-
Ocular Immunology and Inflammation Jun 2024Vitamin D deficiency has been associated with higher rates of autoimmune disease, including noninfectious uveitis. This PRISMA-compliant review and meta-analysis aimed...
PURPOSE
Vitamin D deficiency has been associated with higher rates of autoimmune disease, including noninfectious uveitis. This PRISMA-compliant review and meta-analysis aimed to analyze the correlation between noninfectious uveitis and vitamin D levels.
METHODS
We searched PubMed, Embase, Cochrane, and Web of Science databases for studies, published in English, assessing vitamin D levels in patients diagnosed with noninfectious uveitis. The outcomes of interest were vitamin D deficiency, vitamin D mean level, vitamin D supplementation, and smoking rates. A subgroup analysis of inactive uveitis and active uveitis was performed. The heterogeneity was assessed with Cochrane Q-test and I statistics; > 0.10 and I > 50% were considered significant for heterogeneity. Statistical analysis was conducted using Review Manager 5.3.
RESULTS
9 studies were included in the meta-analysis comprising a total of 10 711 patients, of whom 1,368 were diagnosed with noninfectious uveitis. Patients with noninfectious uveitis had worse results regarding vitamin D deficiency when compared with the control group (OR 0.58; CI 95% 0.44 to 0.77; = 0.0002; I = 61%). Patients with inactive uveitis had better results towards vitamin D deficiency when compared with active uveitis (OR 5.00; CI 95% 2.84 to 8.81; < 0.001; I = 0%).
CONCLUSION
Our research supports the increasing evidence that associates vitamin D deficiency with noninfectious uveitis and its activity. Further investigation into the efficacy of vitamin D screening and supplementation in reducing the recurrence of uveitis is necessary.
PubMed: 38916195
DOI: 10.1080/09273948.2024.2367676 -
Cureus May 2024There have been suggestions that vitamin D has anti-inflammatory effects; however, the variabilities of vitamin D levels among specific groups of patients and its... (Review)
Review
There have been suggestions that vitamin D has anti-inflammatory effects; however, the variabilities of vitamin D levels among specific groups of patients and its association with these inflammatory events have not been demonstrated. This study aims to study the association between vitamin D levels and vitamin D deficiency and inflammatory events among the elderly population. PubMed, Web of Science, Scopus, Science Direct, and ClinicalKey were systematically searched in December 2023 to include the relevant data. Comprehensive Meta-Analysis (version 3.0, Biostat, Inc., Englewood, NJ) was the software used for data analyses. A total of 12 studies were included in this analysis with 14,717 elderly patients. There was an overall significant decrease in vitamin D levels in elderly patients with high inflammatory markers compared to controls (Hedges' g = -0.221, 95% CI: -0.268, -0.173, P < 0.001), and event of vitamin D deficiency was found to be 0.321 (95% CI: 0.305, 0.337, P < 0.001). There is a significant decrease in vitamin D levels among the elderly with different inflammatory conditions. Future longitudinal studies and well-designed, large, randomized controlled trials are required to study the association between vitamin D deficiency and the incidence of inflammatory events in this specific group of patients.
PubMed: 38910627
DOI: 10.7759/cureus.60892 -
Clinical Nutrition ESPEN Aug 2024The emerging role of vitamin D has drawn the attention of researchers around the world, including its involvement in cardiovascular complications among individuals with... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The emerging role of vitamin D has drawn the attention of researchers around the world, including its involvement in cardiovascular complications among individuals with diabetes.
AIM
This study aimed to obtain comprehensive evidence on the association between serum vitamin D level and the risk of cardiovascular disease among patients with diabetes.
METHODS
Systematic search was performed on July 1st, 2023, to identify and screen published literature reporting the association between vitamin D and cardiovascular disease among diabetic patients in six databases. Each eligible study was appraised for its quality using modified Newcastle Ottawa Scale for cross-sectional and cohort studies. Meta-analysis was performed using Dersimonian-Laird random effect model or fix-effect model. The heterogeneity and publication bias were judged based on percentage of I and the symmetry of Begg's funnel plot, respectively.
RESULTS
As many as 22 studies were found eligible for the systematic review. A meta-analysis from 13 studies comprising of 3850 and 1797 (control and exposure groups, respectively) revealed that serum vitamin D level was significantly lower in patients with diabetes and cardiovascular diseases (Z = 4.89; p-total<0.001; SMD = 0.68 [95%CI: 0.41-0.95]), yet the heterogeneity was high. Following the adjustment of removing the potential outliers, the same results were still observed (Z = 6.19; p-total<0.001; SMD = 0.35 [95%CI: 0.24-0.46]). Though decreased, high heterogeneity could not be resolved, resulting in moderate level of this evidence. Another pooled analysis of 7 studies with 4211 patients in control group and 2381 patients in exposure group revealed that lower level of serum vitamin D is a risk factor for cardiovascular disease incidence among diabetic patients (Z = 4.89; p-total<0.001; OR: 1.76 [95%CI: 1.4-2.2]).
CONCLUSION
Serum vitamin D level status is a risk factor for developing cardiovascular diseases among diabetic patients, hence should be carefully monitored and maintained.
PROSPERO REGISTRATION
CRD42023437698.
Topics: Humans; Cardiovascular Diseases; Vitamin D; Risk Factors; Vitamin D Deficiency; Diabetes Mellitus; Cross-Sectional Studies
PubMed: 38901950
DOI: 10.1016/j.clnesp.2024.04.018 -
Nutrients May 2024Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D.... (Meta-Analysis)
Meta-Analysis Review
Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D. Additionally to the recognized functions in the regulation of calcium absorption, bone remodeling, and bone growth, vitamin D plays a key role as a hormone, which is supported by various enzymatic, physiological, metabolic, and pathophysiological processes related to various human organs and systems. Accruing evidence supports that vitamin D plays a key role in pancreatic islet dysfunction and insulin resistance in type 2 diabetes. From an epidemiological viewpoint, numerous studies suggest that the growing incidence of type 2 diabetes in humans may be linked to the global trend of prevalent vitamin D insufficiency. In the past, this association has raised discussions due to the equivocal results, which lately have been more convincing of the true role of vitamin D supplementation in the prevention of incident type 2 diabetes. Most meta-analyses evaluating this role have been conducted in adults or young older persons (50-60 years old), with only one focusing on older populations, even if this is the population at greater risk of both hypovitaminosis D and type 2 diabetes. Therefore, we conducted an update of the previous systematic review and meta-analysis examining whether hypovitaminosis D (low serum 25OHD levels) can predict incident diabetes in prospective longitudinal studies among older adults. We found that low 25OHD was associated with incident diabetes in older adults even after adjusting for several relevant potential confounders, confirming and updating the results of the only previous meta-analysis conducted in 2017.
Topics: Humans; Diabetes Mellitus, Type 2; Vitamin D; Vitamin D Deficiency; Aged; Incidence; Risk Factors; Middle Aged; Male; Female
PubMed: 38892495
DOI: 10.3390/nu16111561 -
Brain and Behavior Jun 2024The research intended to probe the connection between the risk of stroke and serum vitamin D levels. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The research intended to probe the connection between the risk of stroke and serum vitamin D levels.
METHODS
Three electronic databases (Cochrane Library, EMBASE, PubMed) were searched according to the subject terms from inception until July 29, 2022, and retrieved researches were screened on the basis of inclusion and exclusion criteria. Two investigators conducted the quality assessment and data extraction. Using Stata 16.0 software, a meta-analysis was conducted on the extracted data.
FINDINGS
In total, 27 studies with 45,302 participants were included. Among these studies, 20 focused on stroke risk, while 7 examined stroke prognosis. According to the meta-analysis findings, it was observed that a higher stroke risk is connected to reduced levels of serum vitamin D. This association was reflected in a combined relative risk (RR) of 1 .28 (95% confidence interval (CI): 1.15-1.42) and a worse prognosis after stroke (RR = 2.95, 95% CI: 1.90-4.60). Additional analysis indicated that no apparent relationship between a decrease in vitamin D and the probability of experiencing a hemorrhagic stroke was found. The RR found was 1.93 (95% CI: 0.95-3.95). On the other hand, it was observed that a reduction in serum vitamin D levels was linked to an elevated likelihood of developing an ischemic stroke. The RR identified was 1.72 (95% CI: 1.78-2.03). Moreover, a lower level of vitamin D in the bloodstream was associated with a more unfavorable prognosis for individuals who suffered from a stroke. The RR for this correlation was 2.95 (95% CI: 1.90-4.60). However, further research is required to confirm the above-mentioned findings.
CONCLUSION
In conclusion, lower concentration vitamin D was found to be related to an increased risk of stroke, which could mainly be reflected in ischemic stroke patients but not in patients with hemorrhagic stroke. A lower serum vitamin D level was correlative with the poor prognosis of stroke.
Topics: Humans; Prognosis; Stroke; Vitamin D; Vitamin D Deficiency; Risk Factors; Ischemic Stroke
PubMed: 38873864
DOI: 10.1002/brb3.3577 -
Nutrition Journal Jun 2024This meta-analysis aims to analyze the relationship between serum vitamin D (VD) levels and Graves' disease (GD). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This meta-analysis aims to analyze the relationship between serum vitamin D (VD) levels and Graves' disease (GD).
METHODS
We conducted a search for publications on VD and GD in the English language. Our search encompassed databases such as PubMed, Embase, Web of Science, and the Cochrane Library, covering publications available through August 2023. A meta-analysis was performed using Cochrane RevMan 5.4 software. The standardized mean difference (SMD) and 95% confidence interval (CI) were used for outcome calculation. We used R software to test for publication bias.
RESULTS
Twelve studies were selected, comprising 937 (22.4%) cases with GD and 3254 (77.6%) controls. The overall meta-analysis revealed that patients with GD are significantly more likely to have low VD levels (SMD = - 0.66; 95% CI: -1.05, - 0.27; p = 0.001) than those in the control group. Egger's test results indicated no publication bias (p = 0.0791). These studies exhibited a high degree of heterogeneity (chi-square = 205.86, p < 0.00001; I = 95%). Subgroup analysis was conducted based on assay method, geographic location, and mean age of the case group to explore the heterogeneity sources. Assay methods and geographic locations were identified as potential heterogeneity sources. Based on the mean age, there were no statistically significant differences found in the subgroup analysis of the included studies.
CONCLUSION
There is promising evidence that low serum VD levels may increase the risk of GD. Further rigorous and long-term trials are needed to explore the role of VD in the onset and treatment of GD.
Topics: Humans; Graves Disease; Vitamin D; Vitamin D Deficiency
PubMed: 38849834
DOI: 10.1186/s12937-024-00960-2 -
Nutrition & Diabetes May 2024Vitamin D deficiency has been linked with several adverse maternal and fetal outcomes.
BACKGROUND
Vitamin D deficiency has been linked with several adverse maternal and fetal outcomes.
OBJECTIVE
To summarize systematic reviews and meta-analyses evaluating the effects of vitamin D deficiency and of vitamin D supplementation in pregnancy on maternal and offspring health-related outcomes.
METHODS
Prior to conducting this umbrella review, we registered the protocol in PROSPERO (CRD42022368003). We conducted searches in PubMed, Embase, and Cochrane Library for systematic reviews and meta-analyses on vitamin D in pregnancy, from database inception to October 2, 2023. All outcomes related to vitamin D in pregnancy obtained from the systematic reviews and meta-analyses were extracted.
DATA EXTRACTION
Two reviewers independently chose studies and collected information on health outcomes. The quality of the included articles' methodology was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews-2).
RESULTS
We identified 16 eligible systematic reviews and meta-analyses, which included 250,569 women. Our results demonstrated that vitamin D deficiency in pregnancy is associated with increased risk of preterm birth, small-for gestational age/low birth weight infants, recurrent miscarriage, bacterial vaginosis and gestational diabetes mellitus. Vitamin D supplementation in pregnancy increases birth weight, and reduces the risk of maternal pre-eclampsia, miscarriage, and vitamin D deficiency, fetal or neonatal mortality, as well as attention-deficit hyperactivity disorder, and autism spectrum disorder in childhood. In women with gestational diabetes mellitus, vitamin D supplementation in pregnancy can reduce the risk of maternal hyperbilirubinemia, polyhydramnios, macrosomia, fetal distress, and neonatal hospitalization.
CONCLUSION
Due to the association with adverse maternal and offspring health outcomes, we recommend the vitamin D status in pregnancy should be monitored, particularly in women at high risk of vitamin D deficiency. It is suggested that pregnant women take a dose of >400 IU/day of vitamin D supplementation during pregnancy to prevent certain adverse outcomes.
Topics: Humans; Pregnancy; Female; Vitamin D Deficiency; Vitamin D; Pregnancy Complications; Dietary Supplements; Pregnancy Outcome; Systematic Reviews as Topic; Meta-Analysis as Topic; Infant, Newborn; Premature Birth
PubMed: 38816412
DOI: 10.1038/s41387-024-00296-0 -
Frontiers in Pediatrics 2024To systematically evaluate the effect of vitamin D deficiency during pregnancy on neonatal adverse outcomes, such as preterm infants, low birth weight infants (LBWI),...
OBJECTIVE
To systematically evaluate the effect of vitamin D deficiency during pregnancy on neonatal adverse outcomes, such as preterm infants, low birth weight infants (LBWI), and small for gestational age (SGA) infants.
METHODS
A comprehensive literature search was conducted across multiple databases including PubMed, Embase, Cochrane Library, SinoMed, Wanfang Data Knowledge Service Platform, China National Knowledge Internet (CNKI), and VIP Chinese Science and Technology Journal Database (VIP). Following predefined inclusion and exclusion criteria, two researchers independently screened, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4 and Stata 14 software to synthesize the findings.
RESULTS
This study incorporated 13 cohort studies from 8 different countries and regions, encompassing a total of 55,162 pregnant women, among whom 28,155 were identified as having vitamin D deficiency. The Newcastle-Ottawa Scale (NOS) score ranged from 7-9 points. Meta-analysis results indicated a higher incidence of LBWI (OR = 5.52, 95% CI = 1.31-23.22. 0.02) in the group of pregnant women with vitamin D deficiency compared to those with adequate levels. However, there was no statistically significant difference in the likelihood of premature birth (OR = 1.25, 95% CI = 0.78-1.99. = 0.36) or SGA (OR = 1.47, 95% CI = 0.81-2.68. = 0.21) among newborns born to mothers with vitamin D deficiency vs. those with sufficient levels of vitamin D. Subgroup analysis based on the timing of maternal blood collection revealed that there was no statistically significant association between vitamin D levels during pregnancy and the incidence of preterm birth across all stages of pregnancy. Furthermore, vitamin D deficiency throughout the entire pregnancy was associated with an increased incidence of neonatal LBWI, whereas vitamin D levels during the first, second, and third trimesters did not demonstrate statistically differences on LBWI. Neonates born to mothers with vitamin D deficiency throughout pregnancy were found to have a higher likelihood of developing SGA. However, there was no statistically significant association between vitamin D levels and the development of SGA during the first and second trimesters.
CONCLUSIONS
Adequate levels of vitamin D during pregnancy may decrease the incidence of LBWI, although further research is needed to determine its impact on the occurrence of preterm birth and SGA.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024535950, (CRD42024535950).
PubMed: 38808102
DOI: 10.3389/fped.2024.1399615 -
Archives of Endocrinology and Metabolism May 2024Burosumab, a monoclonal antibody directed against the fibroblast growth factor 23 (FGF23), has been approved for the treatment of X-linked hypophosphatemia (XLH). We... (Comparative Study)
Comparative Study
Burosumab, a monoclonal antibody directed against the fibroblast growth factor 23 (FGF23), has been approved for the treatment of X-linked hypophosphatemia (XLH). We conducted a systematic review to compare the efficacy and safety of burosumab versus conventional therapy (phosphorus and calcitriol) on XLH treatment. After a comprehensive literature search on MEDLINE/PubMed and Embase, we found nine studies for inclusion in the analysis. Risk of bias was assessed, and a random-effects model was used to determine the effect size. Clinical, biochemical, and radiological parameters of disease severity before and after treatment were analyzed and expressed in standardized mean difference (SMD). Burosumab resulted in normalization of phosphate homeostasis with an increase in renal tubular phosphate reabsorption and significant resolution of skeletal lesions (change in Thacher's total rickets severity score SMD: -1.46, 95% confidence interval [CI]: -1.76 to -1.17, < 0.001, improvement in deformities, and decline in serum alkaline phosphatase levels [SMD: 130.68, 95% CI: 125.26-136.1, < 0.001)]. Conventional therapy led to similar improvements in all these parameters but to a lower degree. In adults, burosumab normalized phosphorus levels (SMD: 1.23, 95% CI: 0.98-1.47, < 0.001) with resultant clinical improvement. Burosumab treatment was well tolerated, with only mild treatment-related adverse effects. The present review indicates a potential role for burosumab in improving rickets, deformities, and growth in children with XLH. Given its superior efficacy and safety profile, burosumab could be an effective therapeutic option in children. We suggest further studies comparing burosumab versus conventional therapy in children and adults with XLH.
Topics: Humans; Familial Hypophosphatemic Rickets; Antibodies, Monoclonal, Humanized; Fibroblast Growth Factor-23; Treatment Outcome; Calcitriol; Antibodies, Monoclonal; Phosphorus
PubMed: 38788147
DOI: 10.20945/2359-4292-2023-0242 -
PloS One 2024Acute respiratory infections (ARIs) have a substantial impact on morbidity, healthcare utilization, and functional decline among older adults. Therefore, we... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Acute respiratory infections (ARIs) have a substantial impact on morbidity, healthcare utilization, and functional decline among older adults. Therefore, we systematically reviewed evidence from randomized controlled trials (RCTs) to evaluate the efficacy and safety of vitamin D supplementation in preventing ARIs in older adults.
METHODS
PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov were searched until 1 February 2024. RCTs evaluating the use of vitamin D supplements to protect older adults from ARIs were included. Two reviewers independently screened papers, extracted the data and assessed the risk of bias. Data were summarised as relative risks (RRs) or odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Random effects meta-analyses were used to synthesise the results. GRADE was used to evaluate the quality of evidence. All the analysis were performed with Stata version 17.
RESULTS
Twelve trials (41552 participants) were included in the meta-analysis. It showed that vitamin D supplementation probably does not reduce the incidence of ARIs (RR, 0.99; 95% CI, 0.97-1.02, I2 = 0%; moderate certainty). No significant effect of vitamin D supplementation on the risk of ARI was observed for any of the subgroups defined by baseline 25(OH)D concentration, control treatments, dose frequency, study duration, and participants' condition. However, there was a possibility, although not statistically significant, that vitamin D may reduce the risk of ARI in patients with a baseline 25(OH)D concentration <50 nmol/L (OR, 0.90; 95% CI, 0.79-1.04, I2 = 14.7%). Additionally, vitamin D supplements might result in little to no difference in death due to any cause, any adverse event, hypercalcinemia, and kidney stones.
CONCLUSIONS
Vitamin D supplementation among older adults probably results in little to no difference in the incidence of ARIs. However, further evidence is needed, particularly for individuals with vitamin D deficiency and populations residing in low and middle income countries.
TRIAL REGISTRATION
This study was registered on PROSPERO (CRD42023451265).
Topics: Humans; Vitamin D; Respiratory Tract Infections; Dietary Supplements; Aged; Acute Disease; Randomized Controlled Trials as Topic
PubMed: 38787821
DOI: 10.1371/journal.pone.0303495