Published online Jun 18, 2023. doi: 10.13105/wjma.v11.i5.218
Peer-review started: December 24, 2022
First decision: February 28, 2023
Revised: March 27, 2023
Accepted: May 6, 2023
Article in press: May 6, 2023
Published online: June 18, 2023
The definition of diabetic foot syndrome (DFS) varies depending on the location and resources. Few classifications are available according to the indication. DF ulcers and vitamin D deficiency are common diseases among patients with diabetes. Previous literature has shown an association between DF ulcer (DFU) and vitamin D deficiency. However, the available meta-0analysis was limited by substantial bias.
To investigate the association between DFUs and vitamin D levels.
We searched PubMed, MEDLINE, and Cochrane Library, EBSCO, and Google Scholar for studies comparing vitamin D levels and DF. The keywords DFU, DFS, diabetic septic foot, vitamin D level, 25-hydroxy vitamin D, vitamin D status, and vitamin D deficiency were used. The search engine was set for articles published during the period from inception to October 2022. A predetermined table was used to collect the study information.
Vitamin D level was lower among patients with DFU compared to their counterparts [odds ratio (OR): -5.77; 95% confidence interval (CI): -7.87 to -3.66; χ2 was 84.62, mean difference, 9; I2 for heterogeneity, 89%; P < 0.001 and P for overall effect < 0.001]. The results remained robust for hospitalized patients (OR: -6.32 95%CI: -11.66 to -0.97; χ2 was 19.39; mean difference, 2; I2 for heterogeneity, 90%; P = 0.02).
Vitamin D was lower among outpatients and hospitalized patients with DFUs. Further larger randomized controlled trials are needed.
Core Tip: This is the first study to assess the relationship between diabetic foot ulcer and vitamin D deficiency, avoiding the bias of the two published meta-analyses.