The association between serum vitamin D levels and abnormal lipid profile in pediatrics: A GRADE-assessed systematic review and dose-response meta-analysis of epidemiologic studies.

Abstract

Several studies have investigated the relationship between serum vitamin D and dyslipidemia in children and adolescents, but the findings have been contradictory. The current systematic review and dose-response meta-analysis investigated the serum vitamin D - dyslipidemia relationship in children and adolescents. ISI Web of Science, Scopus, MEDLINE (PubMed), EMBASE databases, and Google Scholar, were searched up to December 2022. Observational studies that investigated the odds of dyslipidemia in categories of serum vitamin D levels in children were included, and their data were extracted. Pooling of 17 effect sizes from 15 studies (39 342 participants) showed that subjects with higher serum vitamin D had 27% lower odds of hypertriglyceridemia (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.60, 0.88). A meta-analysis of 18 effect sizes from 16 studies (39 718 participants) illustrated that highest vs lowest serum vitamin D was related to 22% lower odds of low high-density lipoprotein cholesterol (HDL-c) (OR = 0.78; 95% CI: 0.66, 0.91). Also, a nonlinear association between serum vitamin D and odds of abnormal lipid profile was found: elevating values of 25-hydroxyvitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in odds of hypertriglyceridemia, hyper low-density lipoprotein cholesterolemia, hypercholesterolemia, and hypo HDL-cholesterolemia. However, no significant linear association was observed. Based on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), the certainty of all evidence was rated as high. This meta-analysis revealed that the level of 25-hydroxyvitamin D was inversely related to odds of abnormal serum triglycerides and HDL-c in children and adolescents. Increasing serum vitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in the odds of abnormal serum triglycerides, HDL-c, low-density lipoprotein cholesterol, and total cholesterol in children. PROSPERO registration no. 42023400787.