Impact of vitamin D on the prognosis after spinal cord injury: A systematic review

Abstract

Vitamin D (VitD) insufficiency is a worldwide health problem and affects billions of people. Spinal cord injury (SCI) patients seem more susceptible to developing suboptimal levels of VitD. However, the literature regarding its impact on the prognosis of SCI is limited. Thus, in this review, we systematically investigated the published studies via a combination of keywords associated with SCI and VitD in four medical databases (Medline, Embase, Scopus, and Web of Science). All included studies were analyzed, and selected clinical data on the prevalence of VitD insufficiency (serum 25-hydroxyvitamin D < 30 ng/ml) and deficiency (serum 25-hydroxyvitamin D < 20 ng/ml) were collected for further meta-analysis via random effects. Through literature review, a total of 35 studies were eligible and included. The meta-analysis of VitD status (13 studies, 1,962 patients) indicated high prevalence of insufficiency (81.6% [75.7, 87.5]) and deficiency (52.5% [38.1, 66.9]) after SCI. Besides, low levels of VitD were reported to be associated with a higher risk of skeletal diseases, venous thromboembolism, psychoneurological syndromes, and chest illness after injury. Existing literature suggested that supplemental therapy might act as an adjuvant treatment to facilitate post-injury rehabilitation. Non-human experimental studies highlighted the neuroprotective effect of VitD, which was associated with enhancing axonal and neuronal survival, suppressing neuroinflammation, and modulating autophagy. Therefore, the current evidence suggests that the prevalence of VitD insufficiency is high in the SCI population, and low-level VitD may impair functional restoration after SCI. VitD supplemental treatment may have potential benefits to accelerate rehabilitation in mechanistically related processes after SCI. However, due to the limitation of the available evidence, more well-designed randomized controlled trials and mechanism experimental research are still needed to validate its therapeutic effect, elucidate its neuroprotective mechanism, and develop novel treatments.

Quality of Life in Patients with Lumbosacral Radicular Syndrome and Complete Rehabilitation Program (PRISUM PHSD/1/2022)

“…patients have mixed pain; nerve root impingement is supplied by distorted neurodynamics in the course of inflammation that accompanies every degenerative process. Vitamin D receptors are found in several parts of the nervous system, indicating that PHSD has a protective role in preventing neurotoxicity and aiding in detoxification pathways due to its vitamin D content [63].…”

Nutrition and eating beliefs and behaviors among individuals with spinal cord injuries and disorders: Healthy or misconceived?

“…In addition, nutrient intake and nutrition behaviors have important implications for the management and prevention of SCI/D secondary conditions, such as pressure injuries, bowel and bladder dysfunction (Bernardi et al, 2020;Richards et al, 2004;Yeung et al, 2021), and bone health (L. Wang et al, 2023;Weaver et al, 2021). For example, after SCI/D, pressure injuries rapidly deplete the limited protein stores as the body attempts to heal the wound, which occurs in the presence of already diminished protein reserves due to reduced skeletal muscle mass in this population (Vecin & Gater, 2022).…”

“…Also, fiber and water intake must be regulated for individuals with SCI/ D and neurogenic bowel dysfunction due to potentially reduced gastrointestinal emptying and motility (Bernardi et al, 2020;Holmes & Blanke, 2019;Kurze et al, 2022;Yeung et al, 2021). Further, in persons with SCI/D, secondary conditions of osteoporosis and fractures require tailored treatment recommendations for vitamin D, calcium, and phosphorus intake (L. Wang et al, 2023;Weaver et al, 2021). As a result, nutrient intake behaviors may need to be adjusted in the presence of SCI/D secondary conditions.…”

“…In addition, nutrient intake and nutrition behaviors have important implications for the management and prevention of SCI/D secondary conditions, such as pressure injuries, bowel and bladder dysfunction (Bernardi et al, 2020; Richards et al, 2004; Yeung et al, 2021), and bone health (L. Wang et al, 2023; Weaver et al, 2021).…”

The Role of Vitamins in Spinal Cord Injury: Mechanisms and Benefits

“…Individuals with SCI are particularly vulnerable to vitamin D deficiency for various reasons, including insufficient dietary intake, the use of anticonvulsant medications, and limited sunlight exposure [ 131 ]. A meta-analysis involving 13 studies with 1,962 patients revealed a high prevalence of vitamin D insufficiency (81.6%) and deficiency (52.5%) in the SCI population [ 115 ] ( Table 2 ). Vitamin D plays a critical role in maintaining skeletal health, muscle function, and immune system efficiency.…”