Vitamin D and diabetic foot ulcer: a systematic review and meta-analysis.

Jiezhi Dai, Chaoyin Jiang, Hua Chen, Yimin Chai

Journal: Nutrition & diabetes 2020;9(1):8

PMID: 30858355

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Plain Language Summary

The diabetic foot ulcer is a severe complication in patients with diabetes mellitus. The aim of the study was to assess the relationship between serum vitamin D levels with diabetic foot ulcer. The study is a review and metanalysis of seven cohort studies of which one was published in Russian. 115 patients were recruited for the study. The meta-analysis results indicate that patients with diabetic foot ulcer had significantly lower vitamin D levels compared to diabetic patients without foot ulcer. Authors conclude that severe vitamin D deficiency was associated with an increased risk of diabetic foot ulcer.

Abstract

We aimed to evaluate the association between vitamin D deficiency and diabetic foot ulcer (DFU) in patients with diabetes. Pubmed, EMBASE, BIOSIS, the Cochrane Library, and Web of Knowledge, last updated in July 2018, were searched. We assessed eligible studies for the association between vitamin D deficiency and DFU in diabetic patients. The mean difference (MD) or the odds ratio (OR) was calculated for continuous or dichotomous data respectively. Data were analyzed by using the Cochrane Collaboration's RevMan 5.0 software. Seven studies that involved 1115 patients were included in this study. There were significantly reduced vitamin D levels in DFU (MD -13.47 nmol/L, 95%CI -16.84 to -10.10; P = 0.34, I = 12%). Severe vitamin D deficiency was significantly associated with an increased risk of DFU (OR 3.22, 95%CI 2.42-4.28; P = 0.64, I = 0%). This is the first meta-analysis demonstrating the association between serum vitamin D levels and DFU. Severe vitamin D deficiency is significantly associated with an increased risk of DFU.

Address: Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.; Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. [email protected].; Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. [email protected].

DOI: 10.1038/s41387-019-0078-9