Vitamin D Levels in Patients with Behcet's Disease: A Systematic Review and Meta-Analysis

Abstract

Objective: Behcet’s disease (BD) is a chronic multisystem inflammatory disease classi-fied as Variable Vessel Vasculitis with unclear etiology. We designed this systematic review and meta-analysis to evaluate vitamin D status in Behcet’s disease patients with this background. Methods: We performed this systematic review and meta-analysis according to PRISMA guide-lines. We included all observational studies in humans published in English, evaluating the associa-tion of 25(OH)D concentrations in Behcet’s patients. Two reviewers (HRK and AE) independently searched the databases and screened articles based on their titles and abstracts. A third reviewer re-solved all disagreements. We performed analysis using Cochrane Program Review Manager Ver-sion 5.3. The protocol for this review was registered on PROSPERO (CRD42020197426). Results: A total of 341 publications were initially identified according to the search strategy. Final-ly, 12 publications were included in the meta-analysis. We performed this meta-analysis on 1265 participants from different studies with a sample size ranging from 63 to 224 individuals. In studies comparing active and inactive subgroups of patients with Behcet’s disease, we found a significantly lower serum level of vitamin D in patients with Active BD (-0.4; 95 % CI: -0.61, -0.25; p<0.001). We found that the serum level of vitamin D in Behcet’s disease is significantly higher than in health controls (0.5; 95 % CI: 0.15, 0.50; p=0.001). Conclusion: We demonstrated that the existing evidence is consistent with the hypothesis that an increased serum level of vitamin D would be associated with substantially lower risk of active Behcet’s disease.