The Association between Vitamin D Deficiency and Diabetic Retinopathy in Type 2 Diabetes: A Meta-Analysis of Observational Studies.
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SUBMITTER: Luo BA
PROVIDER: S-EPMC5372970 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Aims/introductionNon-alcoholic fatty liver disease (NAFLD) is becoming more and more prevalent in type 2 diabetes mellitus. Evidence connecting NAFLD to diabetic retinopathy (DR) is increasing, but the results vary. Thus, we undertook a meta-analysis to explore the effect of NAFLD on diabetic retinopathy in patients with type 2 diabetes mellitus.Materials and methodsPubMed, Embase, Cochrane and Scopus database were searched for until September 30, 2019. Original studies analyzing the association between NAFLD and diabetic retinopathy in the type 2 diabetic population were included. This meta-analysis was processed by RevMan 5.3 software. Subgroup analyses based on countries were carried out. The pooled odds ratios and 95% confidence intervals were used to evaluate the association between NAFLD and diabetic retinopathy incidence. The I2 test was used to assess heterogeneity of studies.ResultsWe retrieved 414 articles, and nine studies involving 7,170 patients were included in the final analysis. The pooled effects estimate suggested that NAFLD was not associated with the risk of diabetic retinopathy in patients with type 2 diabetes mellitus. Subgroup analysis suggested that in China, Korea and Iran, patients with type 2 diabetes mellitus with NAFLD had a decreased risk for diabetic retinopathy compared with the non-NAFLD individuals. However, in Italy and India, patients with type 2 diabetes mellitus with NAFLD had an increased risk for diabetic retinopathy compared with the non-NAFLD individuals. In addition, no relevance between NAFLD and diabetic retinopathy was found in America.ConclusionsOn the whole, there was no association between NAFLD and diabetic retinopathy in individuals with type 2 diabetes mellitus. However, subgroup analysis showed that a difference of country may have an influence on the result.
| S-EPMC8354494 | biostudies-literature
Project description:Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM). The associations of alcohol intake with DR risk have demonstrated contradictory results. Relevant studies were identified by searching electronic databases (Medline, EMBASE and Web of Science) until May 2016. We identified a total of 12,875 DR cases among 37,285 participants in 15 observational studies. The pooled estimation of all the included observational studies was 0.91 (95% CI, 0.79 to 1.06) in a random-effect model. Analyses stratified by study design showed no significant association between alcohol intake and DR incidence in cohort, case control or cross-sectional studies. In the subgroup analyses, neither beer nor spirits intake were associated with DR risk. Furthermore, it was interesting to find that protective effects were detected in the wine (OR = 0.77, 95% CI = 0.64 to 0.92) and sherry (OR = 0.22, 95% CI = 0.05 to 0.95) groups. In conclusion, this current meta-analysis demonstrated that alcohol intake was not associated with risk of DR. Subgroup analysis by alcoholic beverage types showed that wine consumption would reduce the incidence of DR. In the future, more large-scale prospective studies with detailed alcohol subtypes and contents are still warranted to clarify the association.
| S-EPMC5428369 | biostudies-literature
Project description:ObjectiveThe prognostic significance of diabetic retinopathy (DR) for death and cardiovascular (CV) outcomes is debated. We investigated the association of DR with all-cause mortality and CV events in patients with diabetes by a systematic review and meta-analysis.Research design and methodsThe electronic databases Medline and Embase were searched for cohort studies that evaluated DR in type 2 or type 1 diabetic patients and reported total mortality and/or fatal and nonfatal CV events, including myocardial infarction, angina pectoris, coronary artery bypass graft, ischemic changes on a conventional 12-lead electrocardiogram, transient ischemic attack, nonfatal stroke, or lower leg amputation. Data extraction was performed by two reviewers independently. Pooled effect estimates were obtained by using random-effects meta-analysis.ResultsThe analysis included 20 studies that fulfilled the inclusion criteria, providing data from 19,234 patients. In patients with type 2 diabetes (n = 14,896), the presence of any degree of DR increased the chance for all-cause mortality and/or CV events by 2.34 (95% CI 1.96-2.80) compared with patients without DR. In patients with type 1 diabetes (n = 4,438), the corresponding odds ratio was 4.10 (1.50-11.18). These associations remained after adjusting for traditional CV risk factors. DR was also predictive of all-cause mortality in type 2 diabetes (odds ratio 2.41 [1.87-3.10]) and type 1 diabetes (3.65 [1.05-12.66]).ConclusionsThe presence of DR was associated with an increased risk of all-cause mortality and CV events in both type 2 and type 1 diabetic patients.
| S-EPMC3114518 | biostudies-literature
Project description:The results investigating the relationship between vitamin D levels and gestational diabetes mellitus (GDM) are inconsistent. Thus, we focused on evaluating the association of vitamin D deficiency with GDM by conducting a meta-analysis of observed studies. A systematic literature search was conducted via PubMed, MEDLINE, and Cochrane library to identify eligible studies before August 2015. The meta-analysis of 20 studies including 9209 participants showed that women with vitamin D deficiency experienced a significantly increased risk for developing GDM (odds ratio (OR) = 1.53; 95% confidence intervals (CI), 1.33, 1.75) with a little heterogeneity (I² = 16.20%, p = 0.252). A noteworthy decrease of 4.93 nmol/L (95% CI, -6.73, -3.14) in serum 25(OH)D was demonstrated in the participants with GDM, and moderate heterogeneity was observed (I² = 61.40%, p = 0.001). Subgroup analysis with study design showed that there were obvious heterogeneities in nested case-control studies (I² > 52.5%, p < 0.07). Sensitivity analysis showed that exclusion of any single study did not materially alter the overall combined effect. In summary, the evidence from this meta-analysis indicates a consistent association between vitamin D deficiency and an increased risk of GDM. However, well-designed randomized controlled trials are needed to elicit the clear effect of vitamin D supplementation on prevention of GDM.
| S-EPMC4632418 | biostudies-literature
Project description:BACKGROUND:Genetic studies have reported contradictory results on the association between the intercellular adhesion molecule-1 (ICAM-1) rs5498 polymorphism and diabetic retinopathy (DR) risk in type 2 diabetic patients. We aimed to perform a systematic literature search and conduct random-effects meta-analysis to provide a quantitative evaluation. METHODS:We searched Pubmed, Embase, Scopus, Web of Science and Wanfang databases from inception up to January 2018. Allelic and genotype frequencies of rs5498 was compared between DR cases and controls. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random effects model. RESULTS:Nine studies involving a total of 1792 cases and 1400 controls met our inclusion criteria. We did not find any significant association between rs5498 and DR risk at the dominant model (GG?+?GA versus AA, OR?=?1.00, 95% CI: 0.66-1.50, P?=?0.987), the recessive model (GG versus GA?+?AA, OR?=?1.24, 95% CI: 0.86-1.77, P?=?0.245), the GG versus AA contrast (OR?=?1.14, 95% CI: 0.68-1.92, P?=?0.611), and the G allele versus A allele contrast (OR?=?1.08, 95% CI: 0.81-1.45, P?=?0.592). Subgroup analysis by ethnicity showed no association in Asian populations (G allele versus A allele: OR?=?1.05, 95% CI: 0.76-1.44, P?=?0.790). Subgroup analysis by DR subtype also did not reveal any association of rs5498 with proliferative DR (G allele versus A allele: OR?=?1.34, 95% CI: 0.71-2.52, P?=?0.364) and non-proliferative DR (G allele versus A allele: OR?=?0.71, 95% CI: 0.43-1.17, P?=?0.180). CONCLUSION:Our meta-analyses provide no evidence of the association of rs5498 with DR in type 2 diabetic patients.
| S-EPMC6233373 | biostudies-literature
Project description:Emerging evidence has shown that vitamin D deficiency may be related with community-acquired pneumonia (CAP), but individually published studies showed inconclusive results. The aim of this study was to quantitatively summarize the association between vitamin D and the CAP.We conducted this meta-analysis though a systematic literature search of PubMed, Medline, and EMBASE up to 31 September 2018 with the following keywords 'vitamin D' or 'cholecalciferol' or '25-hydroxyvitamin D' or '25(OH)D' in combination with 'community-acquired pneumonia' or 'CAP' or 'pneumonia' with no limitations. This meta-analysis was performed following the guidelines of Meta-analysis of Observational Studies in Epidemiology. The association between vitamin D levels and CAP were measured as odds ratio (OR) and weighted mean difference (WMD). Results were combined using a random-effect or a fix-effect meta-analysis, and sensitivity analyses were conducted to explore potential factors.Eight observational studies involving 20,966 subjects were included. In this meta-analysis, CAP patients with vitamin D deficiency (serum 25(OH)D levels <20?ng/mL) experienced a significantly increased risk of CAP (odds ratio (OR) = 1.64, 95% confidence intervals (CI): 1.00, 2.67), and an obvious decrease of -5.63?ng/mL (95% CI: -9.11, -2.14) in serum vitamin D was demonstrated in CAP patients. Sensitivity analysis showed that exclusion of any single study did not materially alter the overall combined effect.The evidence from this meta-analysis indicates an association between vitamin D deficiency and an increased risk of CAP patients. However, well-designed trails are required to determine the explicit effect of vitamin D supplementation.
| S-EPMC6756683 | biostudies-literature
Project description:OBJECTIVE: Diabetic retinopathy is a sight-threatening microvascular complication of diabetes with a complex multifactorial pathogenesis. A systematic meta-analysis was undertaken to collectively assess genetic studies and determine which previously investigated polymorphisms are associated with diabetic retinopathy. RESEARCH DESIGN AND METHODS: All studies investigating the association of genetic variants with the development of diabetic retinopathy were identified in PubMed and ISI Web of Knowledge. Crude odds ratios (ORs) and 95% CIs were calculated for single nucleotide polymorphisms and microsatellite markers previously investigated in at least two published studies. RESULTS: Twenty genes and 34 variants have previously been studied in multiple cohorts. The aldose reductase (AKR1B1) gene was found to have the largest number of polymorphisms significantly associated with diabetic retinopathy. The z-2 microsatellite was found to confer risk (OR 2.33 [95% CI 1.49-3.64], P = 2 x 10(-4)) in type 1 and type 2 diabetes and z+2 to confer protection (0.58 [0.36-0.93], P = 0.02) against diabetic retinopathy in type 2 diabetes regardless of ethnicity. The T allele of the AKR1B1 promoter rs759853 variant is also significantly protective against diabetic retinopathy in type 1 diabetes (0.5 [0.35-0.71], P = 1.00 x 10(-4)), regardless of ethnicity. These associations were also found in the white population alone (P < 0.05). Polymorphisms in NOS3, VEGF, ITGA2, and ICAM1 are also associated with diabetic retinopathy after meta-analysis. CONCLUSIONS: Variations within the AKR1B1 gene are highly significantly associated with diabetic retinopathy development irrespective of ethnicity. Identification of genetic risk factors in diabetic retinopathy will assist in further understanding of this complex and debilitating diabetes complication.
| S-EPMC2731535 | biostudies-literature
Project description:Type 2 diabetes is one of the most common diseases with devastating complications. However, genetic susceptibility of diabetic complications has not been clarified. The vitamin D endocrine system is related with calcification and lipolysis, insulin secretion, and may be associated with many complicated disease including diabetes and cardiovascular disease. Recent studies reported that single nucleotide polymorphisms of vitamin D receptor (VDR) gene were associated with diabetic complications.In present study, we evaluated the association of BsmI polymorphism of VDR with diabetic complications in Korean diabetes patients. Total of 537 type 2 diabetic subjects from the Endocrinology Clinic of Chungbuk National University Hospital were investigated. Polymerase chain reaction-restriction fragment length polymorphism was used to test the genotype and allele frequency of BsmI (rs1544410; BB, Bb, bb) polymorphisms.Mean age was 62.44±10.64 years and mean disease duration was 13.65±7.39 years. Patients with B allele (BB or Bb) was significantly associated with lower risk of diabetic retinopathy (severe non-proliferative diabetic retinopathy or proliferative retinopathy; 7.4%, 5/68) compared with patients without B allele (bb; 17.3%, 81/469; P=0.035). This association was also significant after adjusting for hemoglobin A1c level, body mass index, age, sex, and diabetes mellitus duration, concurrent dyslipidemia and hypertension (odds ratio, 2.99; 95% confidence interval, 1.08 to 8.29; P=0.035) in logistic regression analysis.Our findings suggest that B allele of Bsm1 polymorphism in VDR gene is associated with lower risk of diabetic retinopathy in type 2 diabetic patients. Bsm1 genotype could be used as a susceptibility marker to predict the risk of diabetes complication.
| S-EPMC4722400 | biostudies-literature
Project description:BACKGROUND AND OBJECTIVES:The association of diabetic retinopathy (DR) and diabetic macular oedema (DME) with renal function in southern Chinese patients with diabetes is poorly understood. So we aimed to study the correlation between stage of DR and DME with stage of estimated glomerular filtration rate (eGFR) and stage of urine albumin-to-creatinine ratio (UACR), and to explore the systemic risk factors for DR and DME. DESIGN AND SETTING:This single-centre retrospective observational study was conducted from December 2017 to November 2018. PARTICIPANTS:413 southern Chinese patients with type 2 diabetes mellitus. OUTCOME MEASURES:The correlations between stage of DR and DME with stage of eGFR/UACR were assessed by Spearman's or χ² analyses and represented with histograms. Risk factors associated with the occurrence of DR and DME were performed by logistic regression and represented with nomograms. RESULTS:Stage of DR had a positive correlation with stage of eGFR (r=0.264, p<0.001) and stage of UACR (r=0.542, p<0.001). With the stage of eGFR/UACR being more severe, the prevalence of DME became higher as well (both p<0.001). The risk factors for DR were DM duration (OR 1.072; 95% CI 1.032 to 1.114; p<0.001), stage of UACR (OR 2.001; 95% CI 1.567 to 2.555; p<0.001) and low-density lipoprotein (LDL) (OR 1.301; 95% CI 1.139 to 1.485; p<0.001), while risk factors for DME were stage of UACR (OR 2.308; 95% CI 1.815 to 2.934; p<0.001) and LDL (OR 1.460; 95% CI 1.123 to 1.875; p=0.008). CONCLUSIONS:Among southern Chinese patients, stage of DR and DME were positively correlated with renal function, while stage of UACR performed a better relevance than stage of eGFR.
| S-EPMC6731866 | biostudies-other
Project description:Type 2 diabetic mellitus (T2DM) is a disease with high prevalence and a major cause for death worldwide. Diabetic retinopathy (DR) is one of the major manifestation of diabetes. Aldehyde dehydrogenease 2 (ALDH2) detoxifies aldehyde produced during ethanol metabolism and oxidative stress. It has been found that the polymorphism in ALDH2 rs671 is probably associated with the risk of T2DM and DR. However, a lot of inconsistency and controversy still exists. In order to get a more precise and comprehensive estimation for the association between ALDH2 polymorphism with the risk of T2DM and DR, we conducted the present meta-analysis. A comprehensive literature search was conducted using databases, such as Pubmed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, and Chinese Biomedical Literature Database, for all related studies. The included studies met the inclusion criteria, such as being case-control studies about the association of ALDH2 polymorphism and T2DM or DR susceptibility, with sufficient data for the present analysis. Eight studies with 2374 cases and 6694 controls were involved in the present meta-analysis. The results indicated a significant lower risk of T2DM for *1/*1 genotype in homozygous models (*1/*1 vs. *2/*2, OR = 0.31, 95% CI = 0.11-0.89, p = 0.03) and in the dominant model (*1/*1 vs. *2/*2 + *1/*2, OR = 0.61, 95% CI = 0.37-1.00, p = 0.05). Subgroup analysis by ethnicity found a significant lower risk of T2DM in Chinese in all genotype models. No significant relation was found between ALDH2 rs671 and DR. In conclusion, the current meta-analysis indicated that ALDH2 rs671 was significantly related with T2DM. The ALDH2 rs671 might be able to be used as a predictor for the risk of T2DM. However, due to the existence of heterogeneity and publication bias in the involved studies, our results should be interpreted with caution.
| S-EPMC5334719 | biostudies-literature