Abstract
BackgroundA growing body of literature indicates that, worldwide, immigrants experience health deterioration after their arrival into their adopted country, and moreover, they have lower vitamin D compared to the native-born population. We plan to review if the levels of vitamin D are comparable between different ethnic groups in different regions of the world with those of native-born populations and to identify the possible associations between vitamin D deficiency and disease status among immigrants.Methods/designA systematic review and meta-analysis will be conducted following the methods of the Cochrane handbook for systematic reviews. A literature search was performed to identify studies on immigrants and vitamin D. The primary outcome is vitamin D levels, and the secondary outcome is any vitamin D deficiency-related disease. Study design and participant characteristics will be extracted, including ethnicity, country of birth and/or origin, and the host country. Descriptive and meta-analytic summaries of the outcomes will be derived. Distiller-SR and RevMan will be used respectively for data management and meta-analysis.DiscussionThis systematic review may partially help clarify vitamin D-related health deterioration in migrants; moreover, to develop a global guideline that specifies sub-populations, in which the evidence and vitamin D-related recommendations might differ from the overall immigrant population.Systematic review registrationPROSPERO CRD42018086729
Highlights
A growing body of literature indicates that, worldwide, immigrants experience health deterioration after their arrival into their adopted country, and they have lower vitamin D compared to the native-born population
This systematic review may partially help clarify vitamin D-related health deterioration in migrants; to develop a global guideline that specifies sub-populations, in which the evidence and vitamin D-related recommendations might differ from the overall immigrant population
The baseline risk for vitamin D deficiency is higher among migrants especially those who have darker skin, such as Middle Eastern and African populations, and those who migrate from equatorial region to northern latitude [20, 33, 53]
Summary
The baseline risk for vitamin D deficiency is higher among migrants especially those who have darker skin, such as Middle Eastern and African populations, and those who migrate from equatorial region to northern latitude [20, 33, 53]. No additional recommendations are given for sub-populations such as immigrants living in high northern latitudes, those with darker skin pigmentation, or those who wear heavy clothing that inhibits sun exposure [54, 55]. Abbreviations 25(OH)D: 25-Hydroxyvitamin D serum; A&HCI: Arts and Humanities Citation Index (1975–present); CIHI: Canadian Institute for Health Information; CPCIS: Conference Proceedings Citation Index—Science (1990–present); CPCISSH: Conference Proceedings Citation Index—Social Science and Humanities (1990–present); DRIs: Dietary Reference Intakes; ESCI: Emerging Sources Citation Index (2005–present); IOM: Institute of Medicine; NICE: National Institute for Health Care Excellence; PECO: Population, Exposure, Comparator, and Outcomes; PRESS: Peer Review of Electronic Search Strategies; PRISMAP: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol; ROB: Risk of bias tool; ROBINS-E: Risk Of Bias In Non-randomized Studies of Exposure; SCI-EXPANDED: Science Citation Index Expanded (1900– present); SIGN50: Scottish Intercollegiate Guidelines Network-Publication no.
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