The Association Between Vitamin D Serum Level and COVID-19 Patients’ Outcomes in a Tertiary Center in Saudi Arabia: A Retrospective Cohort Study

Alzahrani, Mahmoud A; Almalki, Faisal A.; Aljohani, Ayman; Alharbi, Bassam; Alsulami, Bandar; Alhaddad, Ahmed; Althubaiti, Alaa; Khawaji, Bader; Farahat, Fayssal

doi:10.7759/cureus.26266

Cited by 3 publications

(5 citation statements)

References 23 publications

(24 reference statements)

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“…Noteworthily, previous studies have linked suboptimal glycemic control to factors like older age, vitamin D levels, illiteracy, comorbidities, insufficient self-monitoring of blood glucose levels, insufficient physical activity, hyperlipidemia, antidiabetic drugs, longer diabetes duration, and elevated waist-to-hip ratio [ 15 , 16 ]. Our findings were consistent with previous local and Middle East studies that indicated poor glycemic control among individuals with T2DM based on HbA1c levels [ 10 , 16 , 17 ]. These findings highlight the severe condition of inadequate glycemic control in our patients, which requires attention due to the negative health consequences.…”

Section: Discussionsupporting

confidence: 93%

“…We found that lower levels of serum 25(OH) vitamin D were found to be associated with higher levels of HbA1c (Correlation coefficient r: -0.5452; 95% CI: -0.6109 to -0.4720, p <0.0001). This study's negative link between vitamin D and HbA1c levels lends support to earlier reports that have established an association between T2DM and vitamin D status [ 6 - 10 , 18 ]. This negative correlation might be due to vitamin D deficiency causing glucose intolerance and resistance to exogenous insulin.…”

Section: Discussionsupporting

confidence: 89%

“…Previous studies have found significant links between insufficient glycemic management and various issues in patients with type 2 diabetes mellitus (T2DM) implying that greater levels of vitamin D levels lead to improved glucose homeostasis management [ 6 - 10 ]. Alotaibi et al found a significant association between vitamin D deficiency and higher glycated hemoglobin (HbA1c) and hyperlipidemia in T2DM patients [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Relationship Between Glycated Hemoglobin (HbA1c) and Vitamin D Levels in Type 2 Diabetes Patients: A Retrospective Cross-Sectional Study

Abdo,

Abdullah,

AlShoaibi

et al. 2024

Cureus

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Background: Significant links between low serum levels of vitamin D3 and insufficient glycemic control in patients with type 2 diabetes mellitus (T2DM) have been reported previously in the literature. However, there is no exciting evidence on the association between glycated hemoglobin (HbA1c) and vitamin D levels in T2DM individuals in our nation (Yemen). This study aimed to investigate the relationship between HbA1c and vitamin D levels in T2DM patients in a resource-limited setting. Method: A retrospective cross-sectional study was conducted at the Al-Raffa Center, Ibb, Yemen between June 2018 and September 2023 including 396 patients diagnosed with T2DM. The patient characteristics, comorbidities, HbA1c, and vitamin D levels were gathered from patients' medical profiles. Linear regression analysis was used to find the factors associated with vitamin D deficiency (serum 25(OH)D levels < 20 ng/mL) among T2DM patients. Subsequently, the correlation between HbA1c and vitamin D levels was examined using receiver operating characteristic (ROC) curve analysis. Results: The mean age was 44.6 ±14.6 years and most of them (n= 227, 57.3%) were female and from a rural area (n= 229, 57.8%). Comorbidities were hypertension, dyslipidemia disease, and cardiovascular disease in 176 (44.4%), 63 (15.9%), and 88 (22.2%) cases, respectively. The mean HbA1c was 8.1 ±2.5%. The mean vitamin D level was 26.9 ±16.5 ng/mL and low vitamin D was present in 260 (65.7%) (vitamin D deficiency in 160 (40.4%) and vitamin D insufficiency in 100 (25.3%) cases). In regression analysis, obesity (>30 kg/m 2 ) (odds ratio (OR): 299.49; 95% confidence interval (CI): 72.66 - 1234.42, p <0.0001), higher HbA1c levels (OR: 1.61; 95% CI: 1.26 - 2.05, p =0.0001), and urban residence (OR: 23.98; 95% CI: 5.62 - 102.42, p <0.0001) were associated with vitamin D deficiency. There was a negative correlation between the vitamin D level and HbA1c which was statistically significant (correlation coefficient r: -0.5452; 95% CI: -0.6109 to -0.4720, p <0.0001). Using the ROC analysis, the serum vitamin D value of ≤18.42 ng/ml was the best cut-off point to predict hyperglycemia (area under the curve: 0.633, 95% CI: 0.672 to 0.770, sensitivity: 52%, specificity: 84.71 %, Yoden’s index: 0.3671, p <0.001). Based on this cut-off, 39.4% of individuals (37.5% in the normoglycemic group and 90.9% in the hyperglycemic group) were vitamin D deficient. Conclusion: In this study, low vitamin D was common among T2DM patients, especially those with poor glycemic control. We observed a link between HbA1c levels, urban residency, and BMI with vitamin D deficiency in T2DM patients. The association was distinguished by low vitamin D levels and elevated HbA1c. Additionally, we found that the serum vitamin D value of ≤18.42 ng/ml was the best cut-off point to predict hyperglycemia in T2DM patients with moderate agreement. To manage their disease, patients with T2DM should take their medications as prescribed and live a healt...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Relationship Between Glycated Hemoglobin (HbA1c) and Vitamin D Levels in Type 2 Diabetes Patients: A Retrospective Cross-Sectional Study

Abdo,

Abdullah,

AlShoaibi

et al. 2024

Cureus

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“…After that, 300 articles were evaluated for full-text eligibility, and 197 articles with available data but not Asian were excluded. Ultimately, 103 studies conducted in Asia were enrolled in this meta-analysis [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ,…”

Section: Resultsmentioning

confidence: 99%

Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis

et al. 2022

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We aimed to explore the influence of comorbid asthma on the risk for mortality among patients with coronavirus disease 2019 (COVID-19) in Asia by using a meta-analysis. Electronic databases were systematically searched for eligible studies. The pooled odds ratio (OR) with 95% confidence interval (CI) was estimated by using a random-effect model. An inconsistency index (I2) was utilized to assess the statistical heterogeneity. A total of 103 eligible studies with 198,078 COVID-19 patients were enrolled in the meta-analysis; our results demonstrated that comorbid asthma was significantly related to an increased risk for COVID-19 mortality in Asia (pooled OR = 1.42, 95% CI: 1.20–1.68; I2 = 70%, p < 0.01). Subgroup analyses by the proportion of males, setting, and sample sizes generated consistent findings. Meta-regression indicated that male proportion might be the possible sources of heterogeneity. A sensitivity analysis exhibited the reliability and stability of the overall results. Both Begg’s analysis (p = 0.835) and Egger’s analysis (p = 0.847) revealed that publication bias might not exist. In conclusion, COVID-19 patients with comorbid asthma might bear a higher risk for mortality in Asia, at least among non-elderly individuals.

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“…(2). 𝐶𝑜𝑟𝑟 (𝑄, 𝑌) = 0 does not imply that Q and Y are independent (3). The I 2 statistic can be negative when Q is less than df.…”

Section: Discussionmentioning

confidence: 98%

The bounds of meta-analytics and an alternative method

Shanmugam,

Tabatabai,

Wilus

et al. 2024

Epidemiol Health

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OBJECTIVES Meta-analysis is a statistical appraisal of the data analytic implications of published articles ( Y ), estimating parameters including the odds ratio and relative risk. This information is helpful for evaluating the significance of the findings. The Higgins I 2 index is often used to measure heterogeneity among studies. The objectives of this article are to amend the Higgins I 2 index score in a novel and innovative way and to make it more useful in practice. METHODS Heterogeneity among study populations can be affected by many sources, including the sample size and study design. They influence the Cochran Q score and, thus, the Higgins I 2 score. In this regard, the I 2 score is not an absolute indicator of heterogeneity. Q changes by bound as Y increases unboundedly. An innovative methodology is devised to show the conditional and unconditional probability structures. RESULTS Various properties are derived, including showing that a zero correlation between Q and Y does not necessarily mean that they are independent. A new alternative statistic, S 2 , is derived and applied to mild cognitive impairment and coronavirus disease 2019 vaccination for meta-analysis. CONCLUSIONS A hidden shortcoming of the Higgins I 2 index is overcome in this article by amending the Higgins I 2 score. The usefulness of the proposed methodology is illustrated using 2 examples. The findings have potential health policy implications.

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The Association Between Vitamin D Serum Level and COVID-19 Patients’ Outcomes in a Tertiary Center in Saudi Arabia: A Retrospective Cohort Study

Cited by 3 publications

References 23 publications

Relationship Between Glycated Hemoglobin (HbA1c) and Vitamin D Levels in Type 2 Diabetes Patients: A Retrospective Cross-Sectional Study

Relationship Between Glycated Hemoglobin (HbA1c) and Vitamin D Levels in Type 2 Diabetes Patients: A Retrospective Cross-Sectional Study

Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis

The bounds of meta-analytics and an alternative method

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