scholarly journals The Effect of Vitamin D Supplementation on Glycaemic Control in Women with Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

2019 ◽  
Vol 16 (10) ◽  
pp. 1716 ◽  
Author(s):  
Omorogieva Ojo ◽  
Sharon M. Weldon ◽  
Trevor Thompson ◽  
Elisabeth J. Vargo
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Glycaemic Control ◽  
Gestational Diabetes ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Randomised Controlled

Vitamin D deficiency is highly prevalent amongst pregnant women and is linked to a range of adverse complications, including gestational diabetes. However, there is no consensus among researchers regarding the impact of vitamin D supplementation in alleviating adverse effects in gestational diabetes. The objective of this systematic review and meta-analysis was to determine whether supplementation of vitamin D given to women with gestational diabetes can promote glycaemic control. EMBASE and PubMed were searched up to November, 2018. The selection criteria included randomised controlled trials of the effect of vitamin D supplementation (1000–4762 IU/day) on pregnant women with gestational diabetes mellitus. Study data and outcome measures (fasting blood glucose, glycated haemoglobin and serum insulin) were extracted from included studies. Random-effects models were used for meta-analyses. Heterogeneity tests, and analysis of the risk of bias were conducted. Most of the studies were graded as having either low risk or moderate risk of bias although two studies had a high risk of bias in the areas of blinding of participants and personnel, and incomplete outcome data. On the other hand, the heterogeneity statistic (I2) ranged from 0–41% in the studies included. Five randomised controlled trials were selected for this review and meta-analysis (involving a total of 173 participants supplemented with vitamin D and 153 participants as control drawn from the studies). Vitamin D supplementation was associated with a decrease in fasting blood glucose by a mean of 0.46 mmol/L (−0.68, −0.25) (p < 0.001), glycated haemoglobin by a mean of 0.37% (−0.65, −0.08) (p < 0.01) and serum insulin concentration by mean of 4.10 µIU/mL (−5.50, −2.71) (p < 0.001) compared to controls. This review shows evidence that vitamin D supplementation has the potential to promote glycaemic control in women with Gestational Diabetes Mellitus (GDM). However, due to the limited number of studies in the meta-analysis, the conclusion should be interpreted with caution. Further studies are needed to fully understand the exact mechanism by which vitamin D influences glucose metabolism.

scholarly journals Vitamin D Supplementation in Childhood Asthma: A Systematic Review and Meta-analysis of Randomised Controlled Trials

2021 ◽  
pp. 00662-2021
Author(s):  
Jogender Kumar ◽  
Prawin Kumar ◽  
Jagdish Prasad Goyal ◽  
Chirag Thakur ◽  
Puja Choudhary ◽  
...  
Keyword(s):  
Vitamin D ◽  
Childhood Asthma ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Emergency Visits ◽  
Significant Difference ◽  
Randomised Controlled

BackgroundThere is conflicting evidence for vitamin D supplementation in childhood asthma. We aimed to systematically synthesize the evidence on the efficacy and safety of vitamin D supplementation in childhood asthma.MethodsWe searched electronic databases (Medline, Embase, Web of Science) and register (CENTRAL) for randomised controlled trials (RCTs) published until September 30, 2021. RCTs enrolling asthmatic children (1–18 years) and comparing vitamin D against placebo/routine care were included if they met at least one of the endpoints of interest (asthma attacks, emergency visits, hospitalisation). We used the Risk of Bias (RoB) 2 tool for risk of bias assessment. Random-effects meta-analysis with RevMan 5.3 software was done. The GRADE approach was used to assess the level of certainty of the evidence.ResultsEighteen RCTs (n=1579 participants) were included. The pooled meta-analysis did not find a significant effect of vitamin D supplementation on asthma attacks requiring rescue systemic corticosteroids (6 studies, 445 participants, Risk ratio: 1.13; 95% CI: 0.86 to 1.48, I2–0%) (Moderate-certainty evidence). In addition, there was no significant difference in the proportion of children with asthma attacks of any severity (11 trials, 1132 participants, RR: 0.84; 95% CI: 0.65 to 1.09; I2–58%) (Very-low certainty evidence). Vitamin D does not reduce the need for emergency visits (3 studies, 361 participants, RR: 0.97; 95% CI: 0.89 to 1.07, I2–0%) and hospitalisation (RR: 1.38; 95% CI: 0.52 to 3.66, I2–0%) (Low certainty evidence).ConclusionVery low to moderate certainty evidence suggests that vitamin D supplementation might not have any protective effect in childhood asthma.

scholarly journals Vitamin D supplementation to prevent acute respiratory infections: systematic review and meta-analysis of aggregate data from randomised controlled trials

2020 ◽  
Author(s):  
David A Jolliffe ◽  
Carlos A Camargo ◽  
John D Sluyter ◽  
Mary Aglipay ◽  
John F Aloia ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomised Controlled Trials ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Controlled Trials ◽  
Acute Respiratory Infections ◽  
Dosing Regimen ◽  
Randomised Controlled ◽  
Reduced Risk

AbstractBackgroundA 2017 meta-analysis of data from 25 randomised controlled trials of vitamin D supplementation for the prevention of acute respiratory infections revealed a protective effect of the intervention. Since then, 20 new RCTs have been completed.MethodsSystematic review and meta-analysis of data from randomised controlled trials (RCTs) of vitamin D for ARI prevention using a random effects model. Pre-specified sub-group analyses were done to determine whether effects of vitamin D on risk of ARI varied according to baseline 25-hydroxyvitamin D (25[OH]D) concentration or dosing regimen. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and the ClinicalTrials.gov registry from inception to 1st May 2020. Double-blind RCTs of supplementation with vitamin D or calcidiol, of any duration, were eligible if they were approved by a Research Ethics Committee and if ARI incidence was collected prospectively and pre-specified as an efficacy outcome. Aggregate data, stratified by baseline 25(OH)D concentration, were obtained from study authors. The study was registered with PROSPERO (no. CRD42020190633).FindingsWe identified 45 eligible RCTs (total 73,384 participants). Data were obtained for 46,331 (98.0%) of 47,262 participants in 42 studies, aged 0 to 95 years. For the primary comparison of vitamin D supplementation vs. placebo, the intervention reduced risk of ARI overall (Odds Ratio [OR] 0.91, 95% CI 0.84 to 0.99; P for heterogeneity 0.01). No statistically significant effect of vitamin D was seen for any of the sub-groups defined by baseline 25(OH)D concentration. However, protective effects were seen for trials in which vitamin D was given using a daily dosing regimen (OR 0.75, 95% CI 0.61 to 0.93); at daily dose equivalents of 400-1000 IU (OR 0.70, 95% CI 0.55 to 0.89); and for a duration of ≤12 months (OR 0.82, 95% CI 0.72 to 0.93). No significant interaction was seen between allocation to vitamin D vs. placebo and dose frequency, dose size, or study duration. Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (OR 0.97, 95% CI 0.86 to 1.09). Risk of bias within individual studies was assessed as being low for all but three trials. A funnel plot showed left-sided asymmetry (P=0.008, Egger’s test).InterpretationVitamin D supplementation was safe and reduced risk of ARI, despite evidence of significant heterogeneity across trials. Protection was associated with administration of daily doses of 400-1000 IU vitamin D for up to 12 months. The relevance of these findings to COVID-19 is not known and requires investigation.FundingNone

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