Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials
Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP
BMJ (Clinical research ed.) · 682 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2014-04-01 · BMJ · vol. 348 · número apr01 2 · pág. g2035
- Citado
- 956 citas · más que el 100% de estudios similares · 17.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 159 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY-NC
- Áreas de investigación
- Vitamin D Research Studies · Nutrition and Health Studies · Nutritional Studies and Diet
- Palabras clave
- vitamin D, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, vitamin D supplementation, birth weight, dental caries, parathyroid hormone, chronic kidney disease, bone mineral density, fracture, falls in older adults, quality of evidence
- MeSH
- humans, vitamins, vitamin d, dietary supplements, meta-analysis as topic, randomized controlled trials as topic, observational studies as topic, systematic reviews as topic
4 autores
- Evropi Τheodoratou🇬🇧 · autor de correspondenciaUniversity of Edinburgh
- Ioanna Tzoulaki🇬🇷🇬🇧University of Ioannina; Imperial College London
- Lina Zgaga🇮🇪Trinity College Dublin
- John P. A. Ioannidis🇺🇸Stanford Medicine; Stanford University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
To evaluate the breadth, validity, and presence of biases of the associations of vitamin D with diverse outcomes.
Design
Umbrella review of the evidence across systematic reviews and meta-analyses of observational studies of plasma 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D concentrations and randomised controlled trials of vitamin D supplementation.
Data sources
Medline, Embase, and screening of citations and references.
Eligibility criteria
Three types of studies were eligible for the umbrella review: systematic reviews and meta-analyses that examined observational associations between circulating vitamin D concentrations and any clinical outcome; and meta-analyses of randomised controlled trials assessing supplementation with vitamin D or active compounds (both established and newer compounds of vitamin D).
Results
107 systematic literature reviews and 74 meta-analyses of observational studies of plasma vitamin D concentrations and 87 meta-analyses of randomised controlled trials of vitamin D supplementation were identified. The relation between vitamin D and 137 outcomes has been explored, covering a wide range of skeletal, malignant, cardiovascular, autoimmune, infectious, metabolic, and other diseases. Ten outcomes were examined by both meta-analyses of observational studies and meta-analyses of randomised controlled trials, but the direction of the effect and level of statistical significance was concordant only for birth weight (maternal vitamin D status or supplementation). On the basis of the available evidence, an association between vitamin D concentrations and birth weight, dental caries in children, maternal vitamin D concentrations at term, and parathyroid hormone concentrations in patients with chronic kidney disease requiring dialysis is probable, but further studies and better designed trials are needed to draw firmer conclusions. In contrast to previous reports, evidence does not support the argument that vitamin D only supplementation increases bone mineral density or reduces the risk of fractures or falls in older people.
Conclusions
Despite a few hundred systematic reviews and meta-analyses, highly convincing evidence of a clear role of vitamin D does not exist for any outcome, but associations with a selection of outcomes are probable.
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