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The American Journal of Clinical... Sep 2023Evidence is uncertain about the association between serum 25-hydroxyvitamin D (25(OH)D) concentration and health outcomes in people with type 2 diabetes. (Meta-Analysis)
Meta-Analysis
Serum 25(OH)D Concentration, Vitamin D Supplementation, and Risk of Cardiovascular Disease and Mortality in Patients with Type 2 Diabetes or Prediabetes: a Systematic Review and Dose-Response Meta-Analysis.
BACKGROUND
Evidence is uncertain about the association between serum 25-hydroxyvitamin D (25(OH)D) concentration and health outcomes in people with type 2 diabetes.
OBJECTIVES
We aimed to assess the association between vitamin D status and all-cause mortality and cardiovascular disease in people with type 2 diabetes.
METHODS
We did a systematic search in PubMed, Scopus, CENTRAL, and Web of Science until May 2022. We selected 1) cohort studies investigating the association between serum 25(OH)D concentration and mortality or cardiovascular disease in people with type 2 diabetes or prediabetes and 2) randomized trials of vitamin D supplementation in these patients. We used random-effects pairwise meta-analyses to calculate summary relative risks (RRs) and 95% confidence intervals (CI).
RESULTS
21 cohort studies and 6 randomized trials were included. Compared with sufficient vitamin D status (≥50 nmol/L), the RR of all-cause mortality was 1.36 (95% CI: 1.23, 1.49; n = 11 studies, GRADE = moderate) for vitamin D insufficiency (25 to <50 nmol/L), and 1.58 (1.33, 1.83; n = 16, GRADE = moderate) for deficiency (<25 nmol/L). Similar findings were observed for cardiovascular mortality and morbidity but not for cancer mortality. The certainty of evidence ranged from very low to moderate. Dose-response meta-analyses indicated nonlinear associations, with the lowest risk at 25(OH)D ∼60 nmol/L for all-cause and cardiovascular mortality. Supplementation with vitamin D did not reduce the risk of all-cause mortality (RR: 0.96, 95% CI: 0.79, 1.16; risk difference per 1000 patients: 3 fewer, 95% CI: 16 fewer, 12 more; n = 6 trials with 7316 participants; GRADE = low) or the risk of cardiovascular mortality and morbidity (very low- to low-certainty evidence).
CONCLUSIONS
Vitamin D deficiency and insufficiency are associated with a higher risk of all-cause and cardiovascular mortality in patients with type 2 diabetes or prediabetes. Vitamin D deficiency should be corrected in patients with type 2 diabetes to reach normal serum 25(OH)D concentrations, preferably 60 nmol/L.
SYSTEMATIC REVIEW REGISTRATION
This systemic review was registered at PROSPERO as CRD42022326429 (=https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=326429).
Topics: Humans; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Prediabetic State; Vitamin D; Vitamins; Vitamin D Deficiency; Dietary Supplements
PubMed: 37467897
DOI: 10.1016/j.ajcnut.2023.07.012 -
Journal of Research in Health Sciences Dec 2023According to the findings from observational studies and clinical trials assessing the effect of vitamin D supplements on cardiovascular diseases (CVDs), there are still... (Meta-Analysis)
Meta-Analysis Review
Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 134000 Individuals in 29 Randomized Clinical Trials and 157000 Individuals in 30 Prospective Cohort Studies: An Updated Systematic Review and Meta-analysis.
BACKGROUND
According to the findings from observational studies and clinical trials assessing the effect of vitamin D supplements on cardiovascular diseases (CVDs), there are still contradictory results. This systematic review aimed to assess the effect of vitamin D supplements on CVDs considering cohort studies and clinical trials. A systematic review.
METHODS
MEDLINE/PubMed, Science Direct, Embase, and Cochrane Library databases were reviewed by two reviewers independently until 2022. The study effect is risk ratio (RR) and 95% confidence interval (CI) according to Mantel Haenszel's random-effects model. Then, Stata version 14 was used for statistical analysis.
RESULTS
In clinical trial studies, the incidence of CVDs among the vitamin D-consuming group was not significantly different from that in the placebo group (RR: 0.99, 95% CI: 0.95-1.03; =0.77; I =0%). CVD mortality was also not significantly different between the two groups (RR: 0.97, 95% CI: 0.90-1.05; =0.72; I=0%). In cohort studies, circulating 25 (OH) D increased the risk of CVD incidence by 31% (RR: 1.31, 95% CI: 1.19-1.45) and CVD mortality by 37% (RR: 1.37, 95% CI: 1.17-1.61).
CONCLUSION
According to current evidence from clinical trials, vitamin D supplementation should not be recommended for CVD prevention. However, there is a direct association between vitamin D deficiency and the incidence of CVDs as well as its mortality. According to the results of clinical trial studies carrying higher levels of scientific evidence, it can be concluded that vitamin D supplementation does not exert a significant effect on the incidence, mortality, and reduction of CVDs.
Topics: Humans; Cardiovascular Diseases; Prospective Studies; Randomized Controlled Trials as Topic; Vitamins; Vitamin D; Dietary Supplements
PubMed: 38315909
DOI: 10.34172/jrhs.2023.129 -
Orthopaedic Journal of Sports Medicine Jan 2024Deficiency in vitamin D has been shown to increase the risk of injury. (Review)
Review
BACKGROUND
Deficiency in vitamin D has been shown to increase the risk of injury.
PURPOSE
To synthesize current placebo-controlled randomized trials investigating the effect of vitamin D supplementation in elite athletes on (1) aerobic capacity; (2) anaerobic measures, such as strength, speed, and anaerobic power; (3) serum biomarkers of inflammation; and (4) bone health.
STUDY DESIGN
Systematic review; Level of evidence, 1.
METHODS
A literature search was conducted on November 30, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included were randomized, placebo-controlled studies of longer than 2 weeks on subjects with active participation in organized sport. Excluded were nonrandomized controlled trial study designs, vitamin D administration routes other than oral, studies that did not use vitamin D supplementation as the sole intervention, and studies with nonathletic or military populations.
RESULTS
Out of 2331 initial studies, 14 studies (482 athletes) were included. Of the 3 studies that assessed aerobic capacity, 2 demonstrated significantly greater improvements in maximal oxygen uptake and physical working capacity-170 ( < .05) in supplemented versus nonsupplemented athletes. Measurements of anaerobic power and strength were consistently increased in supplemented groups compared with nonsupplemented groups in 5 out of the 7 studies that assessed this. Of the 6 studies that assessed sprint speed, 4 found no significant difference between supplemented and nonsupplemented groups. Aside from 1 study that found significantly lower interleukin-6 levels in supplemented athletes, measures of other inflammatory cytokines were not affected consistently by supplementation. The 4 studies that assessed markers of bone health were conflicting regarding benefits of supplementation. One study found demonstrated improvements in bone mineral density in response to supplementation ( = .02) compared with control whereas another found no significant difference between supplemented and nonsupplemented groups. However, in 3 other studies, serum biomarkers of bone turnover such as bone-specific alkaline phosphatase, parathyroid hormone, and N-terminal telopeptide appeared to be higher in subjects with lower serum vitamin D levels ( < .05).
CONCLUSION
Results of this systematic review indicated that the greatest benefit of vitamin D supplementation in elite athletes may be improving aerobic endurance, anaerobic power, and strength. More research is needed to determine the effect of vitamin D supplementation on bone health and injury risk in this population.
PubMed: 38188620
DOI: 10.1177/23259671231220371 -
Cureus Jan 2024Vitamin D deficiency is a globally recognized health concern, with particular prominence in specific geographies and demographics. Saudi Arabia, with its unique climatic... (Review)
Review
Vitamin D deficiency is a globally recognized health concern, with particular prominence in specific geographies and demographics. Saudi Arabia, with its unique climatic conditions and cultural practices, has been under scrutiny regarding the prevalence of this deficiency, especially among children and adolescents. This systematic review aimed to assess the prevalence of vitamin D deficiency among children and adolescents in Saudi Arabia by compiling and analyzing various studies to offer a comprehensive view of the situation. The comprehensive web search encompassed a range of databases, including Google Scholar and PubMed, to gather studies published between 2012 and 2023. An analysis was conducted on seven studies, totaling 2,429 participants, with each study focusing on various aspects, regions, and cohorts within Saudi Arabia. These studies employed different methodologies, ranging from cross-sectional surveys to randomized clinical trials. The review unveiled an alarming prevalence of vitamin D deficiency in the studied population. On average, around 81.1% of children and adolescents showcased inadequate vitamin D levels. Specific vulnerable groups, such as those with Type 1 diabetes mellitus or asthma, had pronounced deficiencies. Factors influencing these levels ranged from dietary habits, sun exposure, physical activity, and socioeconomic parameters. The compelling evidence from the studies underscores a consistent health issue among the pediatric population in Saudi Arabia that the overwhelming majority of Saudi children and adolescents lack adequate vitamin D. Addressing this widespread deficiency needs a multifaceted approach. Implementing policies that support vitamin D food fortification, encouraging routine screenings, and launching public awareness campaigns about safe sun exposure and diet can play a transformative role in this health crisis.
PubMed: 38344540
DOI: 10.7759/cureus.52040 -
Cureus Nov 2023This systematic review aims to investigate the published literature on vitamin D deficiency (VDD) as a risk factor for developing type 2 diabetes mellitus (T2DM) or... (Review)
Review
This systematic review aims to investigate the published literature on vitamin D deficiency (VDD) as a risk factor for developing type 2 diabetes mellitus (T2DM) or affecting the glycemic state of patients in Saudi Arabia. PubMed, Scopus, Web of Science, ScienceDirect, and the Cochrane Library were systematically searched to include the relevant literature. Rayyan QCRI (Rayyan Systems Inc., Cambridge, MA) was used throughout this systematic approach. Eleven studies were included with a total of 4229 patients. Three studies demonstrated that VDD was a significant risk factor for developing T2DM, and one reported that it increased insulin resistance. However, two studies found that VDD did not affect the incidence of T2DM and did not affect the insulin sensitivity or glycated hemoglobin (HbA1c) levels in patients with T2DM. This systematic review demonstrated that VDD significantly increases the risk of developing T2DM and negatively affects the glycemic state of patients with T2DM among Saudi patients. Due to the many populations examined, vitamin D chemical compositions, doses, and supplementation periods, interventional research has produced contradictory and ambiguous results. Additional research is necessary, particularly in individuals with a high risk of developing diabetes (impaired fasting glucose and/or glucose tolerance, possibly without obesity). These individuals may be the primary benefactors of vitamin D's benefits in preventing T2DM, according to the hypothesized mechanism of action for the vitamin.
PubMed: 38073984
DOI: 10.7759/cureus.48577 -
Nutrients Jul 2023Multiple myeloma (MM) is a hematological malignancy characterized by the exponential growth of malignant plasma cells. Individuals diagnosed with MM exhibit a deficiency... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Multiple myeloma (MM) is a hematological malignancy characterized by the exponential growth of malignant plasma cells. Individuals diagnosed with MM exhibit a deficiency in vitamin D and may suffer fatigue, a loss of muscular strength, persistent musculoskeletal aches, and pain. The objective of this systematic review and meta-analysis is to determine the prevalence of vitamin D insufficiency and deficiency in individuals diagnosed with MM.
METHODS
We searched five electronic databases using relevant keywords. The quality of the included studies was evaluated using the critical appraisal tool developed by the Joanna Briggs Institute. We employed a random-effects model and presented the findings in the form of percentages accompanied by 95% confidence intervals (CI). This protocol has been officially registered in PROSPERO under the registration number CRD42021248710.
RESULTS
The meta-analysis comprised a total of eighteen studies and found that, among patients with MM, the occurrence of serum vitamin D deficiency and insufficiency was 39.4% (95% CI: 25.8 to 52.9, n = 3746) and 34.1% (95% CI: 20.9 to 47.2, n = 3559), respectively. The findings indicate that a greater proportion of newly diagnosed patients exhibited vitamin D deficiency and insufficiency, with rates of 43.0% and 41.6%, respectively, compared to those receiving treatment (rates of 41.6% and 32.3%, respectively). The findings of the sensitivity analyses were consistent, and most of the studies (72.2%) were deemed to be of high quality. The results of Egger's test indicated the absence of publication bias.
CONCLUSIONS
Patients diagnosed with MM have been found to exhibit significantly elevated levels of both vitamin D deficiency and insufficiency. Therefore, it is recommended to consider vitamin D testing as an additional parameter in the current criteria for the clinical evaluation of MM.
Topics: Humans; Multiple Myeloma; Prevalence; Vitamin D Deficiency; Vitamin D; Vitamins; Pain
PubMed: 37513645
DOI: 10.3390/nu15143227 -
Clinical Neurology and Neurosurgery Apr 2024There's an increasing body of evidence on vitamin D deficiency and the risk of neuromyelitis optica spectrum disorder (NMOSD). The aim of this meta-analysis was to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND OBJECTIVE
There's an increasing body of evidence on vitamin D deficiency and the risk of neuromyelitis optica spectrum disorder (NMOSD). The aim of this meta-analysis was to assess serum vitamin D levels in patients with NMOSD versus healthy controls.
METHODS
We searched PubMed, EMBASE, Cochrane Library, Web of Science and CNKI for publications up to November 2022 and explored the relationship between NMOSD and serum vitamin D levels. The standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random-effects model. Subgroup analysis and sensitivity analysis were applied to explore the sources of heterogeneity. Begg's test, Egger's test, and Egger's funnel plot were adopted to evaluate publication bias.
RESULTS
6 studies (including 319 patients and 595 healthy controls) met the inclusion criteria and all compared vitamin D levels in patients with NMOSD versus healthy controls. Levels of serum vitamin D detected in NMOSD patients were significantly lower than those in healthy controls (SMD=-1.57, 95% CI=-2.27 ∼ -0.87, P<0.001, I = 94.6%). The results of the different sensitivity analysis remained statistically significant, which demonstrated the robustness of the meta-analysis. There was no significant publication bias in our meta-analysis (P>0.05).
CONCLUSION
Patients with NMOSD showed significantly reduced vitamin D levels compared with healthy controls. Our findings highlighted the importance of measuring vitamin D levels in patients with NMOSD. Multi-center randomized controlled trials with large samples will further confirm whether the association is casual and modifiable.
Topics: Humans; Vitamin D; Neuromyelitis Optica; Vitamins
PubMed: 38520792
DOI: 10.1016/j.clineuro.2024.108190 -
Frontiers in Endocrinology 2023Some studies have investigated the association between vitamin D levels and precocious puberty (PP) but with limited sample sizes and inconsistent conclusions across... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Some studies have investigated the association between vitamin D levels and precocious puberty (PP) but with limited sample sizes and inconsistent conclusions across studies.
METHODS
Until July 2022, a comprehensive electronic search of works of literature was conducted in MEDLINE, Web of Science, and CNKI (Chinese National Knowledge Infrastructure). A systematic review and meta-analysis of 15 case-control studies with 2145 cases and 2063 controls was conducted to explore the relationship between vitamin D and PP. Stratified analyses by year of publication, country, diagnosis category of PP, child's sex, and methods of 25(OH)D test were conducted.
RESULTS
There was a negative correlation between 25(OH)D concentrations and PP in all study populations (SMD = -1.046, 95%CI = -1.366, -0.726). The pooled SMD remained significant in Chinese studies (SMD = -1.113, 95%CI = -0.486, -0.741), studies published before or after 2018 (SMD = -0.9832 and -1.185, 95%CI = -2.044, -1.133 and -1.755, -0.726), studies with female children (SMD = -1.114, 95%CI = -1.446, -0.781), and studies using electrochemiluminescence to detect 25(OH)D (SMD = -0.999, 95%CI = -1.467, -0.531). Vitamin D deficiency also increased the risk of PP (OR = 1.531, 95%CI = 1.098, 2.134). Unfortunately, heterogeneity was high in all analyses, and there was some publication bias.
CONCLUSION
This systematic review and meta-analysis demonstrated an association between vitamin D and precocious puberty. We recommend more high-quality studies, especially prospective cohort studies with big sample sizes or some randomized controlled intervention trials, to validate the reliability of the results.
Topics: Child; Humans; Female; Vitamin D; Puberty, Precocious; Prospective Studies; Reproducibility of Results; Vitamins
PubMed: 38116317
DOI: 10.3389/fendo.2023.1298374 -
International Journal of Surgery... Dec 2023To estimate the prevalence and associated factors of vitamin D deficiency (VDD) after Roux-en-Y gastric bypass (RYGB). (Meta-Analysis)
Meta-Analysis
OBJECTS
To estimate the prevalence and associated factors of vitamin D deficiency (VDD) after Roux-en-Y gastric bypass (RYGB).
METHODS
PubMed, EMBASE, and CENTRAL were searched for relevant records from inception to 17 March 2023, using search terms: vitamin D, vitamin D3, vitamin D deficiency, hypovitaminosis D, gastric bypass, and RYGB. Studies were eligible for inclusion if they provided related data on VDD prevalence after RYGB.
RESULTS
Of the 1119 screened studies, 72 studies involving 7688 individuals were enrolled in the final analysis. The prevalence estimates of VDD after RYGB were 42%. Subgroup analyses suggested the pooled prevalence of postoperative VDD was 35% for follow-up duration less than or equal to 1 year, 43% for greater than 1 and less than or equal to 5 years, and 54% for greater than 5 years. Meta-regression showed that VDD prevalence was positively correlated with follow-up time. Also, the prevalence was higher in studies with inadequate vitamin D supplementation than in those with adequate supplementation and in Asia population than in those from South America, Europe, and North America. Other factors associated with high VDD prevalence after RYGB included high presurgical VDD prevalence, noncompliant patients, and black populations. No significant association existed between VDD and alimentary length.
CONCLUSION
VDD presented a high prevalence in patients following RYGB. It occurred more frequently with longer postoperative follow-up time. Population-specific vitamin D supplementation measures, targeted treatment for presurgical VDD, improved patient compliance, and periodical follow-ups were necessary to reduce VDD and other adverse outcomes.
Topics: Humans; Gastric Bypass; Prevalence; Vitamin D Deficiency; Vitamin D; Vitamins; Obesity, Morbid
PubMed: 37738003
DOI: 10.1097/JS9.0000000000000732 -
Journal of Cosmetic Dermatology Apr 2024Non-scarring alopecia mainly includes androgenetic alopecia (AGA), female pattern hair loss (FPHL), alopecia areata (AA), telogen effluvium (TE), anagen effluvium (AE)... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Non-scarring alopecia mainly includes androgenetic alopecia (AGA), female pattern hair loss (FPHL), alopecia areata (AA), telogen effluvium (TE), anagen effluvium (AE) and so on. Many studies had investigated the serum 25-hydroxyvitamin D level and vitamin D deficiency of patients with these diseases, but opinions varied, and no conclusion was reached.
METHODS
Relevant articles were retrieved through PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and other databases. Serum 25-hydroxyvitamin D [25(OH) D] levels and vitamin D deficiency were used as our primary outcome. The odds ratio (OR) and the standardized mean difference (SMD) with 95% confidence interval were both examined for vitamin D deficiency and levels.
RESULTS
Our meta-analysis had included a total of 3374 non-scarring alopecia patients and 7296 healthy controls from 23 studies through the inclusion criteria and exclusion criteria. We found non-scarring alopecia had decreased serum 25(OH)D level (WMD -7.29; 95% CI -9.21, -5.38) and increased vitamin D deficiency incidence (OR 3.11 95% CI 2.29, 4.22), compared with healthy controls. This meta-analysis chose to conduct random-effect model and subgroup analysis, because of the high heterogeneity (serum 25(OH)D level: I 95%, vitamin D deficiency: I = 0%).
CONCLUSION
Patients with non-scarring alopecia (including AA, FPHL, AGA and TE) have insufficient serum level of 25(OH)D and increased incidence of vitamin D deficiency. Vitamin D supplementation and monitoring for vitamin D deficiency may be helpful in treating non-scarring alopecia.
Topics: Humans; Female; Alopecia; Vitamin D; Alopecia Areata; Vitamin D Deficiency; Calcifediol
PubMed: 38010941
DOI: 10.1111/jocd.16093