Liu Lu, Zhang Fan, Jamali Mehrdad, Guimarães Nathalia Sernizon, Radkhah Nima, Jamilian Parmida, Wang Qian
Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Department of Orthopedics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.
Front Nutr. 2024 Oct 9;11:1454779. doi: 10.3389/fnut.2024.1454779. eCollection 2024.
Complications related to diabetic foot ulcers (DFU) due to diabetes are increasing. One of the factors influencing the management and treatment of complications related to DFU is the vitamin D serum levels of patients. Therefore, we sought to comprehensively review meta-analyses from randomized controlled trials and observational studies examining the link between serum vitamin D levels and DFU outcomes in diabetic patients.
We searched PubMed, Scopus, and ISI Web of Science until September 2024 and extracted the required data from related articles according to Inclusion criteria. The certainty of the evidence and the quality of conduct of the published meta-analyses were rated using the ASMTAR 2 tools, respectively.
A total of 8 meta-analyses studies that met inclusion criteria were included. Based on the obtained results, it has been noted that individuals with DFU exhibit serum vitamin D levels significantly lower, ranging from -7.14 (5.44, 8.83) to -0.93 (95% CI: 0.17, 1.68) ng/ml, compared to those with diabetes but without DFU. Furthermore, individuals exhibiting severe vitamin D deficiency are found to be at least 1.82 times more susceptible to developing DFU. Conversely, administering varying doses of vitamin D supplementation has been shown to positively affect the size and number of ulcers in DFU patients.
This study suggests a potential link between lower levels of vitamin D in the blood and the risk of DFU, hinting at the benefits of vitamin D supplementation in improving outcomes associated with DFU. However, caution is warranted due to the potential bias present in the included studies.
糖尿病引发的糖尿病足溃疡（DFU）相关并发症日益增多。影响DFU相关并发症管理与治疗的因素之一是患者的血清维生素D水平。因此，我们试图全面回顾来自随机对照试验和观察性研究的荟萃分析，以探究糖尿病患者血清维生素D水平与DFU结局之间的联系。
我们检索了截至2024年9月的PubMed、Scopus和ISI科学网，并根据纳入标准从相关文章中提取所需数据。分别使用ASMTAR 2工具对已发表荟萃分析的证据确定性和实施质量进行评级。
共纳入8项符合纳入标准的荟萃分析研究。根据所得结果，已注意到与患有糖尿病但无DFU的个体相比，DFU患者的血清维生素D水平显著更低，范围在-7.14（5.44，8.83）至-0.93（95%置信区间：0.17，1.68）ng/ml之间。此外，发现维生素D严重缺乏的个体发生DFU的易感性至少高1.82倍。相反，给予不同剂量的维生素D补充剂已显示对DFU患者溃疡的大小和数量有积极影响。
本研究表明血液中维生素D水平较低与DFU风险之间可能存在联系，提示维生素D补充剂在改善与DFU相关结局方面的益处。然而，由于纳入研究中存在潜在偏倚，仍需谨慎。
