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1.
Effect of Vitamin D Deficiency on Liver Cancer Risk: A Systematic Review and Meta-Analysis.
Yi, Z, Wang, L, Tu, X
Asian Pacific journal of cancer prevention : APJCP. 2021;(4):991-997
Abstract
UNLABELLED Epidemiological studies have showed that vitamin D deficiency can increase the risk of liver cancers. Hence, we conducted a meta-analysis to explore the relationship between 25-hydroxyvitamin D [25(OH)D] levels and liver cancer risk. METHODS Cochrane Library, Medline, Web of Science, and Embase were searched up to Mar. 2020, and the references of those studies were also searched by hand. A meta-analysis of 11 studies was performed which met the inclusion criteria. Six case-control studies and five cohort studies were included. RESULTS A total of 11 studies (6 case-control and 5 cohort studies) with 12,895 incident cases were included in the meta-analysis. The meta-analysis showed that liver cancer risk was significantly increased for vitamin D deficiency, and the pooled RR and its 95% CIs was 2.16 (1.2, 3.88; P = 0.01). In comparative analyses between 25(OH)D levels in patients with hepatocellular carcinoma(HCC) and those in the control group individuals, the summary RR of liver cancer was -1.11 (95% CI=-1.96 to -0.25). The subgroup analysis of the different geographical region of the population showed that the risk of liver cancer in Asian subgroup, European subgroup and Egyptian subgroup increased for vitamin D deficiency (RR=1.34,95% CI 0.72 to 2.48, p <0.00001; RR=2.53,95% CI 1.62 to 3.93,p <0.0001;RR=29.5,95% CI 4.14 to 209.93, P=0.88). CONCLUSION The results of this meta-analysis indicate that vitamin D deficiency is associated with increased risk of liver cancer. The 25(OH)D3 levels are lower in HCC patients than those in health controls. Maintenance of sufficient serum vitamin D levels would be beneficial for prevention of liver cancer.
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2.
Low vitamin D status is associated with coronavirus disease 2019 outcomes: a systematic review and meta-analysis.
Liu, N, Sun, J, Wang, X, Zhang, T, Zhao, M, Li, H
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2021;:58-64
Abstract
BACKGROUND Observational studies suggest that the risk and clinical prognosis of coronavirus disease 2019 (COVID-19) are related to low vitamin D status; however, the data are inconsistent. OBJECTIVES We conducted a systematic review and meta-analysis to assess the association between low vitamin D status and COVID-19. METHODS A systematic search was conducted with PubMed, Embase, and the Cochrane Library from database inception to September 25, 2020. The standardized mean difference (SMD) or odds ratio (OR) and corresponding 95% confidence interval (CI) was applied to estimate pooled results. Random - or fixed-effect models based on heterogeneity were used for the meta-analysis. Funnel plots and Egger regression tests were used to assess publication bias. RESULTS A total of ten articles with 361,934 participants were selected for meta-analysis. Overall, the pooled OR in the fixed-effect model showed that vitamin D deficiency or insufficiency was associated with an increased risk of COVID-19 (OR = 1.43, 95% CI 1.00-2.05). In addition, COVID-19-positive individuals had lower vitamin D levels than COVID-19-negative individuals (SMD = -0.37, 95% CI = -0.52 to -0.21). Significant heterogeneity existed in both endpoints. Funnel plots and Egger regression tests revealed significant publication bias. CONCLUSIONS This systematic review and meta-analysis indicated that low vitamin D status might be associated with an increased risk of COVID-19 infection. Further studies are needed to evaluate the impact of vitamin D supplementation on the clinical severity and prognosis in patients with COVID-19. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no: CRD42020216740.
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3.
Vitamin D and Type 1 Diabetes Risk: A Systematic Review and Meta-Analysis of Genetic Evidence.
Najjar, L, Sutherland, J, Zhou, A, Hyppönen, E
Nutrients. 2021;(12)
Abstract
Several observational studies have examined vitamin D pathway polymorphisms and their association with type 1 diabetes (T1D) susceptibility, with inconclusive results. We aimed to perform a systematic review and meta-analysis assessing associations between selected variants affecting 25-hydroxyvitamin D [25(OH)D] and T1D risk. We conducted a systematic search of Medline, Embase, Web of Science and OpenGWAS updated in April 2021. The following keywords "vitamin D" and/or "single nucleotide polymorphisms (SNPs)" and "T1D" were selected to identify relevant articles. Seven SNPs (or their proxies) in six genes were analysed: CYP2R1 rs10741657, CYP2R1 (low frequency) rs117913124, DHCR7/NADSYN1 rs12785878, GC rs3755967, CYP24A1 rs17216707, AMDHD1 rs10745742 and SEC23A rs8018720. Seven case-control and three cohort studies were eligible for quantitative synthesis (n = 10). Meta-analysis results suggested no association with T1D (range of pooled ORs for all SNPs: 0.97-1.02; p > 0.01). Heterogeneity was found in DHCR7/NADSYN1 rs12785878 (I2: 64.8%, p = 0.02). Sensitivity analysis showed exclusion of any single study did not alter the overall pooled effect. No association with T1D was observed among a Caucasian subgroup. In conclusion, the evidence from the meta-analysis indicates a null association between selected variants affecting serum 25(OH)D concentrations and T1D.
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4.
The association between vitamin D and acute rejection in human kidney transplantation: A systematic review and meta-analysis study.
Mirzakhani, M, Mohammadkhani, S, Hekmatirad, S, Aghapour, S, Gorjizadeh, N, Shahbazi, M, Mohammadnia-Afrouzi, M
Transplant immunology. 2021;:101410
Abstract
BACKGROUND Vitamin D (VitD) deficiency is associated with several diseases such as multiple sclerosis, rheumatoid arthritis, respiratory infection, and so forth. In the field of transplantation (kidney transplantation), some studies reported that patients with VitD deficiency are of increased chance of acute rejection, but other studies did not show such a chance. On the other hand, since VitD is a modulatory factor and can reduce the inflammatory response, understanding the exact role of it in transplantation may contribute to tolerance condition in these patients. METHODS The electronic databases, including PubMed, Scopus, Embase, ProQuest, Web of Science, and Google Scholar, were searched for eligible studies. In general, 14 studies with a total of 4770 patients were included in this meta-analysis. Regarding the methodological heterogeneity, we selected a random-effects combination model. Moreover, OR was chosen as an effect size for this study. RESULTS After the combination of 14 studies, we showed that patients in the VitD-deficient group had an 82% increased chance of acute rejection compared with patients in the VitD-sufficient group, and this effect was significant (OR 1.82; 95% confidence interval [CI] [1.29, 2.56]; I2 = 52.3%). This result was significant, and, regarding the narrow CI, it can be a conclusive result. Study quality and gender variables were the main sources of inconsistent results in the primary studies. Moreover, using meta-regression, we showed that VitD deficiency (independent from the estimated glomerular filtration rate (eGFR) of patients) increased the chance of acute rejection. CONCLUSION The normal VitD status of patients a few days before and after transplantation can reduce the chance of acute rejection.
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5.
Maternal vitamin D status and risk of gestational diabetes mellitus: A systematic review and meta-analysis of prospective cohort studies.
Milajerdi, A, Abbasi, F, Mousavi, SM, Esmaillzadeh, A
Clinical nutrition (Edinburgh, Scotland). 2021;(5):2576-2586
Abstract
BACKGROUND No earlier systematic review and meta-analysis have been done on the association between maternal serum vitamin D status and risk of GDM among prospective studies. The current study was done to systematically review prospective cohort studies (with several years of follow-up) on the association between maternal serum vitamin D deficiency or insufficiency and risk of GDM. METHODS Relevant papers published up to January 2020 were searched through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar using suitable keywords. All prospective cohort studies reporting Hazard Ratios (HRs) or Relative Risks (RRs) and 95% Confidence Intervals (CI) for GDM across categories of maternal serum vitamin D status were included. RESULTS A total of 29 prospective and nested case-control studies were included in the current systematic review, of which 27 studies had sufficient data for the meta-analysis. Individuals with vitamin D deficiency had a 26% greater risk of developing GDM than those with normal serum vitamin D concentrations (OR: 1.26; 95% CI: 1.13, 1.41). In addition, a significant positive association was seen between combined vitamin D insufficiency and deficiency and risk of developing GDM (OR: 1.23; 95% CI: 1.11, 1.35). Dose-response analysis showed a significant U-shaped non-linear association between serum vitamin D concentrations and risk of developing GDM (P < 0.001), such that those with serum vitamin D concentrations between 40 and 90 nmol/L had significantly reduced risk of GDM. CONCLUSIONS We found a significant association between vitamin D deficiency and an increased risk of GDM. The lowest risk of GDM was found among those with a serum vitamin D levels of 40-90 nmol/L. Further studies, including randomized clinical trials, are needed to confirm our findings. REGISTRATION PROSPERO (ID: 180722), https://www.crd.york.ac.uk/prospero/.
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6.
Association between serum vitamin D levels and venous thromboembolism (VTE): A systematic review and meta-analysis of observational studies.
Wan, J, Yuan, J, Li, X, Bao, Y, Hou, Y, Li, Z, Tan, SC, Low, TY, Chu, Y
Complementary therapies in medicine. 2020;:102579
Abstract
OBJECTIVE Although many studies have attempted to unravel the relationship between vitamin D deficiency and the incidence of VTE, the results remained inconsistent. To address this discrepancy, we performed a systematic review and meta-analysis to precisely disentangle the relationship between serum vitamin D levels and VTE risk. METHODS The Web of Science, Scopus, PubMed/Medline, Embase, and Google Scholar databases were searched for all available observational studies that reported the risk of venous thromboembolism (VTE) based on serum vitamin D levels categories. The search was performed up to March 2020. RESULTS Seven studies were included. The overall analysis showed a significantly increased risk of VTE in subjects with low levels of serum vitamin D compared with those with normal vitamin D levels (RR = 1.34; 95% CI: 1.07-1.69; P = 0.011). In a sensitivity analysis, we did not observe a significant effect of any individual study on the combined effect sizes. Nevertheless, significant heterogeneity was present among the studies (Cochrane Q test, p = 0.018, I2 = 61%). In the stratified analysis, low vitamin D levels were positively associated with an increased risk of VTE in prospective population-based studies (RR = 1.31; 95% CI: 1.06-1.61; P = 0.010) and in subjects below 60 years old (RR = 1.28; 95% CI: 1.07-1.54; P = 0.060). CONCLUSION our systematic review and meta-analysis showed that a low serum vitamin D level was indeed associated with an increased risk of VTE.
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7.
Low Vitamin D Levels and Frailty Status in Older Adults: A Systematic Review and Meta-Analysis.
Marcos-Pérez, D, Sánchez-Flores, M, Proietti, S, Bonassi, S, Costa, S, Teixeira, JP, Fernández-Tajes, J, Pásaro, E, Valdiglesias, V, Laffon, B
Nutrients. 2020;(8)
Abstract
Serum vitamin D deficiency is widespread among older adults and is a potential modifiable risk factor for frailty. Moreover, frailty has been suggested as an intermediate step in the association between low levels of vitamin D and mortality. Hence, we conducted a systematic review of the literature and meta-analysis to test the possible association of low concentrations of serum 25-hydroxyvitamin D (25(OH)D), a marker of vitamin D status, with frailty in later life. We reviewed cross-sectional or longitudinal studies evaluating populations of older adults and identifying frailty by a currently validated scale. Meta-analyses were restricted to cross-sectional data from studies using Fried's phenotype to identify frailty. Twenty-six studies were considered in the qualitative synthesis, and thirteen studies were included in the meta-analyses. Quantitative analyses showed significant differences in the comparisons of frail (standardized mean difference (SMD)-1.31, 95% confidence interval (CI) (-2.47, -0.15), p = 0.0271) and pre-frail (SMD-0.79, 95% CI (-1.58, -0.003), p = 0.0491) subjects vs. non-frail subjects. Sensitivity analyses reduced heterogeneity, resulting in a smaller but still highly significant between-groups difference. Results obtained indicate that lower 25(OH)D levels are significantly associated with increasing frailty severity. Future challenges include interventional studies testing the possible benefits of vitamin D supplementation in older adults to prevent/palliate frailty and its associated outcomes.
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8.
Vitamin D deficiency is not associated with graft versus host disease after hematopoietic stem cell transplantation: A meta-analysis.
Chiengthong, K, Cheungpasitporn, W, Thongprayoon, C, Lertjitbanjong, P, Cato, LD, Bathini, T, Ungprasert, P, Mao, MA, Chokesuwattanaskul, R
Journal of evidence-based medicine. 2020;(3):183-191
Abstract
OBJECTIVE Vitamin D status plays an important role in immunoregulation, and a deficiency is believed to be related to Graft Versus Host Disease (GVHD) in patients after hematopoietic stem cell transplantation (HSCT). We aim to study the association between vitamin D deficiency and GVHD after HSCT. METHODS A literature search was conducted utilizing MEDLINE, EMBASE, and The Cochrane Library Database from inception to July 2019. Eligible studies were required to1 be clinical trials or observational studies (cohort, case-control, or cross-sectional studies);2 provide data to calculate the odds ratios (OR) of GVHD in HSCT patients with vitamin D deficiency. Two reviewers independently extracted the data and assessed the risk of bias. Pooled odds ratios (OR) with 95% confidence interval (CI) were estimated using random-effects meta-analysis through the Comprehensive Meta-Analysis 3.3 software. RESULTS In total, 8 observational studies consisting of 1335 HSCT patients were enrolled in this systematic review. Overall, there was no significant association between vitamin D deficiency and acute GVHD (OR = 1.06, 95% CI 0.74-1.53, P > 0.05). There was no significant association between vitamin D deficiency and chronic GVHD (OR = 1.75, 95% CI 0.72-4.26, P > 0.05). Funnel plots and Egger regression asymmetry test were performed and showed no publication bias. CONCLUSION There is not a statistically significant association between vitamin D deficiency and neither acute nor chronic GVHD.
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9.
Is there an association between vitamin D and diabetic foot disease? A meta-analysis.
Yammine, K, Hayek, F, Assi, C
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society. 2020;(1):90-96
Abstract
It has been demonstrated that Vitamin D (25(OH)D) deficiency is associated with diabetes and with diabetic neuropathy. Some reports stated that vitamin D deficiency is also associated with diabetic foot ulcer and/or infection. Knowing the beneficial effect of vitamin D on wound healing, a quantitative evidence synthesis is needed to look for such association. Medline, Embase, Scopus, CINAHL, Cochrane Library, and Google Scholar were searched for from inception. The outcomes were set to be either the serum 25(OH)D level or the prevalence of patients with 25(OH)D with severe deficiency. Ten studies met the inclusion criteria with 1,644 patients; 817 diabetic patients with foot ulcers and 827 patients having diabetes without foot complications. The weighted mean differences was -0.93 (95% CI = -1.684 to -0.174, I2 = 97.8%, p = 0.01). The odds ratio of having severe vitamin D deficiency was 3.6 (95% CI = 2.940 to 4.415, I2 = 40.9%, p < 0.0001), in favor of the foot group. The quality of the included studies was found to be good to excellent. Diabetic foot complications are associated with significantly lower levels of vitamin D. Patients with diabetic ulcers or diabetic infection are at higher risk of bearing severe vitamin D deficiency. Knowing the beneficial effect of vitamin D on wound healing, it is likely that recognizing and supplementing with vitamin D could prevent or improve the outcomes of diabetic foot complications.
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10.
The Association Between Vitamin D Deficiency and Recurrent Tonsillitis: A Systematic Review and Meta-analysis.
Mirza, AA, Alharbi, AA, Marzouki, H, Al-Khatib, T, Zawawi, F
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2020;(5):883-891
Abstract
OBJECTIVES The role of vitamin D deficiency has been linked with recurrent upper respiratory tract infections, but its impact on the frequency of tonsillitis is not yet fully understood. The objective of this study is to determine the association between vitamin D deficiency and recurrent tonsillitis based on current literature. DATA SOURCE A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Data were collected from online medical databases (PubMed, MEDLINE, EMBASE, and Cochrane Collaboration Registry of Controlled Trials). REVIEW METHODS All studies addressing the association of vitamin D deficiency and recurrent tonsillitis prior to March 2019. The data were collected in different phases: screening review using search words and controlled vocabularies followed by detailed review of screened articles based on inclusion and exclusion criteria, then a full review that included screening the references of selected articles. RESULTS Fifty-three studies were potentially eligible; of these, 4 publications met the inclusion criteria and were included in the quantitative synthesis. There was a statistically significant reduction of vitamin D levels in patients with recurrent tonsillitis as compared to healthy controls (mean difference, -10.71; 95% CI, -19.12 to -2.31; P = .01). The odds of vitamin D insufficiency were significantly higher in patients with recurrent tonsillitis as compared to the control group (odds ratio, 4.37; 95% CI, 2.78-6.88; P < .001). CONCLUSION Vitamin D deficiency was present in patients with recurrent tonsillitis and might be associated with an increase in the risk of recurrent tonsillitis. There is a need to explore these findings via clinical trials based on large populations.