Journal Article Review Epublish
PubMed: 39857652 DOI: 10.3390/biomedicines13010068
Vitamin D Deficiency as a Risk Factor for Diabetic Retinopathy: A Systematic Review and Meta-Analysis.
Biomedicines 13(1)
Authors: Claudia Elena Petrea, Laura Andreea Ghenciu, Roxana Iacob, Emil Robert Stoicescu, Dorel Săndesc
Affiliations
- Department of Anatomy and Embriology, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
- Department of Functional Sciences, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
- Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, "Politehnica" University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania.
- Radiology and Medical Imaging University Clinic, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
- Research Center for Pharmaco-Toxicological Evaluations, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
- Department of Anesthesia and Intensive Care, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Abstract
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 = 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.
MeSH
Diabetes Mellitus, Vitamin D, Research Design, Vitamins, Risk Factors, Vitamin D Deficiency, Diabetic Retinopathy