Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Clin Cardiol. 2023 Jul;46(7):721-728. doi: 10.1002/clc.24035. Epub 2023 May 24.
Vasovagal syncope (VVS) is the most prevalent type of syncope and its management includes pharmacologic and non-pharmacologic interventions. Recently, studies have investigated vitamin D levels in VVS patients. In this systematic review and meta-analysis, we aim to review these studies to find possible associations between vitamin D deficiency and vitamin D levels with VVS. International databases including Scopus, Web of Science, PubMed, and Embase were searched with keywords related to "vasovagal syncope" and "vitamin D." Studies were screened and the data were extracted from them. Random-effect meta-analysis was conducted to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for vitamin D levels in comparison to VVS patients and controls. Also, VVS occurrence was measured and the odds ratio (OR) and 95% CI were calculated for comparison of vitamin D deficient cases and nondeficient individuals. Six studies were included with 954 cases investigated. Meta-analysis showed that patients with VVS had significantly lower vitamin D serum levels in comparison to non-VVS cases (SMD -1.05, 95% CI -1.54 to -0.57, p-value < .01). Moreover, VVS occurrence was higher in vitamin D-deficient individuals (OR 5.43, 95% CI 2.40 to 12.27, p-value < .01). Our findings which show lower vitamin D levels in VVS patients can have clinical implications in order for clinicians to pay attention to this when approaching VVS. Further randomized controlled trials are certainly warranted to assess the role of vitamin D supplementation in individuals with VVS.
血管迷走性晕厥 (VVS) 是最常见的晕厥类型，其治疗包括药物和非药物干预。最近，有研究调查了 VVS 患者的维生素 D 水平。在这项系统评价和荟萃分析中，我们旨在回顾这些研究，以发现维生素 D 缺乏症与 VVS 之间的可能关联。我们使用了与“血管迷走性晕厥”和“维生素 D”相关的关键词，对 Scopus、Web of Science、PubMed 和 Embase 等国际数据库进行了搜索。筛选研究并从中提取数据。我们进行了随机效应荟萃分析，以计算与 VVS 患者和对照组相比维生素 D 水平的标准化均数差 (SMD) 和 95%置信区间 (CI)。此外，还测量了 VVS 的发生情况，并计算了比较维生素 D 缺乏症和非缺乏症个体的比值比 (OR) 和 95%CI。纳入了 6 项研究，共纳入了 954 例患者。荟萃分析显示，与非 VVS 病例相比，VVS 患者的维生素 D 血清水平明显较低 (SMD -1.05，95%CI -1.54 至 -0.57，p 值 < .01)。此外，维生素 D 缺乏症患者的 VVS 发生率更高 (OR 5.43，95%CI 2.40 至 12.27，p 值 < .01)。我们的研究结果表明，VVS 患者的维生素 D 水平较低，这可能对临床医生在处理 VVS 时具有重要意义。当然，还需要进一步的随机对照试验来评估维生素 D 补充剂在 VVS 患者中的作用。
