scholarly journals Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: a meta-analysis

Author(s):  
YUSUKE ITO ◽  
Akira Honda ◽  
mineo kurokawa

Vitamin D deficiency impairs prognosis in many types of cancer; however, its significance in each subtype of hematological malignancies is unclear. In addition, data on the association between pre-transplant vitamin D levels and outcomes of hematopoietic stem cell transplantation (HSCT) are inconsistent. This systematic review and meta-analysis aimed to elucidate the impact of vitamin D levels at diagnosis or pre-HSCT on the prognosis of hematological malignancies. A total of 30 articles and abstracts were extracted from PubMed, Embase, Cochrane Library databases, and conference proceedings. Fixed and random-effect models were used to analyze primary outcomes: overall survival (OS) and progression-free survival (PFS). Lower vitamin D level was significantly associated with poorer OS and PFS in myeloid (hazard ratio [HR]: 1.39, 95% confidence interval [CI] 1.06-1.82; HR: 2.03, 95%CI 1.23-3.32, respectively) and lymphoid malignancies (HR: 2.07, 95%CI 1.79-2.40; HR:1.91, 95%CI 1.61-2.25, respectively), as well as outcomes of several lymphoma subtypes individually. Furthermore, pre-transplant lower vitamin D level was associated with poorer OS in both autologous and allogeneic HSCT (HR: 1.65, 95%CI 1.04-2.61; HR: 1.50, 95%CI 1.03-2.18, respectively). Despite the relatively small number of studies evaluated, these data suggest the importance of vitamin D status in outcomes of hematological malignancies (PROSPERO registration number: CRD42020205821).

2019 ◽  
Vol 53 (2) ◽  
Author(s):  
Felix Paolo J. Lizarondo ◽  
Patricia A. Nacianceno ◽  
Claudine Yap-Silva

Background. Alopecia areata is postulated to be an autoimmune disease of which vitamin D may play a role being found in the immune system and hair. Objective. To determine the association between serum 25-hydroxyvitamin D levels in patients with alopecia areata compared with healthy controls. Methods. Observational studies on association of vitamin D levels on alopecia areata compared to healthy controls were obtained from all published articles until July 2018 on MEDLINE, Cochrane Library, TRIP, HERDIN, and Google. Review Manager 5.3 was used for the meta-analysis. Results. The search strategy yielded 13 qualified articles for the full-length review and 11 studies, containing 916 patients, were included in the meta-analysis using the pooled random effects model. The pooled mean difference of the serum 25-hydroxyvitamin D levels between alopecia areata patients and healthy controls was -9.55 (95% CI, -10.51 to -8.59) with heterogeneity (I2=85%). Conclusion. In conclusion, there were reduced levels of serum 25-hydroxyvitamin D levels in alopecia areata compared to healthy controls and vitamin D deficiency was more prevalent in alopecia areata compared to healthy controls. There was also a trend of lower vitamin D levels in the more severe forms of alopecia.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Marta Michalska-Kasiczak ◽  
Amirhossein Sahebkar ◽  
Dimitri P Mikhailidis ◽  
Jacek Rysz ◽  
Paul Muntner ◽  
...  

Introduction: Vitamin D (vit D) deficiency may be associated with an increased risk of statin-related muscle complaints, and symptomatic myalgia in statin-treated patients. Hypothesis: The aim of this meta-analysis was to investigate whether subjects with statin-induced myalgia have lower serum vit D levels compared with those who are asymptomatic. Methods: We searched PubMed, Web of Science, Cochrane Library, Scopus and EMBASE (up to March 2014) to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. Two independent reviewers extracted data on study characteristics, methods and outcomes. Results: The electronic search yielded 437 articles, of those 20 were scrutinized in the full text, of which 13 studies were considered unsuitable. The final analysis included 7 studies with 2416 statin-treated patients divided to subgroups of patients with (n = 666 [27.6%]) or without (n = 1750) myalgia. The combination of data from individual observational studies revealed a significantly lower vit D plasma concentration in the statin-induced myalgia compared with the asymptomatic subgroup with weighted mean difference -9.41 ng/mL(95% confidence interval (Cl): -10.17 to -8.64; p < 0.00001) (figure) . Conclusions: This meta-analysis provides evidence that low vit D levels are associated with myalgia in patients on statin therapy. Well-designed, randomized controlled trials are necessary to establish whether vitamin D supplementation reduces risk for statin myalgia in patients with vitamin D deficiency.


2021 ◽  
Author(s):  
Seshadri Reddy Varikasuvu ◽  
Balachandar Thangappazham ◽  
Hemanth Raj

Background: Vitamin D levels have been reported to be associated with COVID-19 susceptibility, severity and mortality events.. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the use of vitamin D intervention on COVID-19 outcomes. Methods: Literature search was conducted using PubMed, Cochrane library, and ClinicalTrials.gov databases (latest search on August 5, 2021). We included RCTs reporting the use of vitamin D intervention to control/placebo group in COVID-19. Two independent researchers did literature search, abstracted data, and the risk of bias assessment. Results: A total of 6 RCTs with 551 COVID-19 patients were included. The overall collective evidence pooling all the outcomes across all RCTs indicated the beneficial use of vitamin D intervention in COVID-19 (relative risk, RR = 0.60, 95% CI 0.40 to 0.92, Z=2.33, p=0.02, I2 = 48%). However, no statistical significance was observed for individual outcomes of ICU care (RR = 0.11, 95% CI 0.15 to 1.30, Z=1.48, p=0.14, I2 = 66%) and mortality (RR = 0.78, 95% CI 0.25 to 2.40, Z=0.66, p=0.02, I2 = 33%), though decreased rates were noted. The rates of RT-CR positivity was significantly decreased in the intervention group as compared to the non-vitamin D groups (RR = 0.46, 95% CI 0.24 to 0.89, Z=2.31, p=0.02, I2 = 0%). Conclusion: COVID-19 patients supplemented with vitamin D are more likely to demonstrate fewer rates of ICU admission, mortality events and RT-PCR positivity. However, no statistical significance has been achieved for individual outcomes of ICU and deaths. More RCTs and completion of ongoing trials largely needed to precisely establish the association between vitamin D use and COVID-19.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245951
Author(s):  
Delfina F. Hlashwayo ◽  
Betuel Sigaúque ◽  
Emília V. Noormahomed ◽  
Sónia M. S. Afonso ◽  
Inácio M. Mandomando ◽  
...  

Introduction Campylobacter spp. are zoonotic bacteria that cause gastroenteritis in humans worldwide, whose main symptom is diarrhea. In certain cases, extra intestinal manifestations may occur, such as Guillain Barré syndrome. The bacteria cause severe diarrhea mostly in children and in immunocompromised individuals. This review aims to address the prevalence of Campylobacter spp. in humans in sub-Saharan Africa. It also aims to understand the impact of HIV in the prevalence, as well as to report data on antibiotic resistance and propose research priorities. Methods We followed PRISMA guidelines to find studies on the occurrence of Campylobacter spp. in humans in all countries from sub-Saharan Africa. Studies published between 2000 and 2020 were searched in PubMed, Cochrane Library, CINAHL, African Index Medicus, African Journals Online, Google Scholar and Science Direct. We have conducted a random-effect meta-analysis and calculated the proportion of resistant isolates to different antibiotics. Results and discussion We found 77 studies that described such occurrence in humans in 20 out of 53 sub-Saharan African countries. Campylobacter jejuni was the most prevalent species. Pooled prevalence was 9.9% (CI: 8.4%–11.6%). No major variations within the different sub-regions were found. Most studies reported Campylobacter spp. as the cause of diarrhea, mainly in children. Some studies reported the bacteria as a possible etiologic agent of acute flaccid paralysis and urinary tract infection. Campylobacter spp. presented a higher pooled prevalence in HIV infected patients, although not statistically significant. High proportions of resistant strains were reported for many antibiotics, including erythromycin and tetracycline. Conclusion Campylobacter spp. occur in sub-Saharan Africa, although information is scarce or inexistent for many countries. Research priorities should include investigation of the understudied species; extra intestinal manifestations; the impact of HIV infection and associated risk factors. Control strategies should be reinforced to contain the spread of this pathogen and drug resistance.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M F Nassar ◽  
E K Emam ◽  
M F Allam

Abstract Background and objectives Both childhood obesity and vitamin D deficiency are common in the Middle East. This systematic review/meta-analysis aims to highlight the effect of vitamin D supplementation in deficient children suffering from obesity. Methods Published clinical studies on vitamin D supplementation in obese children and adolescents with vitamin D deficiency were identified through a comprehensive MEDLINE/PubMed search (from July 1966 to November 2017). Outcomes intended after vitamin D supplementation were improvements in vitamin D status, BMI alterations and appetite changes. The inclusion criteria were children aged 2 to 18 years of both sexes in clinical trials that specified the oral and/or intramuscular dose of vitamin D supplementation. Results Ten studies were retrieved, but only six were relevant. First, supplemented obese children and adolescents were compared to non-obese controls; thereafter, supplemented obese children and adolescents were compared to matching obese peers given placebo. Pooled risks from the two studies that evaluated the number of obese and non-obese children and adolescents who improved upon vitamin D supplementation revealed that obesity poses a risk for not benefiting from the vitamin D supplementation regardless of the dose and the duration of supplementation. Pooled results from the six retrieved studies that compared supplemented obese children and adolescents to matching non-obese or obese peers given placebo revealed significantly lower vitamin D levels in obese participants than in non-obese peers. Conclusion Vitamin D levels are significantly lower in obese children and adolescents with obesity, posing a risk for not benefiting from vitamin D supplementation regardless of the dose and duration of supplementation. Our results suggest that only with simultaneous weight adjustment strategies, vitamin D sufficiency would be achieved more effectively. Vitamin D supplementation in deficient children suffering from obesity.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Guo Tian ◽  
Jia-Ning Liang ◽  
Zhuo-Yun Wang ◽  
Dian Zhou

Background. The incidence of breast cancer in RA patients remains controversial. Thus we performed a meta-analysis to investigate the impact of RA on breast cancer.Methods. Published literature was available from PubMed, Embase, and Cochrane Library. Pooled standardized incidence rate (SIR) was computed by random-effect model analysis.Results. We identified 16 separate studies in the present study, in which the number of patients ranged from 458 to 84,475. We did not find the increased cancer risk in RA patients (SIR=0.86, 95%CI=0.72–1.02). However, subgroup analysis showed that breast cancer risk in RA patients was positively different in Caucasians (SIR=0.82, 95%CI=0.73–0.93) and non-Caucasians (SIR=1.21, 95%CI=1.19–1.23), respectively. In subgroup analysis by style, a reduced incidence was found in hospital-based case subjects (SIR=0.82, 95%CI=0.69–0.97). Similarly, subgroup analysis for adjusted factors indicated that in A3 (age and sex) and A4 (age, sex, and race/ethnicity) the risk was decreased (SIR=0.87, 95%CI=0.76–0.99;SIR=0.63, 95%CI=0.59–0.67).Conclusions. The meta-analysis revealed no increased breast cancer risk in RA patients. However, in the subgroup analysis, the risk of breast cancer is increased in non-Caucasians patients with RA while it decreased in Caucasian population, hospital-based case subjects, and A3 group. Such relationship may provide preference for risk of breast cancer in different population.


2020 ◽  
Author(s):  
bin Yi ◽  
Rui-han Lian ◽  
Ping-an Qi ◽  
Tao Yuan ◽  
Pei-jing Yan ◽  
...  

Abstract Background: Current studies suggest that vitamin D deficiency during pregnancy can produce a certain effect for preterm birth, but there is no research showing whether vitamin D deficiency has a consistent effect in different pregnancies; thus, we conducted a systematic review and meta-analysis of 24 observational studies, grouping them according to the gestational age at the time of serum sampling, to investigate whether vitamin D deficiency in different periods of gestation has different effects on preterm birth and to provide an evidence-based basis for pregnant women to measure and supplement vitamin D. Methods: The databases PubMed-Medline, EMBASE, the Cochrane Library, Web of Science, EBSCO, CBM, and CNKI were searched until July 2019. Two researchers independently assessed the eligibility and quality of studies, and STATA 12.0 software was used for meta-analysis. Result: Seven cohort studies, 13 case-control studies, and four cross-sectional studies were included from 2500 articles by inclusion and exclusion criteria. After adjusting for age, race, and other confounding factors, meta-analysis results showed that vitamin D deficiency in the first trimester, the second trimester and the third trimester did not increase the risk of preterm birth (odds ratio (OR) = 1.01, 95% confidence interval (CI) (0.88, 1.16), P = 0.867; OR = 1.12, 95%CI (0.92, 1.37), P = 0.249; OR = 1.05, 95%CI (0.87, 1.27), P = 0.602). However, there was moderate heterogeneity in the study of vitamin D deficiency in the second trimester, and subgroup analysis suggested that vitamin D deficiency in the second trimester may increase the risk of preterm birth (OR = 1.33, 95%CI (1.15, 1.54), P = 0.000). A sensitivity analysis of the second trimester showed that excluding any one study did not significantly change the results. Conclusions: Vitamin D deficiency in early and late pregnancy may not be associated with preterm birth, while vitamin D deficiency in middle pregnancy is likely to have an important effect on preterm birth. Vitamin D levels should be measured in the second trimester of pregnancy, and vitamin D supplements should be provided if necessary.


2020 ◽  
Author(s):  
Shengjie Sun ◽  
Huiyu Dong ◽  
Tao Yan ◽  
Junchen Li ◽  
Chao Liang ◽  
...  

Abstract Background Published studies present conflicting data regarding the impact of Thrombospondin-1 (TSP-1) expression on prognosis of various cancers . We performed this meta-analysis to clarify the preliminary predictive value of TSP-1. Methods Twenty-four studies with a total of 2379 patients were included. A comprehensive literature search was performed by using PubMed, Cochrane Library, Web of Science, Embase, and hand searches were also conducted of relevant bibliographies. Pooled hazard ratio s ( HRs ) with 95% confidence intervals ( CIs ) for patient survival and disease recurrence were initially identified to explore relationships between TSP-1 expression and patient prognosis. Results A total of 24 eligible studies were included in this meta-analysis. Our results showed that high level of TSP-1 was correlated significantly with poor overall survival ( OS ) (HR=1.40, 95% CI: 1.17~1.68). However, high TSP-1 expression predicted no significant impact on progression-free survival ( PFS )/ metastasis-free survival (MFS ) (HR=1.35, 95%CI: 0.87-2.10) and disease-free survival ( DFS )/ recurrence-free survival ( RFS ) (HR = 1.40, 95%CI: 0.77–2.53). In addition, we performed subgroup analyses which showed that high TSP-1 expression predicted poor prognosis in breast cancer and gynecological cancer. Conclusions Our findings indicated high TSP-1 expression may serve as a promising biomarker of poor prognosis and novel therapeutic target in cancers, especially in breast cancer and gynecological cancer.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Shanshan Zhu ◽  
Yuhui Wang ◽  
Fei Luo ◽  
Jie Liu ◽  
Liangchang Xiu ◽  
...  

Background. The relationship between vitamin D level and NAFLD has not been investigated in children and adolescents. We performed a meta-analysis of published observational studies to assess this association between vitamin D levels (measured as serum 25-hydroxy vitamin D [25(OH)D]) and NAFLD in this age group. Methods. Relevant studies conducted before May 20, 2018, were identified from the following electronic databases: PubMed, the Cochrane Library, Embase, and the Chinese CNKI databases. The quality of the included studies was evaluated using the Newcastle Ottawa Scale, and associations between vitamin D levels and NAFLD were estimated using standardised mean differences (SMD) and 95% confidence interval (CI). Subgroup and sensitivity analysis were used to identify sources of heterogeneity, and publication bias was evaluated using funnel plots. Results. Eight articles were included in this meta-analysis. A significant difference was observed between low 25(OH)D levels and NAFLD in children and adolescents (SMD = -0.59, 95%CI = -0.98, -0.20, P <  0.01). Subgroup analysis revealed no differences in the study type, geographic location, BMI, and age subgroups. Conclusions. Low vitamin D levels were associated with NAFLD in children and adolescents.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1060-1060
Author(s):  
Ranju Kunwor ◽  
Ramkaji Baniya ◽  
Maysa M. Abu-Khalaf

1060 Background: CDK 4/6 inhibitors with Endocrine therapy (ET) are the preferred first line treatment for Hormone Receptor positive and Human Epidermal Growth factor receptor 2 negative (HR+/HER2-) MBC. Over the last few years multiple trials have shown benefit in PFS. Only two studies evaluating Ribociclib and Abemaciclib showed an OS benefit while no statistically significant OS benefit has been reported in any of the studies evaluating Palbociclib raising the possibility that this benefit may be drug specific rather than applicable to all CDK 4/6 Inhibitors. This updated meta-analysis of randomized controlled trials (RCTs) aims to assess the PFS and OS of all three CDK 4/6 inhibitors in HR+/HER2- MBC. Methods: We performed a systematic search for RCTs using Cochrane Library, PubMed, Embase, and Web of Science. Only the phase II and III RCTs comparing CKD 4/6 inhibitors plus ET with ET alone were eligible for this meta-analysis. The pooled analysis of Hazard Ratio (HR) was performed with Review Manager 5.3 using random effect model. Results: A total of 8 RCTs including 4338 patients with HR+/HER2- MBC were included in this meta-analysis (table). The pooled HR for PFS was 0.55 (95% confidence interval (CI), 0.50-0.59; P < .00001) and the pooled HR for OS was 0.75 (95% CI, 0.68-0.84; P < .00001). Conclusions: The result of our meta-analysis confirms the previously reported PFS benefit from CDK 4/6 inhibitors plus ET and shows an OS benefit when including RCTs of all 3 CDK 4/6 inhibitors for the treatment of HR+/HER2- MBC. [Table: see text]


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