A recently published meta-analysis of sixteen observational studies including 47,648 individuals concludes that vitamin D deficiency may be linked to an increased risk of venous thromboembolism (VTE).
Because of the reduced survival rate, high cost of treatment, and frequent recurrence, venous thromboembolism is considered a critical public health problem.
Although vitamin D is antithrombotic, associations between serum vitamin D status and the risk of venous thromboembolism (VTE) remain inconsistent.
In the past, low vitamin D levels have been linked to an increased risk of VTE. However, these findings may have been influenced by a potential dose-dependent effect. In addition, a previous meta-analysis focusing on case-control studies revealed no correlation between vitamin D level and VTE, indicating weak evidence on this topic.
To address these concerns, a new meta-analysis sought to define the relationship between vitamin D level and the risk of venous thromboembolism, along with secondary analyses on study designs, the existence of neurological disease, and the potential effects of vitamin D status.
This analysis included 16 observational studies involving 47,648 people, providing strong additional evidence on this topic.
The previous meta-analysis studied the association between vitamin D status and VTE risk by combining odds ratio and risk ratio. In contrast, the current analysis evaluated the likelihood ratio and risk ratio data separately to minimize possible bias. The dose-dependent correlation between vitamin D levels and VTE risk was also evaluated.
In addition, this meta-analysis covered studies in different clinical settings, so the results can be applied to a spectrum of individuals.
This updated meta-analysis of sixteen observational studies that enrolled 47,648 individuals revealed a negative relationship between vitamin D status and the risk of venous thromboembolism. The low heterogeneity (I2 = 31%) and absence of significant publication bias in the current study highlighted the robustness of the derived evidence.”
Further studies are needed to investigate the potential beneficial effect of vitamin D supplementation on the long-term risk of venous thromboembolism.
Embase, Medaline, Cochrane Library and Google Scholar databases were consulted to find observational studies exploring the links between vitamin D level and the risk of venous thromboembolism in people. The correlation between vitamin levels and the risk of venous thromboembolism was visualized as the odds ratio and the risk ratio.
Secondary outcomes included the effects of research design, existence of neurological disorders, and vitamin D status on associations.
The pool revealed a negative relationship between vitamin D levels and the risk of venous thromboembolism by both odds ratio and risk ratio.
This association remained significant in subgroup analyses of the study design and in the presence of neurological disease. Compared with subjects with normal vitamin D status, an increased risk of venous thromboembolism was observed in subjects with vitamin D deficiency (OR = 2.03, 95% CI: 1.33 to 3.11) but not with insufficiency.
Mechanism of Action
Preservation of calcium and bone homeostasis is a well-known function of vitamin D, a secosteroid hormone. It has been found to have extraskeletal pleiotropic effects on the circulatory, nervous, and immunologic systems. Due to its anti-inflammatory and antioxidative qualities, vitamin D may also protect vascular endothelial injury.
In addition, vitamin D inhibits the coagulation pathway, which makes it antithrombotic. Therefore, a deficiency of this vitamin may hypothetically result in a prothrombotic state that could promote the occurrence of venous thromboembolism.
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Source: “Vitamin D deficiency increases risk of vein thrombosis, meta-analysis concludes”, Olivia Haslam.