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
Processing time: 173 Days and 19.1 Hours
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.