scholarly journals The association between vitamin D concentration and pain: a systematic review and meta-analysis

2018 ◽  
Vol 21 (11) ◽  
pp. 2022-2037 ◽  
Author(s):  
Zhenqiang Wu ◽  
Zarintaj Malihi ◽  
Alistair W Stewart ◽  
Carlene MM Lawes ◽  
Robert Scragg
Keyword(s):  
Vitamin D ◽  
Muscle Pain ◽  
Observational Studies ◽  
Meta Analysis ◽  
Hypovitaminosis D ◽  
Chronic Widespread Pain ◽  
Sensitivity Analyses ◽  
Observational Research ◽  
Cochrane Central Register ◽  
Widespread Pain

AbstractObjectivePain-related conditions, such as chronic widespread pain and fibromyalgia, are major burdens for individuals and the health system. Evidence from previous research on the association between circulating 25-hydroxyvitamin D (25(OH)D) concentrations and pain is conflicting. Thus, we aimed to determine if there is an association between mean 25(OH)D concentration (primary aim), or proportion of hypovitaminosis D (secondary aim), and pain conditions in observational studies.DesignPublished observational research on 25(OH)D concentration and pain-related conditions was systematically searched for in electronic sources (MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials) and a random-effects meta-analysis was conducted on included studies.ResultsEighty-one observational studies with a total of 50 834 participants were identified. Compared with controls, mean 25(OH)D concentration was significantly lower in patients with arthritis (mean difference (MD): −12·34 nmol/l;P<0·001), muscle pain (MD: −8·97 nmol/l;P=0·003) and chronic widespread pain (MD: −7·77 nmol/l;P<0·001), but not in patients with headache or migraine (MD: −2·53 nmol/l;P=0·06). The odds of vitamin D deficiency was increased for arthritis, muscle pain and chronic widespread pain, but not for headache or migraine, compared with controls. Sensitivity analyses revealed similar results.ConclusionsA significantly lower 25(OH)D concentration was observed in patients with arthritis, muscle pain and chronic widespread pain, compared with those without. These results suggest that low 25(OH)D concentrations may be associated with pain conditions.

scholarly journals Is Serum Hypovitaminosis D Associated with Chronic Widespread Pain Including Fibromyalgia? A Meta-analysis of Observational Studies

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. E877-E887 ◽  
Author(s):  
Ke-Vin Chang
Keyword(s):  
Vitamin D ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Serum Vitamin ◽  
Hypovitaminosis D ◽  
Chronic Widespread Pain ◽  
Widespread Pain ◽  
Serum Vitamin D ◽  
Meta Regression ◽  
Definition Of

Background: Chronic widespread pain (CWP) is a global musculoskeletal disorder leading to disability and a reduced quality of life. Low levels of serum vitamin D has long been proposed to be associated with CWP, but previous research remains inconclusive. Objectives: To determine whether hypovitaminosis D was independently associated with CWP. Study Design: Meta-analysis of observational study. Methods: Electronic databases were searched for studies published up to November 2014 comparing the prevalence of hypovitaminosis D and serum vitamin D levels between participants with and without CWP. The crude and adjusted odds ratios (ORs) of hypovitaminosis D with CWP were calculated. Subgroup analysis according to gender, threshold of hypovitaminosis, and definition of patients was performed, as well as meta-regression to test the linear relationship between crude ORs and the latitude of study locations. Results: Twelve studies were included, comprising 1,854 patients with CWP. The patient group showed a significantly higher risk of hypovitaminosis D than the control group (crude OR, 1.63; 95% CI, 1.20 – 2.23). The association was slightly attenuated after adjusting confounders, with a pooled adjusted OR of 1.41 (95% CI, 1.00 – 2.00). There was an increase in ORs of hypovitaminosis D using a lower diagnostic value of serum vitamin D (8 and 10 ng/mL). The subgroup analysis according to gender and definition of CWP did not reveal significant between-group differences. The meta-regression showed no linear relationship between latitude and the crude ORs. Conclusions: There was a positive crude association between hypovitaminosis D and CWP, and the association was likely to remain after adjusting confounding factors. Use of a cut-off value of hypovitaminosis D (8 – 10 ng/mL) could better define the population with and without CWP. Further prospective follow-up studies are warranted to clarify the causal relationship between hypovitaminosis D and CWP. Key words: Vitamin D, fibromyalgia, chronic widespread pain, meta-analysis

scholarly journals Study of hypovitaminosis D as a cause of chronic widespread pain in patients presenting to rheumatology clinic

2014 ◽  
Vol 3 (1) ◽  
pp. 1-4
Author(s):  
Binit Vaidya ◽  
Shweta Nakarmi ◽  
Arvind Chaudhary ◽  
Poojan Batajoo ◽  
Nija Rajbhandari
Keyword(s):  
Vitamin D ◽  
Serum Vitamin ◽  
Visual Analogue Score ◽  
Hypovitaminosis D ◽  
Chronic Widespread Pain ◽  
Response To Therapy ◽  
Widespread Pain ◽  
Serum Vitamin D ◽  
Severe Deficiency ◽  
Vitamin D Levels

Background and aims: Hypovitaminosis D is common in south-east Asian countries. Deficient vitamin-D level is likely to be associated with chronic muscular pains. We do not have data from our country regarding the magnitude of this problem. Methods: A prospective open labeled study at rheumatology opd from December 2009 to December 2012. Patients with chronic widespread pain and bone pains of >3 months duration were included in the study. Hypothyroidism, chronic renal failure and other rheumatological diagnosis except fibromyalgia were excluded. Visual analogue score (VAS) for pain and serum Vitamin-D levels were measured. Patients with low Vitamin-D were given oral Vitamin-D 60,000IU for 6 months. Response to therapy was evaluated using improvement in VAS. Results: Among 1680 patients, 66?2% were females. Hypovitaminosis-D was seen in 1388(82?6%), of which 27?5% had severe deficiency with Vitamin D levels <10ng/ml. Fibromyalgia overlap present in 25?7%. Mean initial VAS score was 8?7, 8?2 and 7?4 for patients in severe deficiency, mild deficiency and insufficiency group respectively. At 6 months follow-up, the VAS scores were 0, 2?1 and 3?6 respectively. After 6 months of treatment, no improvement was seen in 196 patients (11?6%) and all non-responders had fibromyalgia overlap. Vitamin- D level was checked again in non-responders and repeat vitamin-D levels were still low in 10 of them. Conclusions: Hypovitaminosis-D can be a significant cause of Chronic widespread pain in the general population and seems to aggravate the pain of fibromyalgia. Improvement was rapid and better in severe cases. DOI: http://dx.doi.org/10.3126/jaim.v3i1.10694 Journal of Advances in Internal Medicine 2014;03(01):1-4

scholarly journals Circulating Vitamin D Levels and Risk of Vitiligo: Evidence From Meta-Analysis and Two-Sample Mendelian Randomization

2021 ◽  
Vol 8 ◽  
Author(s):  
Jie Song ◽  
Ke Liu ◽  
Weiwei Chen ◽  
Bin Liu ◽  
Hong Yang ◽  
...  
Keyword(s):  
Vitamin D ◽  
Observational Studies ◽  
Mendelian Randomization ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Genome Wide Association Studies ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
25 Hydroxyvitamin D

Background: The association between circulating vitamin D levels and risk of vitiligo was inconsistent among observational studies, and whether these observed associations were causal remained unclear. Therefore, we aimed to evaluate the effect of vitamin D on the risk of vitiigo using meta-analysis and Mendelian randomization (MR).Methods: At the meta-analysis stage, literature search was performed in PubMed and Web of Science to identify eligible observational studies examining the association of circulating 25-hydroxyvitamin D [25(OH)D] or 25-hydroxyvitamin D3 [25(OH)D3] levels with risk of vitiligo up to April 30, 2021. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) of 25(OH)D and 25(OH)D3 in patients with vitiligo relative to controls were pooled. Then at the MR stage, genetic instruments for circulating 25(OH)D (N = 120,618) and 25(OH)D3 (N = 40,562) levels were selected from a meta-analysis of genome-wide association studies (GWAS) of European descent, and summary statistics of vitiligo were obtained from a meta-analysis of three GWASs including 4,680 cases and 39,586 controls. We used inverse-variance weighted (IVW) as main method, followed by weighted-median and likelihood-based methods. Pleiotropic and outlier variants were assessed by MR-Egger regression and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test.Results: In the meta-analysis, patients with vitiligo had a lower level of circulating 25(OH)D compared with controls [SMD = −1.40; 95% confidence interval (CI): −1.91, −0.89; P &lt; 0.001], while no statistically significant difference of 25(OH)D3 between vitiligo cases and controls was found (SMD = −0.63; 95% CI: −1.29, 0.04; P = 0.064). However, in the MR analyses, genetically predicted 25(OH)D [odds ratio (OR) = 0.93, 95% CI = 0.66–1.31, P = 0.66] and 25(OH)D3 levels (OR = 0.95, 95% CI = 0.80–1.14, P = 0.60) had null associations with risk of vitiligo using the IVW method. Sensitivity analyses using alternative MR methods and instrumental variables (IV) sets obtained consistent results, and no evidence of pleiotropy or outliers was observed.Conclusion: Our study provided no convincing evidence for a causal effect of 25(OH)D or 25(OH)D3 levels on the risk of vitiligo. Further longitudinal and experimental studies, as well as functional studies are warranted to elucidate the role of vitamin D in the development of vitiligo.

scholarly journals Prognostic and therapeutic role of vitamin D in COVID-19: systematic review and meta-analysis

2021 ◽  
Author(s):  
Harsha Anuruddhika Dissanayake ◽  
Nipun Lakshitha de Silva ◽  
Manilka Sumanatilleke ◽  
Sawanawadu Dilantha Neomal de Silva ◽  
Kavinga Kalhari Kobawaka Gamage ◽  
...  
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Vitamin D Deficiency ◽  
Observational Studies ◽  
Meta Analysis ◽  
Severe Disease ◽  
Risk Of Bias ◽  
Sensitivity Analyses ◽  
Cochrane Library

Abstract Purpose Vitamin D deficiency/insufficiency may increase the susceptibility to COVID-19. We aimed to determine the association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, its severity, mortality and role of vitamin D in its treatment. Methods We searched CINHAL, Cochrane library, EMBASE, PubMED, Scopus, and Web of Science up to 30.05.2021 for observational studies on association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, severe disease and death among adults, and, randomized controlled trials (RCTs) comparing vitamin D treatment against standard care or placebo, in improving severity or mortality among adults with COVID-19. Risk of bias was assessed using Newcastle-Ottawa scale for observational studies and AUB-KQ1 Cochrane tool for RCTs. Study-level data were analyzed using RevMan 5.3 and R (v4∙1∙0). Heterogeneity was determined by I  2 and sources were explored through pre-specified sensitivity analyses, subgroup analyses and meta-regressions. Results Of 1877 search results, 76 studies satisfying eligibility criteria were included. Seventy-two observational studies were included in the meta-analysis (n=1976099). Vitamin D deficiency/insufficiency increased the odds of developing COVID-19 (OR 1∙46, 95% CI 1∙28–1∙65, p&lt;0∙0001, I  2=92%), severe disease (OR 1∙90, 95% CI 1∙52–2∙38, p&lt;0.0001, I  2=81%) and death (OR 2∙07, 95% CI 1∙28–3∙35, p=0.003, I  2=73%). 25-hydroxy vitamin D (25(OH)D) concentration were lower in individuals with COVID-19 compared to controls (mean difference [MD] -3∙85 ng/mL, 95% CI -5∙44,-2∙26, p=&lt;0.0001), in patients with severe COVID-19 compared to controls with non-severe COVID19 (MD -4∙84 ng/mL, 95% CI -7∙32,-2∙35, p=0∙0001) and in non-survivors compared to survivors (MD -4∙80 ng/mL, 95%-CI -7∙89,-1∙71, p=0∙002). The association between vitamin D deficiency/insufficiency and death was insignificant when studies with high risk of bias or studies reporting unadjusted effect estimates were excluded. Risk of bias and heterogeneity were high across all analyses. Discrepancies in timing of vitamin D testing, definitions of severe COVID-19 and vitamin D deficiency/insufficiency partly explained the heterogeneity. Four RCTs were widely heterogeneous precluding meta-analysis. Conclusion Multiple observational studies involving nearly two million adults suggest vitamin D deficiency/insufficiency increases susceptibility to COVID-19 and severe COVID-19, although with a high risk of bias and heterogeneity. Association with mortality was less robust. Heterogeneity in RCTs precluded their meta-analysis.

scholarly journals Insulin Resistance Is Inversely Associated with the Status of Vitamin D in Both Diabetic and Non-Diabetic Populations

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1742
Author(s):  
Shamaila Rafiq ◽  
Per Bendix Jeppesen
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Observational Studies ◽  
Meta Analysis ◽  
Hypovitaminosis D ◽  
The Body ◽  
Healthy Population ◽  
The Status

Vitamin D has been implicated in the regulation of glucose metabolism and insulin resistance. We designed this study to provide evidence that insulin resistance is dependent on the concentration of vitamin D in the body. Forty observational studies of both type 2 diabetes mellitus patients and healthy subjects were included in this meta-analysis. Related articles were searched from Embase, PubMed, and Medline through January 2021. Filters for search were used to obtain more focused results. We used Comprehensive Meta-Analysis Version 3 for the construction of forest plots. RevMan software version 5.3 was used to build the risk of bias tables and summary plots. The observational studies included in this systematic review and meta-analysis showed an inverse relationship of insulin resistance with the status of vitamin D both in non-diabetic (r = −0.188; 95% CI = −0.141 to −0.234; p = 0.000) and diabetic (r = −0.255; 95% CI = −0.392 to −0.107, p = 0.001) populations. From the meta-analysis we concluded that hypovitaminosis D is related to increased levels of insulin resistance in both type 2 diabetes patients and the healthy population all over the world.

scholarly journals Interventional radiology versus operative management for splenic injuries: a study protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028172
Author(s):  
Masahiro Kashiura ◽  
Noritaka Yada ◽  
Kazuma Yamakawa
Keyword(s):  
Systematic Review ◽  
Interventional Radiology ◽  
Meta Analysis ◽  
Operative Management ◽  
Sensitivity Analyses ◽  
Definitive Treatment ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Statistical Heterogeneity ◽  
Non Operative Management

IntroductionOver the past decades, the treatment for blunt splenic injuries has shifted from operative to non-operative management. Interventional radiology such as splenic arterial embolisation generally increases the success rate of non-operative management. However, the type of intervention, such as the first definitive treatment for haemostasis (interventional radiology or surgery) in blunt splenic injuries is unclear. Therefore, we aim to clarify whether interventional radiology improves mortality in patients with blunt splenic trauma compared with operative management by conducting a systematic review and meta-analysis.Methods and analysisWe will search the following electronic bibliographic databases to retrieve relevant articles for the literature review: Medline, Embase and the Cochrane Central Register of Controlled Trials. We will include controlled trials and observational studies published until September 2018. We will screen search results, assess the study population, extract data and assess the risk of bias. Two review authors will extract data independently, and discrepancies will be identified and resolved through a discussion with a third author where necessary. Data from eligible studies will be pooled using a random-effects meta-analysis. Statistical heterogeneity will be assessed by using the Mantel-Haenszel χ² test and the I² statistic, and any observed heterogeneity will be quantified using the I² statistic. We will conduct sensitivity analyses according to several factors relevant for the heterogeneity.Ethics and disseminationOur study does not require ethical approval as it is based on the findings of previously published articles. This systematic review will provide guidance on selecting a method for haemostasis of splenic injuries and may also identify knowledge gaps that could direct further research in the field. Results will be disseminated through publication in a peer-reviewed journal and presentations at relevant conferences.PROSPERO registration numberCRD42018108304.

Use of Statins and Breast Cancer: A Meta-Analysis of Seven Randomized Clinical Trials and Nine Observational Studies

2005 ◽  
Vol 23 (34) ◽  
pp. 8606-8612 ◽  
Author(s):  
Stefanos Bonovas ◽  
Kalitsa Filioussi ◽  
Nikolaos Tsavaris ◽  
Nikolaos M. Sitaras
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Publication Bias ◽  
Observational Studies ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Fixed Effects Model

Purpose A growing body of evidence suggests that statins may have chemopreventive potential against breast cancer. Laboratory studies demonstrate that statins induce apoptosis and reduce cell invasiveness in various cell lines, including breast carcinoma cells. However, the clinical relevance of these data remains unclear. The nonconclusive nature of the epidemiologic data prompted us to conduct a detailed meta-analysis of the studies published on the subject in peer-reviewed literature. Patients and Methods A comprehensive search for articles published up until 2005 was performed; reviews of each study were conducted; and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random and the fixed-effects models. Subgroup and sensitivity analyses were also performed. Results Seven large randomized trials and nine observational studies (five case-control and four cohort studies) contributed to the analysis. We found no evidence of publication bias or heterogeneity among the studies. Statin use did not significantly affect breast cancer risk (fixed effects model: RR = 1.03; 95% CI, 0.93 to 1.14; random effects model: RR = 1.02; 95% CI, 0.89 to 1.18). When the analyses were stratified into subgroups, there was no evidence that study design substantially influenced the estimate of effects. Furthermore, the sensitivity analysis confirmed the stability of our results. Conclusion Our meta-analysis findings do not support a protective effect of statins against breast cancer. However, this conclusion is limited by the relatively short follow-up times of the studies analyzed. Further studies are required to investigate the potential decrease in breast cancer risk among long-term statin users.

scholarly journals Maternal Vitamin D Status and Risk of Gestational Diabetes: a Meta-Analysis

2018 ◽  
Vol 45 (1) ◽  
pp. 291-300 ◽  
Author(s):  
Lingmin Hu ◽  
Yue Zhang ◽  
Xing Wang ◽  
Lianghui You ◽  
Pengfei Xu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gestational Diabetes ◽  
Observational Studies ◽  
Meta Analysis ◽  
Vitamin D Insufficiency ◽  
Significant Heterogeneity ◽  
Vitamin D Status ◽  
Maternal Vitamin ◽  
Increased Risk ◽  
Maternal Vitamin D Status

Background/Aims: Whether maternal vitamin D deficiency is associated with gestational diabetes remains controversial. This meta-analysis aimed to systematically evaluate published evidence on the association between maternal vitamin D status and the risk of gestational diabetes. Methods: We retrieved relevant articles from the PubMed, Medline and Embase databases up to May 2017 for observational studies investigating the association between vitamin D status and the risk of gestational diabetes. Odds ratios (OR) or risk ratios (RR) from individual studies were pooled using the fixed and random effect models. Results: The meta-analysis of 29 observational studies included 28,982 participants, of which 4,634 were diagnosed with gestational diabetes, and showed that maternal vitamin D insufficiency was associated with a significantly increased risk of gestational diabetes by 39% (pooled OR = 1.39, 95%CI = 1.20-1.60) with moderate heterogeneity (I2 = 50.2%; P = 0.001). Moreover, the 25(OH)D level was significantly lower in gestational diabetes cases than in controls with a pooled effect of -4.79 nmol/L (95% CI = -6.43, -3.15). Significant heterogeneity was also detected (I2 = 65.0%, P < 0.001). Further subgroup analysis indicated that this association was also evident in most subpopulations. Conclusion: This meta-analysis indicated a significant association between vitamin D insufficiency and increased risk of gestational diabetes. Further well-designed large-scale clinical trials are essential to verify this association.

Optimal initial antibiotic regimen for the treatment of acute appendicitis: a systematic review and network meta-analysis with surgical intervention as the common comparator

2021 ◽  
Author(s):  
Chih-Hung Wang ◽  
Chi-Chun Yang ◽  
Wan-Ting Hsu ◽  
Frank Qian ◽  
Julia Ding ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Observational Studies ◽  
Meta Analysis ◽  
Credible Interval ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Antibiotic Regimen ◽  
Paediatric Patients ◽  
Inhibitor Combination ◽  
Lactamase Inhibitor

Abstract Background The optimal antibiotic regimen for the medical management of acute appendicitis remains unknown due to a lack of head-to-head comparisons between different antibiotic regimens. Methods We systematically searched the PubMed, EMBASE, Scopus and Cochrane Central Register of Controlled Trials databases from their inception through to August 2020. We selected randomized controlled trials (RCTs) or observational studies comparing antibiotic therapy and appendectomy as the initial treatment for adult or paediatric patients with acute appendicitis. We performed a Bayesian network meta-analysis (NMA) to obtain the indirect comparison results between different antibiotic regimens by employing the group managed by surgery as a common comparator. Antibiotic regimens were classified into three categories: those including a carbapenem; those including a cephalosporin; and those including a β-lactam/β-lactamase inhibitor combination. Results A total of 9 RCTs (adults, n = 8; paediatrics, n = 1) and 12 observational studies (adults, n = 3; paediatrics, n = 9) were included in the NMA, with a total of 4551 patients. The most commonly administered regimen was a β-lactam/β-lactamase inhibitor combination (9/21; 43%), followed by a cephalosporin (7/21; 33%) or a carbapenem (5/21; 24%). The NMA indicated that surgery significantly increased 1 year treatment success, compared with cephalosporins [OR: 16.79; 95% credible interval: 3.8–127.64] or β-lactam/β-lactamase inhibitor combinations (OR: 19.99; 95% credible interval: 4.87–187.57), but not carbapenems (OR: 3.50, 95% credible interval: 0.55–38.63). In contrast, carbapenems were associated with fewer treatment-related complications compared with surgery (OR: 0.12; 95% credible interval: 0.01–0.85). Conclusions Carbapenems might be recommended as the initial antibiotic regimen for the non-operative management of adult patients with acute appendicitis. Nevertheless, due to the imprecise estimates in our NMA, additional RCTs are needed to corroborate these findings, especially for paediatric patients.

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