadaha. Dhinac kale oo la tixgeliyo waa in la barto xuduudaha kale ee NAFLD, sida saameynta fitamiin D-ga ee bukaanka NAFLD ee xuduudaha bararka, dhibcaha dhaqdhaqaaqa NAFLD (NAS) iyo qallafsanaanta beerka. Gabagabadii, kaabista fitamiin D-ga waxay wanaajisay caabbinta insulin ee bukaanada qaba NAFLD, oo calaamad u ah taas oo la dhimay HOMA-IR.Waxa loo isticmaali karaa daawaynta adjuvant ee suurtagalka ah ee bukaanka NAFLD.
Shuruudaha u-qalmitaanka waxaa lagu go'aamiyaa iyadoo lafulinayo fikradda PICO. Qaabka lagu sharraxay shaxda 3.
Dib-u-eegis nidaamsan ee hadda jira iyo falanqaynta-macnaha waxaa ka mid ah dhammaan daraasadaha ilaa March 28, 2021, oo bixiya qoraalka buuxa, qiimeynta maamulka fiitamiin D ee dheeraadka ah ee bukaanada qaba NAFLD. Maqaallo leh warbixinno kiis, daraasado tayo iyo dhaqaale, dib u eegis, cadavers iyo noocyada anatomy Waxaa laga saaray daraasadda hadda jirta.Dhammaan maqaallada aan bixin xogta loo baahan yahay si loo sameeyo falanqaynta-meta ee hadda jirta ayaa sidoo kale laga saaray. Si looga hortago muunad nuqul ka mid ah, muunado ayaa lagu qiimeeyay maqaallada uu qoray isla qoraaga isla hay'ad isku mid ah.
Dib u eegista waxaa ku jiray daraasado lagu sameeyay bukaanada NAFLD ee qaangaarka ah ee helaya maamulka fitamiin D. iska caabbinta insulin ayaa la qiimeeyay iyadoo la adeegsanayo Qaabka Homeostasis Model Assessment of Insulin Resistance (HOMA-IR).
Faragelinta dib-u-eegista lagu sameeyay waxay ahayd maamulka fitamiin D. Waxaan ku darnay daraasado ay ku jiraan fitamiin D-ga lagu maamulay qiyaas kasta, hab kasta oo maamulka ah, iyo muddada kasta. .
Natiijooyinka ugu muhiimsan ee lagu baaray dib-u-eegis nidaamsan oo hadda jira iyo falanqaynta falanqaynta waxay ahayd caabbinta insulin.Arrintan, waxaan isticmaalnay HOMA-IR si loo go'aamiyo caabbinta insulin ee bukaanka.Natiijooyinka labaad waxaa ka mid ah heerarka fitamiin D serum (ng / mL), alanine aminotransferase (ALT). (IU / l) iyo aspartate aminotransferase (AST) (IU / l) heerarka.
Soo saar Shuruudaha U-qalmitaanka (PICO) ereyada muhiimka ah iyadoo la adeegsanayo hawlwadeennada Boolean (tusaale AMA, IYO, MAYA) iyo dhammaan qaybaha ama ereyada MeSH (Mawduuca Mawduuca Caafimaadka). matoorada si ay u helaan joornaalo u qalma.
Habka xulashada daraasadda waxaa fuliyay saddex qoraa (DAS, IKM, GS) si loo yareeyo suurtagalnimada in meesha laga saaro daraasadaha suurtagalka ah. Marka khilaafaadku yimaado, go'aamada qorayaasha koowaad, labaad iyo saddexaad ayaa la tixgeliyaa. Xulashada daraasaddu waxay ku bilaabataa maaraynta nuqullada. Diiwaanada
Dhammaan qorayaashu waxay isticmaaleen foomamka xog-ururinta elektiroonigga ah si ay uga soo ururiyaan xogta loo baahan yahay maqaal kasta. Xogta ayaa la ururiyey oo la maareeyey iyadoo la adeegsanayo Maareeyaha Dib-u-eegista Software 5.4.
Waxyaabaha xogtu waxay ahaayeen magaca qoraaga, sanadka daabacaada, nooca daraasadda, tirada dadka, qiyaasta fitamiin D, muddada maamulka fitamiin D, cabbirka muunada, da'da, HOMA-IR, iyo heerka aasaasiga ah ee fitamiin D. Falanqaynta-meta ee kala duwanaanshaha celceliska HOMA-IR ka hor iyo ka dib maamulka fitamiin D ayaa lagu sameeyay inta u dhaxaysa daaweynta iyo kooxaha xakamaynta.
Si loo hubiyo tayada dhammaan maqaallada buuxinaya shuruudaha u-qalmitaanka ee dib-u-eegistan, qalab qiimayn heersare ah ayaa la isticmaalay. Habkan, oo loogu talagalay in lagu yareeyo suurtagalnimada eexda ee xulashada daraasadda, waxaa si madax-bannaan u fuliyay laba qoraa (DAS iyo IKM).
Qalabka qiimaynta ee muhiimka ah ee lagu isticmaalay dib u eegistan ayaa ahayd khatarta iskaashiga Cochrane ee habka eexda.
Barkadeynta iyo falanqaynta farqiga celceliska ee HOMA-IR oo leh iyo la'aanta fitamiin D ee bukaanka NAFLD. Sida laga soo xigtay Luo et al., Haddii xogta loo soo bandhigo dhexdhexaad ama kala duwan ee Q1 iyo Q3, isticmaal xisaabiye si aad u xisaabiso celceliska. iyo Wan et al.28,29 Saamaynta saamaynta ayaa lagu soo waramayaa inay tahay kala duwanaansho dhexdhexaad ah oo leh 95% isku-kalsoonida kalsoonida (CI) . Falanqaynta ayaa lagu sameeyay iyadoo la adeegsanayo qaababka saamaynta joogtada ah ama random. sababtoo ah kala duwanaanshaha saameynta dhabta ah, oo leh qiyamka> 60% oo muujinaya heterogeneity muhiim ah.Haddii kala duwanaansho ahaan> 60%, falanqayn dheeraad ah ayaa lagu sameeyay iyada oo la adeegsanayo falanqaynta meta-regression iyo falanqaynta dareenka. (hal daraasad markiiba waa la tirtiray oo falanqaynta ayaa soo noqnoqotay) p-qiimaha <0.05 ayaa loo tixgeliyey inay muhiim tahay. Meta-analyses ayaa la sameeyay iyadoo la adeegsanayo Maamulaha Dib-u-eegista Software 5.4, falanqaynta xasaasiga ah ayaa la sameeyay iyadoo la adeegsanayo xirmada software tirakoobka (Stata 17.0) loogu talagalay Daaqadaha), iyo dib-u-celinta-meta-gaaban ayaa la sameeyay iyada oo la adeegsanayo Isku-dhafka Meta-Analysis Software Version 3.
Wang, S. et al. Faytamiin D ee daaweynta cudurka beerka dufanka leh ee aan khamriga ahayn ee nooca 2-aad ee sonkorowga: Nidaamyada dib-u-eegis nidaamsan iyo falanqayn-meta.Medicine 99(19) /MD.000000000020148 (2020).
Barchetta, I., Cimini, FA & Cavallo, MG Vitamin D supplements iyo cudurka beerka dufanka leh ee aan khamriga ahayn: hadda iyo mustaqbalka. Nafaqooyinka 9 (9), 1015. https://doi.org/10.3390/nu9091015 (2017).
Belentani, S. & Marino, M. Epidemiology iyo taariikhda dabiiciga ah ee cudurka beerka dufanka leh ee aan khamriga ahayn (NAFLD) .install.heparin.8 Supplement 1, S4-S8 (2009).
Vernon, G., Baranova, A. & Younossi, ZM Dib u eegis nidaamsan: Epidemiology iyo taariikhda dabiiciga ah ee cudurka beerka dufanka leh ee aan khamriga ahayn iyo steatohepatitis aan khamriga ahayn ee dadka waaweyn. Nafaqada. Pharmacodynamics.There.34(3), 274-285.https:// doi.org/10.1111/j.1365-2036.2011.04724.x (2011).
Paschos, P. & Paletas, K. Habka labaad ee lagu dhuftay cudurka beerka dufanka leh ee aan khamriga ahayn: sifooyin badan oo kala duwan oo ah garaaca labaad. Hippocrates 13 (2), 128 (2009).
Iruzubieta, P., Terran, Á., Crespo, J. & Fabrega, E. Faytamiin D yaraanta cudurrada beerka ee joogtada ah. World J. Cudurka Beerka.6 (12), 901-915.https://doi.org/ 10.4254/wjh.v6.i12.901 (2014).
Amiri, HL, Agah, S., Mousavi, SN, Hosseini, AF & Shidfar. ), 631-638 (2016).
Bachetta, I. et al. Kaabitaanka fitamiin D-ga afka wax saameyn ah kuma laha cudurka beerka dufanka leh ee aan khamriga ahayn ee bukaanka qaba nooca 2 ee sonkorowga: tijaabo aan kala sooc lahayn, laba-indho la'aan, tijaabo-xakamaynta placebo.BMC Medicine.14, 92. https://doi .org/10.1186/s12916-016-0638-y (2016).
Foroughi, M., Maghsoudi, Z. & Askari, G. Saamaynta kaabista fitamiin D ee calaamadaha kala duwan ee gulukooska dhiigga iyo caabbinta insulin ee bukaanka qaba cudurka beerka dufanka leh ee aan khamriga ahayn (NAFLD).Iran.J.Kalkaaliyaha. Umulisada Res 21(1), 100-104.https://doi.org/10.4103/1735-9066.174759 (2016).
Hussein, M. et al.Saamaynta kaabista fitamiin D ee xuduudaha kala duwan ee bukaanada qaba cudurka beerka dufanka leh ee aan khamriga ahayn.Park.J.Farmashiyaha.sayniska.32 (3 Khaaska ah), 1343-1348 (2019).
Sakpal, M. et al. Faytamiin D ee bukaanka qaba cudurka beerka dufanka leh ee aan khamriga ahayn: tijaabo la xakameynayo oo la kala soocay.JGH Furan Furan J. Gastroenterol.heparin.1 (2), 62-67.https://doi.org/ 10.1002/jgh3.12010 (2017).
Sharifi, N., Amani, R., Hajiani, E. & Cheraghian, B. Fitamiin D miyuu wanaajiyaa enzymes beerka, walbahaarka oksaydhiyaha iyo biomarkers bararka ee bukaanada qaba cudurka beerka dufanka leh ee aan khamriga ahayn? Tijaabo caafimaad oo la kala soocay. 70-80.https://doi.org/10.1007/s12020-014-0336-5 (2014).
Wiesner, LZ et al.Vitamin D ee daaweynta cudurka beerka dufanka leh ee aan khamriga ahayn sida lagu ogaado elastography transient: a randomized, double-inard, trial placebo-controlled. //doi.org/10.1111/dom.14129 (2020).
Guo, XF et al.Vitamin D iyo cudurka beerka dufanka leh ee aan khamriga ahayn: falanqaynta-meta ee tijaabooyinka la xakameeyey.
Pramono, A., Jocken, J., Blaak, EE & van Baak, MA Saamaynta kaabista fiitamiin D ee dareenka insulin: dib u eegis nidaamsan iyo falanqaynta meta. Daryeelka Sonkorowga 43(7), 1659-1669. doi.org/10.2337/dc19-2265 (2020).
Wei Y. et al.Saamaynta kaabista fitamiin D-ga ee bukaanada qaba cudurka beerka dufanka leh ee aan khamriga ahayn: dib u eegis nidaamsan iyo falanqayn-meta. Fasiraadda.J.Endocrinology.metabolism.18(3), e97205.https://doi.org/10.5812/ijem.97205 (2020).
Khan, RS, Bril, F., Cusi, K. & Newsome, PN.Wax ka beddelka caabbinta insulin ee cudurka beerka dufanka leh ee aan khamriga ahayn.Hepatology 70(2), 711-724.https://doi.org/10.1002/hep.30429 (2019).
Peterson.Clin.investigation.126(11), 4361-4371.https://doi.org/10.1172/JCI86013 (2016).
Hariri, M. & Zohdi, S. Saamaynta fitamiin D-ga ee cudurka beerka dufanka leh ee aan khamriga ahayn: dib-u-eegis nidaamsan oo tijaaboyin bukaan-socod ah oo la kantaroolay. Fasiraadda.J.Bogga hore.medicine.10, 14. https://doi.org/10.4103/ijpvm.IJPVM_499_17 (2019).
Waqtiga boostada: Meey-30-2022