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. 2023 Jun 22:10:1132528.
doi: 10.3389/fnut.2023.1132528. eCollection 2023.

The effects of vitamin D on all-cause mortality in different diseases: an evidence-map and umbrella review of 116 randomized controlled trials

Mingyu Cao  1 , Chunrong He  2 , Matthew Gong  2 , Song Wu  1 , Jinshen He  1
Affiliations

The effects of vitamin D on all-cause mortality in different diseases: an evidence-map and umbrella review of 116 randomized controlled trials

Mingyu Cao et al. Front Nutr. .

Abstract

Purpose: To conduct a solid evidence by synthesizing meta-analyses and updated RCTs about the effects of vitamin D on all-cause mortality in different health conditions.

Methods: Data sources: Pubmed, Embase, Web of Science, the Cochrane Library, Google Scholar from inception until 25th April, 2022. Study selection: English-language, meta-analyses and updated RCTs assessing the relationships between vitamin D and all-cause mortality. Data synthesis: Information of study characteristics, mortality, supplementation were extracted, estimating with fixed-effects model. A Measurement Tool to Assess Systematic Reviews, Grading of Recommendations Assessment, Development and Evaluation, and funnel plot was used to assess risk of bias. Main outcomes: All-cause mortality, cancer mortality, cardiovascular disease mortality.

Results: In total of 27 meta-analyses and 19 updated RCTs were selected, with a total of 116 RCTs and 149, 865 participants. Evidence confirms that vitamin D reduces respiratory cancer mortality (RR, 0.56 [95%CI, 0.33 to 0.96]). All-cause mortality is decreased in patients with COVID-19 (RR, 0.54[95%CI, 0.33 to 0.88]) and liver diseases (RR, 0.64 [95%CI, 0.50 to 0.81]), especially in liver cirrhosis (RR, 0.63 [95%CI, 0.50 to 0.81]). As for other health conditions, such as the general health, chronic kidney disease, critical illness, cardiovascular diseases, musculoskeletal diseases, sepsis, type 2 diabetes, no significant association was found between vitamin D and all-cause mortality.

Conclusions: Vitamin D may reduce respiratory cancer mortality in respiratory cancer patients and all-cause mortality in COVID-19 and liver disorders' patients. No benefits showed in all-cause mortality after vitamin D intervention among other health conditions. The hypothesis of reduced mortality with vitamin D still requires exploration.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=252921, identifier: CRD42021252921.

Keywords: COVID-19; all-cause mortality; patients; umbrella review; vitamin D.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Effects of vitamin D on cancer mortality in cancer population. (A) Forest plot showing effects of vitamin D on cancer mortality in all kinds of cancer population. (B) Subgroup analysis on prostate cancer mortality in prostate cancer population. (C) Subgroup analysis on digestive cancer mortality in digestive cancer population. (D) Subgroup analysis on respiratory cancer mortality in respiratory cancer population.
Figure 3
Figure 3
Effects of vitamin D on all-cause mortality in respiratory disease population. (A) Forest plot showing effects of vitamin D on all-cause mortality in all kinds of respiratory diseases population. (B) Subgroup analysis on all-cause mortality in COVID-19 population. (C) Subgroup analysis on all-cause mortality in PTB population. (D) Subgroup analysis on all-cause mortality in COPD population. (E) Subgroup analysis on all-cause mortality in pneumonia population.
Figure 4
Figure 4
Effects of vitamin D on mortality in liver disease population. (A) Forest plot showing effects of vitamin D on all-cause mortality in all kinds of liver diseases population. (B) Forest plot showing effects of vitamin D on CVD mortality in all kinds of liver diseases population. (C) Subgroup analysis on all-cause mortality in liver cirrhosis and hepatitis population. (D) Subgroup analysis on CVD mortality in liver cirrhosis and hepatitis population.
Figure 5
Figure 5
Evidence map of umbrella review by participants and mortality.
Figure 6
Figure 6
Overall discussion.
See this image and copyright information in PMC

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