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Maturitas Dec 2016There is a biologically plausible association between low vitamin D, specifically serum 25-hydroxyvitamin D [25(OH)D] level, and frailty. We conducted a systematic... (Meta-Analysis)
Meta-Analysis Review
There is a biologically plausible association between low vitamin D, specifically serum 25-hydroxyvitamin D [25(OH)D] level, and frailty. We conducted a systematic review and meta-analysis to describe the association between low 25(OH)D level and frailty. We searched literature in OVID (Medline), EMBASE, Web of Knowledge and Cochrane CENTRAL Library Issue in May 2016, for cohort studies evaluating association of low 25(OH)D level with the risk of frailty. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines. A total of seven studies(17,815 participants)were eligible in our study. The prevalence of frailty ranged from 3.9% to 31.9%. The pooled OR of frailty for the lowest versus the highest level of vitamin D was 1.27 (95% CI=1.17-1.38, I=59%), suggesting that low level of vitamin D was significantly associated with the risk of frailty. In addition, results of subgroups analysis indicated that low level of vitamin D was significantly associated with the risk of frailty in female (pooled OR=1.27, 95% CI=1.15-1.40). Similar result was also found when frailty was defined by the Fried criteria or the modified Fried criteria (pooled OR=1.25, 95% CI=1.14-1.37), and FRAIL scale (pooled OR=1.55, 95% CI=1.07-2.25). Compared to the highest level of 25(OH)D, the association between frailty and the lowest level of 25(OH)D was significant in our study.
Topics: Aged; Aged, 80 and over; Cohort Studies; Female; Frail Elderly; Humans; Prevalence; Vitamin D; Vitamin D Deficiency
PubMed: 27823748
DOI: 10.1016/j.maturitas.2016.09.003 -
The Lancet. Global Health Jan 2020Vitamin D deficiency is associated with non-communicable and infectious diseases, but the vitamin D status of African populations is not well characterised. We aimed to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vitamin D deficiency is associated with non-communicable and infectious diseases, but the vitamin D status of African populations is not well characterised. We aimed to estimate the prevalence of vitamin D deficiency in children and adults living in Africa.
METHODS
For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, African Journals Online, and African Index Medicus for studies on vitamin D prevalence, published from database inception to Aug 6, 2019, without language restrictions. We included all studies with measured serum 25-hydroxyvitamin D (25[OH]D) concentrations from healthy participants residing in Africa. We excluded case reports and case series, studies that measured 25(OH)D only after a clinical intervention, and studies with only a meeting abstract or unpublished material available. We used a standardised data extraction form to collect information from eligible studies; if the required information was not available in the published report, we requested raw data from the authors. We did a random-effects meta-analysis to obtain the pooled prevalence of vitamin D deficiency in African populations, with use of established cutoffs and mean 25(OH)D concentrations. We stratified meta-analyses by participant age group, geographical region, and residence in rural or urban areas. The study is registered with PROSPERO, number CRD42018112030.
FINDINGS
Our search identified 1692 studies, of which 129 studies with 21 474 participants from 23 African countries were included in the systematic review and 119 studies were included in the meta-analyses. The pooled prevalence of low vitamin D status was 18·46% (95% CI 10·66-27·78) with a cutoff of serum 25(OH)D concentration less than 30 nmol/L; 34·22% (26·22-43·68) for a cutoff of less than 50 nmol/L; and 59·54% (51·32-67·50) for a cutoff of less than 75 nmol/L. The overall mean 25(OH)D concentration was 67·78 nmol/L (95% CI 64·50-71·06). There was no evidence of publication bias, although heterogeneity was high (I ranged from 98·26% to 99·82%). Mean serum 25(OH)D concentrations were lower in populations living in northern African countries or South Africa compared with sub-Saharan Africa, in urban areas compared with rural areas, in women compared with men, and in newborn babies compared with their mothers.
INTERPRETATION
The prevalence of vitamin D deficiency is high in African populations. Public health strategies in Africa should include efforts to prevent, detect, and treat vitamin D deficiency, especially in newborn babies, women, and urban populations.
FUNDING
Wellcome Trust and the DELTAS Africa Initiative.
Topics: Adolescent; Adult; Africa; Aged; Aged, 80 and over; Child; Child, Preschool; Dietary Supplements; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Prevalence; Vitamin D Deficiency; Young Adult
PubMed: 31786117
DOI: 10.1016/S2214-109X(19)30457-7 -
Aging Clinical and Experimental Research May 2022Over the latest years different studies have investigated the possible relationship between D deficiency and occurrence of orthostatic hypotension (OH), often reaching... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Over the latest years different studies have investigated the possible relationship between D deficiency and occurrence of orthostatic hypotension (OH), often reaching controversial results. We perform an update meta-analysis providing an update overview on the association between hypovitaminosis D and orthostatic hypotension (OH) in older adults.
METHODS
Data extraction was independently performed by two authors and based upon predefined criteria. The meta-analysis was performed using a random-effects model. Statistical heterogeneity between groups was measured using the Higgins I2 statistic.
RESULTS
Eight investigations enrolling 16.326 patients (mean age 75.5 years) met the inclusion criteria and were considered for the analysis. Patients with vitamin D deficiency were more likely to have OH compared to those without (OR: 1.36, 95% CI 1.14-1.63, p = 0.0001, I2 = 43.6%). A further sub-analysis, based on three studies, estimating the risk of OH in patients with hypovitaminosis D receiving antihypertensive treatment, did not reach the statistical significance (OR: 1.40, 95% CI 0.61-3.18, p = 0.418, I2 = 53.3%). Meta-regression performed using age (p = 0.12), BMI (p = 0.73) and gender (p = 0.62) as moderators did not reveal any statistical significance in influencing OH. Conversely, physical activity, Vitamin D supplementation and use of radioimmunoassay for the measurement of vitamin D serum levels showed a significant inverse relationship towards the risk of OH (Coeff.-0.09, p = 0.002, Coeff. - 0.12, p < 0.001 and Coeff. - 0.08, p = 0.03, respectively) among patients with hypovitaminosis D. A direct correlation between the administration of antihypertensive treatment and the risk of OH in older patients with low vitamin D level was observed (Coeff. 0.05, p < 0.001).
CONCLUSIONS
Hypovitaminosis D is significantly associated with OH in older adults and directly influence by the administration of antihypertensive drugs. Conversely, physical activity, vitamin D supplementation and use of radioimmunoassay as analytic method inversely correlated with the risk of OH in older patients.
Topics: Aged; Antihypertensive Agents; Humans; Hypotension, Orthostatic; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 34628636
DOI: 10.1007/s40520-021-01994-w -
Clinical Endocrinology Mar 2022We sought to evaluate the association between vitamin D deficiency and the severity of coronavirus disease 2019 (COVID-19) infection. (Meta-Analysis)
Meta-Analysis
BACKGROUND
We sought to evaluate the association between vitamin D deficiency and the severity of coronavirus disease 2019 (COVID-19) infection.
METHODS
Multiple databases from 1 January 2019 to 3 December 2020 were searched for observational studies evaluating the association between vitamin D deficiency and severity of COVID-19 infection. Independent reviewers selected studies and extracted data for the review. The main outcomes of interest were mortality, hospital admission, length of hospital stay and intensive care unit admission.
RESULTS
Seventeen observational studies with 2756 patients were included in the analyses. Vitamin D deficiency was associated with significantly higher mortality (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.50-4.05; 12 studies; hazard ratio [HR]: 4.11, 95% CI: 2.40-7.04; 3 studies), higher rates of hospital admissions (OR: 2.18, 95% CI: 1.48-3.21; 3 studies) and longer hospital stays (0.52 days; 95% CI: 0.25-0.80; 2 studies) as compared to nonvitamin D deficient status. Subgroup analyses based on different cut-offs for defining vitamin D deficiency, study geographic locations and latitude also showed similar trends.
CONCLUSIONS
Vitamin D deficiency is associated with greater severity of COVID-19 infection. Further studies are warranted to determine if vitamin D supplementation can decrease the severity of COVID-19.
Topics: COVID-19; Humans; Intensive Care Units; SARS-CoV-2; Vitamin D; Vitamin D Deficiency
PubMed: 34160843
DOI: 10.1111/cen.14540 -
Critical Reviews in Food Science and... 2023Vitamin D deficiency is a worldwide health problem. However, the prevalence of vitamin D deficiency in Asian populations is unclear. The aims of our study were to... (Meta-Analysis)
Meta-Analysis
Vitamin D deficiency is a worldwide health problem. However, the prevalence of vitamin D deficiency in Asian populations is unclear. The aims of our study were to investigate the prevalence of vitamin D deficiency and its association with different health outcomes in Asia. Searches for studies published from January 2009 to January 2021 were performed in the MEDLINE (via PubMed), EMBASE, and Web of Science databases. This study was registered in the PROSPERO database (CRD42021229841). In total, 472 studies with 746,564 subjects were included in the meta-analysis. The mean serum 25-hydroxyvitamin D (25[OH]D) concentration was 49.39 nmol/L; 20.93% of the participants had 25(OH)D levels <25 nmol/L, 22.82% had levels <30 nmol/L, 57.69% had levels <50 nmol/L, and 76.85% had levels <75 nmol/L. This review found that the prevalence of vitamin D deficiency in Asia is high. The factors significantly related to vitamin D deficiency were gender, age, altitude, region, and specific diseases (diabetes, cancer, fracture, systemic lupus erythematosus [SLE], fatty liver disease, osteopenia, thyroiditis, anemia, hepatitis, metabolic diseases, and dermatitis). These findings may serve as the foundation for more detailed public health strategies and policies on this issue.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1990850.
Topics: Humans; Prevalence; Vitamin D Deficiency; Vitamin D; Asia; Lupus Erythematosus, Systemic; Global Health
PubMed: 34783278
DOI: 10.1080/10408398.2021.1990850 -
Nutrition Reviews Sep 2023Vitamin D deficiency is considered a global public health issue, even in low-latitude countries where there is abundant sunlight radiation. Nevertheless, the... (Meta-Analysis)
Meta-Analysis
CONTEXT
Vitamin D deficiency is considered a global public health issue, even in low-latitude countries where there is abundant sunlight radiation. Nevertheless, the prevalence of vitamin D insufficiency and deficiency in the South American continent has not been well characterized.
OBJECTIVE
The aim of this review was to estimate the prevalence of vitamin D deficiency (25-hydroxy-calciferol < 20 ng/mL) in South American populations.
DATA SOURCES
Seven electronic databases (MEDLINE, Web of Science, Embase, Biblioteca Virtual de Saúde, SciELO, Scopus, and Google Scholar) were searched systematically for observational studies published before July 1, 2021, and reporting vitamin D status of healthy adults in South America.
DATA EXTRACTION
Data were extracted using a standardized form. Risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Instrument for Studies Reporting Prevalence. All steps were conducted independently by two authors. Data were pooled using a random-effects model. Stratified meta-analysis and meta-regression were conducted (R software).
DATA ANALYSIS
Of 9460 articles identified, 96 studies with a total of 227 758 participants were included. The overall prevalence of vitamin D deficiency was 34.76% (79 studies; 95%CI, 29.68-40.21; I2 = 99%). There were significant differences in prevalence rates related to age, sex, country, latitude, season, and year of publication.
CONCLUSION
The prevalence of vitamin D deficiency is unexpectedly elevated in South American populations. Public health strategies should include efforts to prevent, detect, and treat vitamin D deficiency.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration number CRD42020169439.
Topics: Adult; Humans; Prevalence; Vitamin D Deficiency; Vitamin D; Vitamins; South America
PubMed: 36882047
DOI: 10.1093/nutrit/nuad010 -
BMC Geriatrics Jan 2017Sunlight exposure and high vitamin D status have been hypothesised to reduce the risk of developing dementia. The objective of our research was to determine whether lack... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sunlight exposure and high vitamin D status have been hypothesised to reduce the risk of developing dementia. The objective of our research was to determine whether lack of sunlight and hypovitaminosis D over time are associated with dementia.
METHODS
We systematically searched MEDLINE (via PubMed), Cochrane Library, EMBASE, SCOPUS, Web of Science, ICONDA, and reference lists of pertinent review articles from 1990 to October 2015. We conducted random effects meta-analyses of published and unpublished data to evaluate the influence of sunlight exposure or vitamin D as a surrogate marker on dementia risk.
RESULTS
We could not identify a single study investigating the association between sunlight exposure and dementia risk. Six cohort studies provided data on the effect of serum vitamin D concentration on dementia risk. A meta-analysis of five studies showed a higher risk for persons with serious vitamin D deficiency (<25 nmol/L or 7-28 nmol/L) compared to persons with sufficient vitamin D supply (≥50 nmol/L or 54-159 nmol/L) (point estimate 1.54; 95% CI 1.19-1.99, I = 20%). The strength of evidence that serious vitamin D deficiency increases the risk of developing dementia, however, is very low due to the observational nature of included studies and their lack of adjustment for residual or important confounders (e.g. ApoE ε4 genotype), as well as the indirect relationship between Vitamin D concentrations as a surrogate for sunlight exposure and dementia risk.
CONCLUSIONS
The results of this systematic review show that low vitamin D levels might contribute to the development of dementia. Further research examining the direct and indirect relationship between sunlight exposure and dementia risk is needed. Such research should involve large-scale cohort studies with homogeneous and repeated assessment of vitamin D concentrations or sunlight exposure and dementia outcomes.
Topics: Cohort Studies; Dementia; Female; Humans; Risk Factors; Sunlight; Vitamin D; Vitamin D Deficiency
PubMed: 28086755
DOI: 10.1186/s12877-016-0405-0 -
Vitamin D deficiency is associated with the severity of COPD: a systematic review and meta-analysis.International Journal of Chronic... 2015To explore the association between host serum 25-hydroxyvitamin D (25(OH)D) and the susceptibility and severity of COPD. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To explore the association between host serum 25-hydroxyvitamin D (25(OH)D) and the susceptibility and severity of COPD.
METHODS
Previous studies on the association between host 25(OH)D and the susceptibility and severity of COPD were collected on the basis of a systematic literature search of PubMed and Web of Science up to June 2015. Continuous variable data were presented as standard mean difference (SMD) or weighted mean difference with 95% confidence interval (CI). The dichotomous variable data were analyzed as relative ratio (RR) or odds ratio with 95% CI for cohort and case-control studies. A systematic review was conducted to understand the curative and side effects of vitamin D intake.
RESULTS
A total of 18 studies including eight cohort, five case-control, and five randomized studies met the inclusion criteria. The serum level of 25(OH)D in COPD patients was comparable with controls with a pooled SMD of 0.191 (95% CI: -0.126 to 0.508, P=0.237) based on pooled analyses of cohort studies. However, the serum level of 25(OH)D in COPD patients was lower with a pooled SMD of 0.961 (95% CI: 0.476-1.446, P<0.001) compared with controls based on pooled analyses of case-control studies. The deficiency rates of 25(OH)D were comparable between controls and COPD patients with a pooled RR of 0.955 (95% CI: 0.754-1.211, P=0.705) based on analyses of cohort studies, and the same results were observed based on pooled analyses of case-control studies. Interestingly, the deficiency rate of 25(OH)D was significantly lower in moderate or severe COPD patients with a pooled RR of 0.723 (95% CI: 0.632-0.828, P<0.001) compared with that in mild COPD patients. The same results were obtained from the pooled analysis between moderate and severe COPD patients. The four randomized studies showed that vitamin D intake provided benefit for COPD patients.
CONCLUSION
Low serum levels of 25(OH)D were not associated with COPD susceptibility, but the high deficiency rate of 25(OH)D was associated with COPD severity. Vitamin D supplementation may prevent COPD exacerbation.
Topics: Dietary Supplements; Disease Progression; Humans; Pulmonary Disease, Chronic Obstructive; Severity of Illness Index; Vitamin D; Vitamin D Deficiency
PubMed: 26392765
DOI: 10.2147/COPD.S89763 -
World Neurosurgery Nov 2016Vitamin D deficiency is a relatively common occurrence in patients presenting for spinal surgery; however, whether this abnormality has any effect on spinal fusion... (Review)
Review
BACKGROUND
Vitamin D deficiency is a relatively common occurrence in patients presenting for spinal surgery; however, whether this abnormality has any effect on spinal fusion outcomes remains unclear. We performed a systematic review of the available literature relevant to the association between vitamin D deficiency and spinal fusion outcomes.
METHODS
We conducted a systematic and critical review of recent literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following databases were searched: MEDLINE/PubMed, Google Scholar, Cochrane, Web of Science, and Scopus. Key search terms were "vitamin D," "spinal surgery outcomes," "spinal fusion," and "pseudarthrosis." Papers included in the review were original research articles in peer-reviewed journals. The articles were thoroughly examined and compared on the basis of study design, outcomes, and results.
RESULTS
A total of 5 studies were included in the qualitative analysis. In these studies, patients presenting with vitamin D deficiency achieved lower fusion rates and suffered higher rates of recurrent-persistent low back pain compared with patients with normal vitamin D levels. Studies examining the effect of postoperative vitamin D supplementation in deficient patients reported significant improvements in low back pain intensity, patient-reported outcomes scores, and fusion rates compared with baseline as well as with control groups.
CONCLUSIONS
The literature suggests that patients presenting for spinal fusion may benefit from correction of vitamin D deficiency to maximize the chance of a successful arthrodesis and to achieve optimal surgical outcomes. Future prospective studies are needed to determine whether routine preoperative treatment of this metabolic derangement is warranted.
Topics: Back Pain; Humans; Patient Reported Outcome Measures; Postoperative Complications; Pseudarthrosis; Spinal Diseases; Spinal Fusion; Treatment Outcome; Vitamin D Deficiency
PubMed: 27481599
DOI: 10.1016/j.wneu.2016.07.074 -
Revista Brasileira de Ginecologia E... Apr 2022To estimate the prevalence of inadequate vitamin D level and its associated factors for women of childbearing age in Brazil. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To estimate the prevalence of inadequate vitamin D level and its associated factors for women of childbearing age in Brazil.
METHODS
A systematic review was conducted (last updated May 2020). Meta-analyses were performed using the inverse-variance for fixed models with summary proportion calculation by Freeman-Tukey double arcsine. Reporting and methodological quality were assessed using the Joanna Briggs Institute tool for prevalence studies.
RESULTS
Our review identified 31 studies, comprising 4,006 participants. All the studies had at least one weakness, mainly due to the use of convenience sampling and small sample size. The overall prevalence of vitamin D deficiency, insufficiency, and both deficiency and insufficiency were 35% (confidence interval, 95%CI: 34-37%), 42% (95%CI: 41-44%), and 72% (95%CI: 71-74%), respectively.
CONCLUSION
Although the magnitude of the prevalence of inadequate levels of vitamin D is uncertain, the evidence suggests that presence of vitamin D deficiency or insufficiency in women of reproductive age can cause moderate to severe problems.
Topics: Brazil; Female; Humans; Prevalence; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 35211934
DOI: 10.1055/s-0042-1742409