Impact of vitamin D on the prognosis after spinal cord injury: A systematic review

Frontiers in Nutrition, 2023 · DOI: 10.3389/fnut.2023.920998 · Published: February 14, 2023

Spinal Cord Injury Nutrition & Dietetics Rehabilitation

Simple Explanation

Vitamin D deficiency is prevalent worldwide, and spinal cord injury (SCI) patients are particularly susceptible. This review investigates the impact of vitamin D on the prognosis of SCI by analyzing published studies. The review suggests that vitamin D supplementation may help rehabilitation by promoting axonal and neuronal survival, suppressing neuroinflammation, and modulating autophagy.

Study Duration

Not specified

Participants

1,962 patients (meta-analysis of VitD status)

Evidence Level

Systematic Review

Key Findings

1
The meta-analysis showed a high prevalence of vitamin D insufficiency (81.6%) and deficiency (52.5%) after SCI.
2
Low vitamin D levels were associated with a higher risk of skeletal diseases, venous thromboembolism, psychoneurological syndromes, and chest illness after injury.
3
Supplemental vitamin D therapy might facilitate post-injury rehabilitation, and non-human studies suggest a neuroprotective effect of vitamin D.

Research Summary

This systematic review included 35 studies regarding the impact of VitD on the prognosis of SCI. The limited available studies suggest that the prevalence of VitD insufficiency and deficiency is relatively high in the SCI population, which may be associated with delayed neurofunctional restoration and several systematic complications. VitD supplement treatment may have potential benefits to accelerate rehabilitation in mechanistically related processes after SCI.

Practical Implications

Clinical Practice

Clinicians should monitor vitamin D levels in SCI patients and consider supplementation to improve rehabilitation outcomes.

Further Research

Well-designed randomized controlled trials and mechanistic experimental research are needed to validate the therapeutic effect and elucidate the neuroprotective mechanism of vitamin D.

Therapeutic Strategies

Combining vitamin D treatment with other micronutrients and medicine may have a synergistic effect on the improvement of SCI rehabilitation.

Study Limitations

1
High heterogeneity among included studies in the meta-analysis
2
Most of the included clinical papers are observational and hospital-based, introducing potential bias.
3
Variations in inclusion and exclusion criteria and different baseline levels of VitD in the clinical studies may bias the results.

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