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Journal of Diabetes & Metabolic Disorders
Published in: Journal of Diabetes & Metabolic Disorders 1/2022

Open Access 26-05-2022 | Diabetic Retinopathy | Review article

Associations between vitamin D status and sight threatening and non-sight threatening diabetic retinopathy: a systematic review and meta-analysis

Authors: Mike Trott, Robin Driscoll, Enrico Iraldo, Shahina Pardhan

Published in: Journal of Diabetes & Metabolic Disorders | Issue 1/2022

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Abstract

Background

Vitamin D levels have been shown to be associated with diabetic retinopathy, however to date, no review has examined the relationship between vitamin D and sight threatening diabetic retinopathy (STDR) and non-sight threatening diabetic retinopathy (NSTDR). The aim of this review, therefore, was to pool associations between vitamin D deficiency (25(OH)D < 20 ng/mL) and STDR/NSTDR. A further aim was to examine associations between circulating 25(OH)D levels and STDR/NSTDR.

Methods

A systematic review of major databases was undertaken for studies published from inception to 22/04/2022, using a pre-published protocol. Studies reporting prevalence of STDR or NSTDR versus a control group with diabetes and no DR or DME and either (a) vitamin D deficiency prevalence, or (b) circulating 25(OH)D levels, were included. A random effects meta-analysis was undertaken.

Results

Following screening, 12 studies (n = 9057) were included in the meta-analysis. STDR was significantly associated with vitamin D deficiency (OR = 1.80 95%CI 1.40–2.30; p = <0.001), whereas NSTDR was not (OR = 1.07 95%CI 0.90–1.27; p = 0.48). Both conclusions were graded as low credibility of evidence. Furthermore, circulating 25(OH)D levels were significantly associated with both NSTDR (SMD = -0.27 95%CI -0.50; −0.04; p = 0.02) and STDR (SMD = −0.49 95%CI -0.90; −0.07; p = 0.02), although these were graded as low credibility of evidence.

Conclusion

Vitamin D deficiency is significantly associated with STDR (including DME), but not with NSTDR. Given the well-reported associations between vitamin D deficiency and other unfavourable outcomes, it is important that vitamin D deficiency is managed appropriately and in a timely manner to reduce the risk of blindness in people with diabetes.
Appendix
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Metadata
Title
Associations between vitamin D status and sight threatening and non-sight threatening diabetic retinopathy: a systematic review and meta-analysis
Authors
Mike Trott
Robin Driscoll
Enrico Iraldo
Shahina Pardhan
Publication date
26-05-2022
Publisher
Springer International Publishing
Published in
Journal of Diabetes & Metabolic Disorders / Issue 1/2022
Electronic ISSN: 2251-6581
DOI
https://doi.org/10.1007/s40200-022-01059-3

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