Data_Sheet_1_Vitamin D deficiency and risk of recurrent aphthous stomatitis: updated meta-analysis with trial sequential analysis.docx

BackgroundGrowing evidence suggests a significant association between vitamin D deficiency and RAS. Hence, the present meta-analysis and trial sequential analysis sought to investigate the potential association between low serum vitamin D levels and RAS.
MethodsPubMed, Scopus, Embase, and Web of Science were comprehensively searched on December 1st, 2022 to retrieve all relevant studies. The grey literature was also searched via ProQuest. All case-control studies on the association between vitamin D and RAS were considered. The quality appraisal of the included studies was done using Newcastle-Ottawa scale. RevMan 5.0 and trial sequential analysis (TSA) programs were used for analyses.
ResultsA total of 14 case-control studies with 1468 subjects (721 RAS patients and 747 controls) were included. The pooled data revealed a significant association between low serum levels of vitamin D and the risk of RAS (mean difference = – 8.73, 95% CI: – 12.02 to – 5.44, I2 = 94%, P < 0.00001). Additionally, TSA findings indicated that the current studies surpassed the required information size, confirming that the differences were reliable.
ConclusionThe available evidence suggests that Vitamin D deficiency may have a role in the pathogenesis of RAS. Therefore, evaluation of vitamin D should be considered in RAS patients. Additionally, the results support the possibility of using vitamin D supplements in the management of RAS patients with inadequate serum levels of vitamin D. Future interventional studies are required to evaluate the benefits of vitamin D replacement in prevention and treatment of RAS.

背景 越来越多的研究证据表明，维生素D缺乏与复发性阿弗他口炎（Recurrent Aphthous Stomatitis，RAS）之间存在显著关联。为此，本项荟萃分析与试验序贯分析旨在探讨血清维生素D水平低下与复发性阿弗他口炎之间的潜在关联。
方法 本研究于2022年12月1日全面检索PubMed、Scopus、Embase及Web of Science四大数据库，以获取所有相关研究；同时通过ProQuest数据库检索灰色文献。本研究纳入所有探讨维生素D与复发性阿弗他口炎关联的病例对照研究。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）对纳入研究进行质量评价。数据分析采用RevMan 5.0软件与试验序贯分析（trial sequential analysis, TSA）工具完成。
结果 本研究共纳入14项病例对照研究，合计1468名受试者（其中复发性阿弗他口炎患者721例，对照人群747例）。合并数据分析显示，血清维生素D水平低下与复发性阿弗他口炎的发病风险存在显著关联（均数差= -8.73，95%置信区间：-12.02 ~ -5.44，I²=94%，P<0.00001）。此外，试验序贯分析结果表明，现有研究已达到所需的信息量阈值，证实该关联差异具有可靠性。
结论 现有证据提示，维生素D缺乏可能参与复发性阿弗他口炎的发病进程。因此，针对复发性阿弗他口炎患者，应考虑开展维生素D水平检测。此外，本研究结果支持对血清维生素D水平不足的复发性阿弗他口炎患者采用维生素D补充剂进行干预。未来仍需开展干预性研究，以评估维生素D替代疗法在复发性阿弗他口炎预防与治疗中的获益价值。