Association between Vitamin D and Risk of Stroke: A PRISMA-Compliant Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-10
Author(s):  
Cen Su ◽  
Biao Jin ◽  
Haiping Xia ◽  
Kangren Zhao
Keyword(s):  
Vitamin D ◽  
Web Of Science ◽  
Meta Analysis ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Control Analysis ◽  
25 Oh Vitamin D ◽  
Case Control Analysis ◽  
Circulating Levels

<b><i>Background:</i></b> Previous studies have shown inconsistent results for associations between vitamin D and risk of stroke. We gathered the existing published articles and conducted this meta-analysis with the aim to explore the association between vitamin D and risk of stroke. <b><i>Methods:</i></b> We searched for articles exploring the association between vitamin D and risk of stroke and published before April 2021 in the following databases: PubMed, Web of Science, MEDLINE, EMBASE, and Google Scholar. All statistical analyses were made using STATA 12.0 software. Q test and <i>I</i><sup><i>2</i></sup> were applied to examine heterogeneities between studies. <b><i>Results:</i></b> For the association between serum levels of 25(OH) vitamin D and risks of stroke, the present analysis included 20 cohort studies (including 213,276 participants) and a case-control analysis (including 13,642 participants). Additionally, the analysis included 15 studies (including 41,146 participants given vitamin D supplementation and 41,163 participants given placebo) to evaluate the influence of vitamin D supplementation on risk of stroke. Higher circulating levels of 25(OH) vitamin D were associated with a reduced risk of stroke (odds ratio/relative risk = 0.78, 95% confidence interval [CI]: 0.70–0.86, <i>I</i><sup><i>2</i></sup> = 41.5%, <i>p</i> = 0.025). However, the present analysis showed that vitamin D supplementation did not influence the risk of stroke (hazard ratio = 1.05, 95% CI: 0.96–1.14, <i>I</i><sup>2</sup> = 2.3%, <i>p</i> = 0.425). <b><i>Conclusions:</i></b> Our analysis indicated that lower circulating level of vitamin D was associated with an elevated risk of stroke, but extra supplement of vitamin D failed to show benefit in decreasing the risk of stroke. Further research and study are also needed to show the role of vitamin D in relation to stroke.

scholarly journals Vitamin D supplementation, COVID-19 and disease severity: a meta-analysis

QJM ◽  
2021 ◽  
Author(s):  
K Shah ◽  
D Saxena ◽  
D Mavalankar
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trials ◽  
Usual Care ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Hospitalized Patients ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Objective: Current meta-analysis aims to understand the effect of oral supplementation of vitamin D on intensive care unit (ICU) requirement and mortality in hospitalized COVID-19 patients. Methods: Databases PubMed, preprint servers, and google scholar were searched from December 2019 to December 2020. Authors searched for the articles assessing role of vitamin D supplementation on COVID-19. Cochrane RevMan tool was used for quantitative assessment of the data, where heterogeneity was assessed using I2 and Q statistics and data was expressed using odds ratio with 95% confidence interval. Results: Final meta-analysis involved pooled data of 532 hospitalized patients (189 on vitamin D supplementation and 343 on usual care/placebo) of COVID-19 from three studies (Two randomized controlled trials, one retrospective case-control study). Statistically (p&lt;0.0001) lower ICU requirement was observed in patients with vitamin D supplementation as compared to patients without supplementations (odds ratio: 0.36; 95% CI: 0.210-0.626). However, it suffered from significant heterogeneity, which reduced after sensitivity analysis. In case of mortality, vitamin D supplements has comparable findings with placebo treatment/usual care (odds ratio: 0.93; 95% CI: 0.413-2.113; p=0.87). The studies did not show any publication bias and had fair quality score. Subgroup analysis could not be performed due to limited number of studies and hence dose and duration dependent effect of vitamin D could not be evaluated. Conclusions: Although the current meta-analysis findings indicate potential role of vitamin D in improving COVID-19 severity in hospitalized patients, more robust data from randomized controlled trials are needed to substantiate its effects on mortality.

Weniger akute Atemwegsinfekte durch Vitamin-D-Supplementation?

2018 ◽  
Vol 97 (08) ◽  
pp. 524-525
Author(s):  
Klaus Weckbecker
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Individual Participant Data ◽  
Individual Participant ◽  
25 Hydroxy Vitamin D ◽  
25 Oh Vitamin D ◽  
Tract Infections

Martineau AR. et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017; 356: i6583 Vitamin D spielt Studien zufolge auch eine Rolle bei der Abwehr pathogener Keime: 25-Hydroxy-Vitamin D (25[OH] Vitamin D) unterstützt z. B. die Synthese antimikrobieller Peptide. Es gibt also eine mögliche Erklärung für die Beobachtung, dass Personen mit niedrigen Vitamin-D-Spiegeln besonders empfindlich gegenüber respiratorischen Infekten sind. Untersuchungen zu einer präventiven Wirkung des Vitamin D verliefen jedoch zum Teil widersprüchlich.

scholarly journals Role of Preoperative Calcium and Vitamin D Therapy to prevent Post-thyroidectomy Hypocalcemia

2020 ◽  
Author(s):  
Sunghwan suh ◽  
Ju Won Seok ◽  
Keunyoung Kim ◽  
Mi Kyoung Park ◽  
Kyoungjune Pak ◽  
...  
Keyword(s):  
Vitamin D ◽  
English Language ◽  
Primary Outcome ◽  
Potential Role ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Secondary Outcome ◽  
Significant Difference ◽  
Symptomatic Hypocalcemia

Abstract Purpose: Postsurgical hypocalcemia is the most common and troublesome consequence of thyroidectomy. We investigated the potential role of routine calcium or vitamin D supplementation in preventing postsurgical hypocalcemia. Materials and Methods: We searched MEDLINE and EMBASE for English-language publications using the keywords “calcium”, “vitamin D”, and “thyroid cancer”. The primary outcome was any postoperative hypocalcemia, and the secondary outcome was symptomatic hypocalcemia. Results: Four studies that included 381 patients were eligible for this meta-analysis. The random-effects model showed no significant difference in the occurrence of hypocalcemia between calcium/vitamin D treatment and placebo/no treatment. The occurrence of symptomatic hypocalcemia was lower in patients with calcium/vitamin D treatment. In combined results, preoperative calcium and vitamin D supplementation was associated with a reduced incidence of symptomatic hypocalcemia.Conclusion: We support the use of preoperative calcium and vitamin D supplementation in conjunction with routine postsurgical supplementation for patients after total thyroidectomy.

scholarly journals The Association Between Vitamin D and Acute Rejection in Human Kidney Transplantation: A Systematic Review and Meta-analysis Study

2021 ◽  
Author(s):  
Mohammad Mirzakhani ◽  
Sheyda Mohammadkhani ◽  
Shirin Hekmatirad ◽  
Soudabeh Aghapour ◽  
Negar Gorjizadeh ◽  
...  
Keyword(s):  
Vitamin D ◽  
Kidney Transplantation ◽  
Acute Rejection ◽  
Web Of Science ◽  
Meta Analysis ◽  
Human Kidney ◽  
Before And After ◽  
And Gender ◽  
Role Of It

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 4,770 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 risk of acute rejection, as it has definite modulatory effects on immune cells.

scholarly journals Putative role of vitamin D in the mechanism of alcoholism and other addictions – a hypothesis

2020 ◽  
pp. 1-8
Author(s):  
Tanya M. Galyuk ◽  
Anton J.M. Loonen
Keyword(s):  
Vitamin D ◽  
Clinical Problem ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Practice Research ◽  
Future Research ◽  
Blood Levels ◽  
Vitamin D Status ◽  
Dopaminergic Transmission

Abstract Objective: Vitamin D deficiency may be a clinical problem in patients with addictions. The authors systematically searched for studies addressing vitamin D and addiction and develop a hypothesis which can direct future research of the possible mechanistic role of vitamin D in the process of addiction. Methods: Systematic review of the literature found in PubMed and EMBASE followed by narrative review combined with clinical experiences leading to hypotheses for future research. Results: Only five articles were identified about a role of vitamin D in the pathophysiology of addiction. Their results are in line with a possible influence of vitamin D in dopaminergic transmission. The cerebral vitamin D status depends on the functionality of genetic variants of vitamin D receptor and other involved genes. Routine serum calcidiol levels may not adequately reflect cerebral vitamin D status. Uncertainty exists regarding appropriate calcidiol blood levels and proper dosages for affecting the central nervous system (CNS). Conclusions: The putative pathophysiological role of vitamin D in substance abuse has been insufficiently studied which calls to more studies how to measure cerebral vitamin D status in clinical practice. Research is indicated whether vitamin D supplementation should use higher dosages and aim to reach higher calcidiol serum levels. Measuring dopaminergic functioning within the prefrontal cortex as reflected by neuropsychological tests selected as suitable could be a appropriate proxy for the cerebral vitamin D status when studying the pharmacogenomics of this functionality in patients.

scholarly journals P1002EFFECT OF VITAMIN D ON URINARY ANGIOTENSIOGEN LEVEL IN EARLY DIABETIC NEPHROPATHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Himansu Mahapatra ◽  
Adarsh Kumar ◽  
Bindu Kulshreshtha ◽  
Anubhuti Chirkara
Keyword(s):  
Vitamin D ◽  
Diabetic Nephropathy ◽  
Placebo Group ◽  
Vitamin D Supplementation ◽  
P Value ◽  
Ras Activation ◽  
R Value ◽  
25 Oh Vitamin D ◽  
Early Diabetic Nephropathy

Abstract Background and Aims UrinaryAngiotensinogen (UAGT) is supposed to be a marker of activation of intrarenalreninangiotensin system (RAS) system in early Diabetic Nephropathy (DN). Vitamin D has been studied as a negative regulator of the circulating and tissue RAS activity; so its supplementation may prevent progression of DN. This study was planned to assess the RAS activation and effect of vitamin D supplementation in early diabetic nephropathy progression by estimatingUAGT level. Method A total of 730 Diabetic subjects were screened for early DN based on Inclusion criteria(eGFR ≥ 120ml/min/1.73m2 with unrestricted ACR value eGFR of 60- 120 mL/min/1.73m2 and ACR 30-300mg) and Exclusion criteria(on ACE I or ARB, eGFR&lt;60ml/min/1.73m2, Hypercalcemia (&gt;11.5mg%), UTI, Pregnancy, Hypertension, HbA1c (&gt;8.0 %), vitamin D supplementation during the last 6 month).Of them 103 included subjects were underwent randomization to receive either Cholecalciferol(54) or matching Placebo(49) in a double blind method. All were subjected to routine investigations, urinary albumin: creatinine (UACR), UAGT, serum 25(OH)vitamin D, and intact parathyroid hormone (iPTH) at the zero and six months. A total 40 healthy controls without any comorbidity were also includedfor assessment of same investigations at zero month. Comparative results at zero months of all three groups were analyzed. Results The change in levels of UACR (mg/g), UAGT (ng/ml), vitamin D (ng/ml) and iPTH(pg/ml)in Cholecalciferol group from zero to six month were [Median (IQR)] : 12.50 (-24.82 to -5.95); p&lt;0.001, -6.60 (-20.91 to -2.63);p&lt;0.001, 5.75 (2.07-9.70); p&lt;0.001, -5.35 (-11.55 to -3.67) ;p&lt;0.001, respectively. After six months, median (IQR) of UAGT and UACR levels were significantly lower in the Cholecalciferol group as compared to Placebo group (p&lt;0.001 and p= 0.04 respectively).Significant reduction of UACR (mg/g) and UAGT (ng/ml) level corroborating with increase in 25(OH) vitamin D(ng/ml) levelfrom zero to six months (all three p&lt;0.001). There was significant correlation of vitamin D3 level with UAGT (r value: -0.255 & p value: 0.009) and UACR level (r value: -0.28& p value: &lt;0.01). The median UAGT level was significantly higher in patients with early DN (Cholecalciferol&Placebo Group) than Control Group at zero month (p =0.001). Conclusion Significantly higher UAGT levels in early DN supports role of intrarenal RAS activation. Significant decrease in UAGT level in cholecalciferol group supports beneficial role of vitamin D supplementation in progression of early DN.

scholarly journals POS0502 WHAT IS THE ROLE OF VITAMIN D STATUS IN DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH bDMARDs? – DATA FROM A RHEUMATOLOGY CENTER

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 483.2-484
Author(s):  
D. Fonseca ◽  
M. Rato ◽  
F. Oliveira Pinheiro ◽  
B. M. Fernandes ◽  
S. Garcia ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Disease Activity ◽  
Statistical Significance ◽  
Serum Levels ◽  
Vitamin D Insufficiency ◽  
Vitamin D Status ◽  
Activity Measures ◽  
25 Oh Vitamin D

Background:Vitamin D is a fat-soluble vitamin, mainly involved in the regulation of calcium metabolism, and it has gained increasing interest in recent years because of its potential role in immunomodulatory activity. Recent data suggest that it is negatively associated with disease activity in rheumatoid arthritis (RA), however this is not yet fully understood.Objectives:This study’s aim was to investigate if there is any correlation between vitamin D serum levels at baseline, before taking the first biological disease-modifying antirheumatic drug (bDMARD), and at 6 months after, with disease activity in a cohort of RA patients.Methods:This is a cross-sectional study, including all the rheumatoid arthritis patients taking the first bDMARD with evaluation of the vitamin D status at baseline and 6 months after biologic therapy at our Rheumatology Department and registered in the national database (Reuma.pt).Demographic, clinical and laboratorial characteristics and disease activity measures were collected from the baseline visit and the visit after 6 months of treatment with the first biologic. For the statistical analysis, two groups were defined, based on the serum levels of 25(OH) vitamin D, considering the most common cut-off of 30 ng/mL. For comparison analyses between groups, chi-square test was used for categorical variables and Mann-Whitney U and T-tests were applied for continuous variables.Results:Seventy-seven patients were included, 58 (75.3%) were females; the mean age was 54.24 ±11.0 years and seropositivity was founded in 65 (84.4%) for anti-citrullinated protein antibodies and in 58 (75.3%) for rheumatoid factor. The first bDMARD most commonly prescribed were etanercept (28.6%) and rituximab (26%). Regarding the vitamin D status at baseline, the mean serum level for 25(OH)vitamin D was 28.35 ± 18.21 ng/mL, with the majority of patients having vitamin D insufficiency (25(OH)vitamin D < 30 ng/mL) (63.6%). After 6 months of treatment with the first bDMARD, disease activity measures showed that remission or low activity were achieved in 29.9% of the patients, using DAS28 criteria; in 42.9% and 46.8%, according CDAI and SDAI criteria, respectively. Vitamin D serum levels at 6 months were 26.81 ±11.72, with the majority of patients still with vitamin D insufficiency (62.3%).At baseline, patients with vitamin D insufficiency had greater patient VAS (79.00 ± 19,14 vs 71.71 ± 21.95), greater erythrocyte sedimentation rate (ESR) (40.67 ± 23.17 vs 32.46 ± 26.09) and greater Health Assessment Questionnaire (HAQ) score (1.75 ± 0.609 VS 1.61 ± 0.659) with neither of them having statistical significance. However, when comparing CRP levels at 6 months, it achieved statistical significance with the Mann-Whitney U-test (1.05 ± 1.79 VS 1.41 ± 5.22; p=0.026).The same tendency was confirmed when analyzing vitamin D levels at 6 months. Patients with vitamin D insufficiency presented greater patient VAS (55.33 ± 28.82 vs 42.86 ± 28.28), greater ESR (26.19 ± 21.57 vs 21.00 ± 20.38) and greater HAQ score (1.35 ± 0.662 VS 1.34 ± 0.705), although without statistical significance. However, it did achieve statistical significance when comparing baseline DAS28 and HAQ (5.60 ± 0.91 VS 5.38 ± 1.31; p=0.013 and 1.76 ± 0.53 VS 1.59 ± 0.75; p=0.007, respectively).Conclusion:Our data failed to demonstrate a statistically significant association between vitamin D serum levels at baseline and at 6 months with disease activity in our RA sample. However, it revealed a positive trend of vitamin D insufficiency related to higher activity disease. Interestingly, it showed that vitamin D insufficiency after 6 months of bDMARD treatment is related to higher DAS28 and HAQ at baseline. Nonetheless, we insist it is of paramount importance to conduct larger studies to confirm these findings.References:[1]Bellan M, Sainaghi PP, Pirisi M. Role of Vitamin D in Rheumatoid Arthritis. Adv Exp Med Biol. 2017;996:155-168.Disclosure of Interests:None declared

scholarly journals The impact of vitamin D supplementation on mortality rate and clinical outcomes of COVID-19 patients: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Leila Nikniaz ◽  
Mohammad Amin Akbarzadeh ◽  
Hossein Hosseinifard ◽  
Mohammad-Salar Hosseini
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Mortality Rate ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
World Health ◽  
Ordinal Scale ◽  
Cochrane Library

Background: Several studies have suggested the positive impact of vitamin D on patients infected with SARS-CoV-2. This systematic review aims to evaluate the effects of vitamin D supplementation on clinical outcomes and mortality rate of COVID-19 patients. Methods: A comprehensive search was conducted through the databases of PubMed, Scopus, Web of Knowledge, Embase, Ovid, and The Cochrane Library without time and language limitation, until December 16, 2020. The results were screened, and the outcomes of interest were extracted. Using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, the remaining results were appraised critically. Statistical analysis was performed using the Comprehensive Meta-Analysis (CMA) software version 2.0. Results: Of the 2311 results, four studies and 259 patients were enrolled, including 139 patients in vitamin D intervention groups. The pooled analysis of three studies, reporting the patients’ survival and mortality rate, showed a significantly lower mortality rate among the intervention groups compared with the control groups (OR=0.264, 95% CI=0.099–0.708, p-value=0.008). Two of the studies reported the clinical outcomes based on the World Health Organization’s Ordinal Scale for Clinical Improvement (OSCI) score for COVID-19, where both of them showed a significant decrease in OSCI score in the vitamin D intervention groups. One study reported a lower rate of intensive care unit (ICU) admission, and one study reported a significant decrease in serum levels of Fibrinogen. Conclusion: Prescribing vitamin D supplementation to patients with COVID-19 infection seems to decrease the mortality rate, the severity of the disease, and serum levels of the inflammatory markers. Further studies are needed to determine the ideal type, dosage, and duration of supplementation.

scholarly journals The Relationship Between the Serum Level of Vitamin D and Hypocalcemia After Total Thyroidectomy

2021 ◽  
Author(s):  
Behrang Motamed ◽  
Hossein Hemmati ◽  
Mehdi Pursafar ◽  
Mohaya Farzin ◽  
Zakiyeh Jafaryparvar ◽  
...  
Keyword(s):  
Vitamin D ◽  
Total Thyroidectomy ◽  
Vitamin D Deficiency ◽  
Significant Relationship ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Severe Form ◽  
Benign Goiter ◽  
Male Patients

Vitamin D plays a crucial role in calcium metabolism through the parathormone-dependent process. The deficiency of this important nutrient may be associated with hypocalcemia after thyroidectomy. To evaluate the role of vitamin D in predicting hypocalcemia following total thyroidectomy. In this study, sixty-two patients who underwent total thyroidectomy for benign or malignant thyroid disease were included in this prospective study. Preoperative vitamin D serum levels and parathormone (PTH) levels were determined. The association between preoperative vitamin D status and the development of hypocalcemia was investigated. In this study, 62 patients were evaluated. The mean age of the subjects was 47 years. Of the 62 patients studied, of which 9 were male patients (14.5%), and 53 were female (85.5%), the results of our study showed. In both groups with and without vitamin D deficiency, calcium levels decreased significantly (P=0.01). In our study, it was found that there was no significant relationship between postoperative hypocalcemia and vitamin D deficiency. (P=0.441). After reviewing the data and according to Spearman correlation statistical test, no significant relationship was observed between serum parathyroid hormone (PTH) and calcium after thyroidectomy (P=0.340). Vitamin D deficiency is a risk factor of hypocalcemia after total thyroidectomy for benign goiter. Although post thyroidectomy hypocalcemia is multifactorial, vitamin D deficiency, particularly severe form, is significantly associated with the development of biochemical and clinical hypocalcemia. Vitamin D supplementation can prevent this unwanted complication in such patients.

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