Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis
Diabetic retinopathy (DR), a significant microvascular complication of diabetes mellitus (DM), remains a major cause of vision loss worldwide. Vitamin D, recognized for its role in bone health, has also been implicated in various non-skeletal conditions, including DR. This systematic review analyzed...
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2024-12-01
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| author | Claudia Elena Petrea Laura Andreea Ghenciu Roxana Iacob Emil Robert Stoicescu Dorel Săndesc |
| author_facet | Claudia Elena Petrea Laura Andreea Ghenciu Roxana Iacob Emil Robert Stoicescu Dorel Săndesc |
| author_sort | Claudia Elena Petrea |
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| description | Diabetic retinopathy (DR), a significant microvascular complication of diabetes mellitus (DM), remains a major cause of vision loss worldwide. Vitamin D, recognized for its role in bone health, has also been implicated in various non-skeletal conditions, including DR. This systematic review analyzed data from 20 studies involving 22,408 participants to explore the relationship between vitamin D levels and DR. Studies were included based on strict eligibility criteria, ensuring they could distinctly classify participants into DR and non-DR groups and provide quantitative measurements of vitamin D levels. Of these, nine studies were included in the meta-analysis. The pooled analysis revealed a significant association between lower vitamin D levels and increased odds of DR, with a combined odds ratio (OR) of 1.15 (95% CI: 1.10–1.20) under the fixed-effects model and 1.17 (95% CI: 1.08–1.27) under the random-effects model. Mean serum vitamin D levels were lower in individuals with DR (18.11 ± 5.35 ng/mL) compared to those without DR (19.71 ± 7.44 ng/mL), with a progressive decline observed across DR severity stages. Subgroup analyses showed significantly lower levels of vitamin D in proliferative DR compared to non-proliferative stages. Heterogeneity (I<sup>2</sup> = 89%) was noted, most probably due to geographic differences, varying methodologies for vitamin D measurement, and DR classification approaches. Secondary analyses indicated that vitamin D deficiency prevalence ranged from 27% to 95% in DR populations, highlighting its potential role in disease progression. This review highlights the need for longitudinal studies to better understand the causal relationship. The findings also call attention to a critical gap in the literature regarding the therapeutic role of vitamin D supplementation in preventing and managing DR. Addressing vitamin D deficiency as a modifiable risk factor in DM care may offer new avenues for reducing the burden of DR. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2024-12-01 |
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| series | Biomedicines |
| spelling | doaj-art-3b0572b708004ed5a25b77cdc3c955d92025-01-24T13:23:54ZengMDPI AGBiomedicines2227-90592024-12-011316810.3390/biomedicines13010068Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-AnalysisClaudia Elena Petrea0Laura Andreea Ghenciu1Roxana Iacob2Emil Robert Stoicescu3Dorel Săndesc4Department of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDepartment of Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaDepartment of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaRadiology and Medical Imaging University Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaDepartment of Anesthesia and Intensive Care, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDiabetic retinopathy (DR), a significant microvascular complication of diabetes mellitus (DM), remains a major cause of vision loss worldwide. Vitamin D, recognized for its role in bone health, has also been implicated in various non-skeletal conditions, including DR. This systematic review analyzed data from 20 studies involving 22,408 participants to explore the relationship between vitamin D levels and DR. Studies were included based on strict eligibility criteria, ensuring they could distinctly classify participants into DR and non-DR groups and provide quantitative measurements of vitamin D levels. Of these, nine studies were included in the meta-analysis. The pooled analysis revealed a significant association between lower vitamin D levels and increased odds of DR, with a combined odds ratio (OR) of 1.15 (95% CI: 1.10–1.20) under the fixed-effects model and 1.17 (95% CI: 1.08–1.27) under the random-effects model. Mean serum vitamin D levels were lower in individuals with DR (18.11 ± 5.35 ng/mL) compared to those without DR (19.71 ± 7.44 ng/mL), with a progressive decline observed across DR severity stages. Subgroup analyses showed significantly lower levels of vitamin D in proliferative DR compared to non-proliferative stages. Heterogeneity (I<sup>2</sup> = 89%) was noted, most probably due to geographic differences, varying methodologies for vitamin D measurement, and DR classification approaches. Secondary analyses indicated that vitamin D deficiency prevalence ranged from 27% to 95% in DR populations, highlighting its potential role in disease progression. This review highlights the need for longitudinal studies to better understand the causal relationship. The findings also call attention to a critical gap in the literature regarding the therapeutic role of vitamin D supplementation in preventing and managing DR. Addressing vitamin D deficiency as a modifiable risk factor in DM care may offer new avenues for reducing the burden of DR.https://www.mdpi.com/2227-9059/13/1/68diabetes mellitusdiabetic retinopathyvitamin Dvitamin D deficiency25-hydroxyvitamin Dsystematic review |
| spellingShingle | Claudia Elena Petrea Laura Andreea Ghenciu Roxana Iacob Emil Robert Stoicescu Dorel Săndesc Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis Biomedicines diabetes mellitus diabetic retinopathy vitamin D vitamin D deficiency 25-hydroxyvitamin D systematic review |
| title | Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis |
| title_full | Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis |
| title_fullStr | Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis |
| title_short | Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis |
| title_sort | vitamin d deficiency as a risk factor for diabetic retinopathy a systematic review and meta analysis |
| topic | diabetes mellitus diabetic retinopathy vitamin D vitamin D deficiency 25-hydroxyvitamin D systematic review |
| url | https://www.mdpi.com/2227-9059/13/1/68 |
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