Relationship between Vitamin D Levels and Pediatric Celiac Disease: A Systematic Review and Meta-analysis

Abstract

Abstract Background: The relationship between vitamin D (VitD) levels and pediatric celiac disease (CD) remains controversial. In this study, we conducted a systematic review and meta‐analysis to examine the relationship between VitD and pediatric CD. Methods: We screened relevant studies from PubMed, EMBASE and Web of Science published in English from January 1, 2000, to August 1, 2023. The included studies were assessed according to the STROBE checklist. Heterogeneity was quantified by Cochran’s Q test and the I2 statistic. Publication bias was estimated by Begg’s test and Egger test. Meta‐regression was used to detect potential sources of heterogeneity. Results: A total of 26 studies were included in the meta-analysis. Average 25(OH)D levels, as the main form of VitD, there was significant difference in CD patients and healthy controls (weighted mean difference (WMD) = −5.77, 95% confidence interval (CI) = [−10.86, − 0.69] nmol/L). Meanwhile, there was significant difference in the incidence of 25(OH)D deficiency between CD patients and healthy controls (odds ratio 2.20, 95% CI= [1.19, 4.08]). Ten articles reported changes in 25(OH)D levels before and after administering a GFD in patients with CD, while the result of this study revealed no change in 25(OH)D levels in CD patients after a gluten-free diet (GFD) compared to controls (WMD = −2.22, 95% CI = [−7.25, 2.81] nmol/L). Conclusions: VitD levels in pediatric CD patients were lower than healthy controls, and 25(OH)D deficiency was more prevalent in CD patients. We found no change in 25(OH)D levels in CD patients after GFD compared to controls, which inconsistent with previous research. Further well-designed, longitudinal, prospective cohort studies focusing on the role of VitD in the pathogenesis of CD are therefore needed.