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

Su, Cen; Jin, Bong‐Soo; Xia, Haiping; Kang-ren, Zhao

doi:10.1159/000517584

Cited by 10 publications

(13 citation statements)

References 60 publications

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“…This is also confirmed by a meta-analysis by Zhou, Wang, Huang et al, which also found that low vitamin D levels were not associated with hemorrhagic stroke [72]. There is no lack of systematic reviews and meta-analyses that deny the protective effect of vitamin D [73] and confirm that low vitamin D levels are associated with an increased risk of stroke, but additional supplements have no impact on risk reduction [74].…”

Section: Vitamin D and Stroke Incidencementioning

confidence: 64%

The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review

et al. 2022

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Hypovitaminosis D is a serious public health problem, representing an independent factor in mortality among the general population. Vitamin D deficiency may affect up to one billion people worldwide. Recently, the potential association between vitamin D levels and stroke has gained increasing attention. Many studies suggest that maintaining normal serum vitamin D levels is associated with improvement of the cardiovascular system and a reduction in stroke risk. As a neurosteroid, vitamin D influences brain development and function and immunomodulation and affects brain neuroplasticity. It supports many processes that maintain homeostasis in the body. As stroke is the second most common cause of death worldwide, more studies are needed to confirm the positive effects of vitamin D supplementation, its dosage at different stages of the disease, method of determination, and effect on stroke onset and recovery. Many studies on stroke survivors indicate that serum vitamin D levels only offer insignificant benefits and are not beneficial to recovery. This review article aims to highlight recent publications that have examined the potential of vitamin D supplementation to improve rehabilitation outcomes in stroke survivors. Particular attention has been paid to stroke prevention.

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Section: Vitamin D and Stroke Incidencementioning

confidence: 64%

The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review

et al. 2022

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“…According to recent meta-analyses involving 15 RCTs and more than 80,000 participants ( 15 ), there was no significant benefit from vitamin D supplementation for stroke prevention (Su et al: HR = 1.05, 95% CI: 0.96–1.14, P = 0.425). In total three other meta-analyses ( 26 , 28 , 53 ) also failed to demonstrate a reduction in stroke incidence with vitamin D supplementation.…”

Section: Discussionmentioning

confidence: 99%

“…Vitamin D also exhibits several neuroprotective effects ( 6 – 8 ), namely, enhancing synaptic plasticity ( 9 ), reducing oxidative stress ( 10 ), and reducing brain damage and inflammatory responses in ischemic and neurodegenerative diseases ( 11 , 12 ). Several studies have demonstrated that vitamin D deficiency was an independent risk factor for ischemic stroke ( 13 – 15 ). Vitamin D deficiency has been associated with increased severity and poor prognosis following stroke ( 7 , 8 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, the results of RCTs on the association between vitamin D supplements and the prevention of cardiovascular disease, including stroke showed no protective effect of vitamin D supplementation against stroke ( 22 – 25 ). Furthermore, meta-analyses on vitamin D supplementation have not demonstrated measurable benefits in reducing the risk of stroke ( 15 , 26 – 28 ). Therefore, we performed a meta-analysis of published RCTs to investigate whether vitamin D supplementation could prevent stroke.…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D supplementation and risk of stroke: A meta-analysis of randomized controlled trials

2022

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BackgroundPrevious observational studies have supported the hypothesis that vitamin D supplementation protects against stroke. However, several current intervention studies contradict this observation. Therefore, we conducted a meta-analysis to investigate further the association between vitamin D supplementation and the risk of stroke.MethodsThis meta-analysis was conducted in accordance with the PRISMA statement and included all the randomized controlled trials (RCTs) that analyzed the relationship between vitamin D supplementation and the risk of stroke. A literature search strategy was established, and the following Medical Search Terms (MeSH) were used: “vitamin D,” “Calcitriol,” “Calcifediol,” “Cholecalciferol,” “25-Hydroxyvitamin D 2,” “ergocalciferols,” “stroke,” and stroke-derived terms. We searched for articles published before January 2022 in several databases, namely, PubMed, Web of Science, EMBASE, and The Cochrane Library. We also reviewed references included in relevant published meta-analyses and searched the http://www.ClinicalTrials.gov website for additional RCTs. The Q test and I2 were utilized to assess the degree of heterogeneity among the studies. Review Manager 5.3 and STATA16.0 software programs were used to assess the literature quality and perform statistical analyses.ResultsIn total, twenty-four RCTs (86,202 participants) were included. There was no statistical heterogeneity among the RCTs (I2 = 0.0%, P = 0.94) included in this meta-analysis. We determined that vitamin D supplementation was not associated with a reduced risk of stroke compared with the placebo (RR = 1.02, 95% CI: 0.93–1.13, P = 0.65). In total, 10 studies only included women, and 14 studies included women and men among the 24 RCTs. Therefore, we performed a subgroup analysis based on sex. After the subgroup analysis, the effect remained statistically insignificant (mixed-sex group: RR = 1.06, 95% CI: 0.93–1.22, P = 0.37, women group: RR = 0.98, 95% CI: 0.86–1.13, P = 0.80). The results were generally comparable, based on age, body mass index (BMI), follow-up period, baseline 25-hydroxyvitamin D (25(OH)D) levels, the designated endpoint, latitude, vitamin D dosage, type of vitamin D administered, and an absence or presence of concurrent calcium supplementation (P > 0.05).ConclusionOur study revealed that additional vitamin D supplementation did not reduce the risk of stroke. Therefore, additional RCTs of similar design should not be encouraged to assess any association between vitamin D supplementation and reduced stroke risk.

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“…A higher inflammatory status underpinning the vitamin D deficiency might also explain its role in neurological diseases, such as multiple sclerosis [ 14 ], stroke [ 28 ], and Parkinson disease [ 15 ]. These findings can support a possible role of vitamin D deficiency on brain health, notably for the risk of dementia and cognitive impairment; indeed, Navale et al showed that hypovitaminosis D was associated with neuroimaging outcomes and a higher risk of dementia and stroke [ 29 ].…”

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confidence: 99%

Vitamin D for Clinical Diseases in Women: An Indispensable Factor in Medicine and Dentistry

Calafiore

Lombardo

Migliario

2022

JCM

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Vitamin D, commonly known as the “sunshine vitamin”, is a secosteroid hormone. It is recognized for its neuroprotective role in brain development and it has a key role in bone metabolism, muscle function, oral health, and temporomandibular disorders. Vitamin D is involved in a range of important physiological processes, such as promoting cell growth and differentiation, facilitating immunomodulation regulation, neurotransmission, and alleviating anti-inflammatory effects. Vitamin D deficiency is known to be implicated in a range of pathological conditions, particularly in women, including: musculoskeletal disorders; metabolic, autoimmune, and cardiovascular diseases; oral health status; temporomandibular disorders; malignancies; psychiatric conditions; and chronic pain. In this scenario, ongoing research is investigating the role of vitamin D in subcellular, molecular, and chemical processes, with a high interest in physiology, as read in the recent literature on vitamin D deficiency in the female sex. Therefore, in the present Special Issue, we aim to present evidence on the key role that vitamin D might play in the wellbeing of bone health, musculoskeletal status, oral health status, temporomandibular disorders, and pregnancy, in women.

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

Cited by 10 publications

References 60 publications

The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review

The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review

Vitamin D supplementation and risk of stroke: A meta-analysis of randomized controlled trials

Vitamin D for Clinical Diseases in Women: An Indispensable Factor in Medicine and Dentistry

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