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SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1505616
This article is part of the Research TopicThe Role of Vitamin D in Metabolic and Cardiovascular Health - Volume IIView all 3 articles
Vitamin D supplementation in critically ill patients: A meta-analysis
Provisionally accepted- 1The Second Affiliated Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
- 2Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Background: Vitamin D is commonly used in clinical practice, while its clinical significance in critically ill patients remains controversial. Therefore, we aimed to perform a systemic review and meta-analysis to investigate the effect of vitamin D on this patient population.We searched for randomized controlled trials (RCTs) in PubMed, Embase, and the Cochrane Library databases from inception until August 15, 2024. Studies evaluating critically ill adult patients who received vitamin D compared to controls were included. The primary outcome was short-term mortality. We used the Cochrane risk of bias tool and GRADE system to evaluate the study quality and evidence.Secondary outcomes were changes in serum 25-hydroxyvitamin D levels, mechanical ventilation (MV) duration, and length of stay (LOS) in the ICU or hospital. We also conducted meta-regression, subgroup analyses, and trial sequential analysis (TSA) to explore the potential heterogeneity among the included trials.Results: Nineteen RCTs with 2,754 patients were eligible. Overall, vitamin D significantly increased serum 25-hydroxyvitamin D levels and significantly reduced the short-term mortality (risk ratio [RR]=0.83; 95%CI, 0.70-0.98; P=0.03, I 2 =13%), duration of MV (MD=-2.96 days; 95% CI, -5.39 to -0.52; I 2 =77%; P=0.02) and ICU LOS (MD=-2.66 days; 95% CI, -4.04 to -1.29, I 2 =70%; P=0.0001) but not hospital LOS (MD=-0.48 days; 95% CI, -2.37 to 1.40; I 2 =31%; P=0.61). The meta-regression analysis revealed that the proportion of MV (MV%) accounted for the source of heterogeneity, and the subgroup analyses based on MV% suggested that the MV group 4 was more likely to benefit from vitamin D applications than the partly MV group in all the predefined outcomes (all P values<0.05). TSA for short-term mortality suggested that more data is required to confirm our main conclusion.Conclusions: Vitamin D supplementation increased serum 25-hydroxyvitamin D levels and significantly benefited critically ill patients, especially those with MV.
Keywords: Vitamin D, Critical Illness, mechanical ventilation, Meta-analysis, Mortality
Received: 03 Oct 2024; Accepted: 07 Apr 2025.
Copyright: © 2025 Zheng, Shi, Yu and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hui-Bin Huang, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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