Insuficiência e deficiência de vitamina D em idosos brasileiros: uma revisão sistemática e metanálise

Santos, Jéssica Vendruscolo dos; Closs, Vera Elizabeth; Castanho, Viviane Carrion; Fanton, Marcos; Canuto, Raquel; Hagen, Martine Elisabeth Kienzle

doi:10.1590/1413-81232025304.08072023

person Jéssica Vendruscolo dos Santos

critical review of the content · approval of the final version of the manuscript · conception and planning · data collection · data analysis and interpretation · manuscript writing

schoolPrograma de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2400, sala 204, Santa Cecília. 90035-903 Porto Alegre RS Brasil. jessicav.nutri@hotmail.com

0000-0001-7954-7620

person Vera Elizabeth Closs

critical review of the content · approval of the final version of the manuscript · conception and planning · data collection · data analysis and interpretation · manuscript writing

schoolPontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre RS Brasil.

0000-0002-7602-3984

person Viviane Carrion Castanho

critical review of the content · approval of the final version of the manuscript · conception and planning · data collection

schoolPrograma de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2400, sala 204, Santa Cecília. 90035-903 Porto Alegre RS Brasil. jessicav.nutri@hotmail.com

0000-0002-8961-5858

person Marcos Fanton

critical review of the content · approval of the final version of the manuscript · data analysis and interpretation

schoolUniversidade Federal de Santa Maria. Santa Maria RS Brasil.

0000-0001-5360-3647

person Raquel Canuto

critical review of the content · approval of the final version of the manuscript · data analysis and interpretation · manuscript writing

schoolPrograma de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2400, sala 204, Santa Cecília. 90035-903 Porto Alegre RS Brasil. jessicav.nutri@hotmail.com

0000-0002-4042-1913

person Martine Elisabeth Kienzle Hagen

critical review of the content · approval of the final version of the manuscript · conception and planning · data analysis and interpretation · manuscript writing

schoolPrograma de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2400, sala 204, Santa Cecília. 90035-903 Porto Alegre RS Brasil. jessicav.nutri@hotmail.com

0000-0002-3838-3866

Chief editors:

Maria Cecília de Souza Minayo, Romeu Gomes, Antônio Augusto Moura da Silva

Author (year)	Population (conclusion year)	Design (clinical condition)	Region	Data collection	Sample	INS and DEF
Lips et al. (2006)³⁴	151 (2005)	Cross-sectional (postmenopausal osteoporosis)	SE	Four Seasons	CV	13.2% 44.4%
Lamas (2012)³⁵	119 (2012)	Cross-sectional (normal BMD, osteopenia and osteoporosis)	MW	Four Seasons	CV	27.7% 46.2%
Correia et al. (2013)³⁶	152 (2011)	Cross-sectional (patients admitted for unstable angina)	NE	Four Seasons	CV	32.2% 57.9%
Camargo et al. (2014)³⁷	296 (2011)	Cross-sectional (older adult with osteoporosis)	SE	Fall and winter	CV	37.8% 31.8%
Silva (2015)³²	124 (2014)	Cross-sectional (older adult hospitalized)	S	Fall and winter	RD	11.2% 86.3%
Domiciano et al. (2016)³⁸	701 (2012)	Cohort (normal BMD, osteopenia, and osteoporosis)	SE	Four Seasons	PB	32.1% 55.3%
Guerra et al. (2016)³⁹	341 (2015)	Case-control (patients with and without proximal hip fracture)	S	Four Seasons	CV	29.6% 38.1%
Issa et al. (2016)⁴⁰	142 (2013)	Cross-sectional (most were overweight, obese with e and high blood pressure)	NE	Four Seasons	RD	38.7% 2.1%
Penoni et al. (2016)⁴¹	113 (2015)	Cross-sectional (older adult woman with normal BMD and osteoporosis)	SE	Four Seasons	CV	47.8% 29.2%
Alfierii et al. (2017)⁴²	286 (2015)	Case-control (patients with and without acute ischemic stroke)	S	Four Seasons	CV	40.6% 27.6%
Azevedo et al. (2018)⁴³	729 (2014)	Cross-sectional (most were high blood pressure and metabolic syndrome)	NE	Spring and summer	CV	31.1% 41.9%
Machado et al. (2019)³³	627 (2016)	Case-control (postmenopausal with and without breast cancer)	SE	Four Seasons	CV	51.4% 22.3%
Soares et al. (2018)⁴⁴	241 (2017)	Cross-sectional (patients with non-melanoma skin cancer)	SE	Four Seasons	CV	33.2% 56.8%
Carvalho et al. (2018)⁴⁵	419 (2011)	Cross-sectional (older adult woman with and without regular physical activity)	SE	Fall and winter	CV	23.6% 70.4%
Porto et al. (2018)⁴⁶	137 (2016)	Cross-sectional (most were overweight, obese and metabolic syndrome)	NE	Spring and summer	CV	24.8% 40.1%
Paranhos-Neto et al. (2019)⁴⁷	287 (2014)	Cross-sectional (older adult women with fracture)	SE	Four Seasons	PB	28.6% 39.7%
Sousa et al. (2019)¹³	153 (2015)	Cross-sectional (older adult in LTI)	NE	Spring and summer	CV	36.6% 37.2%
Bazoni et al. (2020)⁴⁸	109 (2010)	Cross-sectional (patients with and without benign paroxysmal positional vertigo)	S	Four Seasons	PB	44.9% 31.2%
Lima-Costa et al. (2020)²³	2,263 (2016)	Cohort (older adult in the community)	VR	Spring and summer	PB	44.5% 16.2%
Santos et al. (2020)⁴⁹	287 (2016)	Cross-sectional (most were depression and high blood pressure)	S	Four Seasons	CV	44.9% 24.7%
Belli et al. (2020)⁵⁰	200 (2016)	Cohort (post parathyroidectomy patients)	SE	Four Seasons	CV	41.0% 50.0%
Cembranel et al. (2021)⁵¹	526 (2014)	Cross-sectional (older adults in the community)	S	Four Seasons	PB	43.7% 21.9%
Barbieri et al. (2022)⁵²	346 (NI)	Cross-sectional (older adults in the community)	SE	NI	CV	44.2% 35.3%
Foroni et al. (2022)⁵³	200 (2012)	Cross-sectional (older adults in the community)	SE	Four Seasons	CV	29.5% 56.0%
Rolizola et al. (2022)⁵⁴	533 (2019)	Cross-sectional (older adults in the community)	SE	Spring and summer	CV	49.5% 15.0%
Vieira et al. (2022)³¹	124 (NI)	Cross-sectional (older adults in the community)	NE	NI	CV	47.6% 0.8%

Nº	Study	1. Study design and appropriate sampling method	2. Appropriate sample basis	3. Appropriate sample size	4. Objective, appropriate and standardized criteria used to measure results	5. Outcome was non-biased	6. Adequate response rate	7. The prevalence and incidence estimates are given with confidence intervals	8. The subjects and the configuration described in detail for generalization	Total	Bias risk rating
1	Lips et al. (2006)³⁴	0	0	0	0	0	1	0	1	2	H
2	Lamas (2012)³⁵	0	0	0	0	1	1	1	1	4	M
3	Correia et al. (2013)³⁶	0	1	0	0	1	1	1	0	4	M
4	Camargo et al. (2014)³⁷	0	0	0	0	0	1	0	1	2	H
5	Silva (2015)³²	1	1	0	0	1	1	0	1	5	L
6	Domiciano et al. (2016)³⁸	0	0	0	0	1	1	0	1	3	M
7	Guerra et al. (2016)³⁹	0	0	0	0	1	1	0	0	2	H
8	Issa et al. (2016)⁴⁰	1	1	1	1	1	1	0	1	7	L
9	Penoni et al. (2016)⁴¹	0	0	1	0	1	1	0	1	4	M
10	Alfieri et al. (2017)⁴²	0	0	0	0	1	1	0	1	3	M
11	Azevedo et al. (2018)⁴³	0	1	0	0	1	1	0	0	3	M
12	Soares et al. (2018)⁴⁴	0	1	0	0	1	1	0	0	3	M
13	Carvalho et al. (2018)⁴⁵	0	0	1	0	1	0	0	0	2	H
14	Porto et al. (2018)⁴⁶	0	1	1	0	1	1	0	0	4	M
15	Paranhos-Neto et al. (2018)⁴⁷	0	1	0	1	1	1	0	1	5	L
16	Machado et al. (2019)³³	0	0	0	0	1	1	0	1	3	M
17	Sousa (2019)¹³	0	1	1	0	1	1	1	1	6	L
18	Bazoni et al. (2020)⁴⁸	1	1	0	0	1	0	0	0	3	M
19	Lima-Costa et al. (2020)²³	1	1	0	0	1	1	1	0	5	L
20	Santos et al. (2020)⁴⁹	0	1	0	0	0	1	1	1	4	M
21	Belli et al. (2020)⁵⁰	0	1	1	0	0	1	0	0	3	M
22	Cembranel et al. (2021)⁵¹	0	1	1	0	1	1	0	0	4	M
23	Barbieri et al. (2022)⁵²	0	1	1	0	1	1	0	0	4	M
24	Foroni et al. (2022)⁵³	0	1	0	0	1	1	0	1	4	M
25	Rolizola et al. (2022)⁵⁴	0	1	1	0	1	1	0	1	5	L
26	Vieira et al. (2022)³¹	0	1	0	0	1	1	0	1	4	M

Variables		N	Npop	Insufficiency Prevalence % [95%CI]	I² (%)	τ²	Deficiency Prevalence % [95%CI]	I² (%)	τ²
Study design				p* 0.499			p* 0.897
	Cross-sectional	20	5188	33.7 [28.8; 39.0]	90.8	0.245	34.2 [22.8; 47.7]	96.7	1.606
	Case-control	3	1254	39.1 [32.9; 45.6]	94.0	0.048	38.2 [19.4; 61.4]	99.5	0.687
	Cohort	3	3164	40.3 [30.5; 51.0]	95.3	0.133	28.8 [22.0; 36.8]	92.6	0.090
Rating by Loney et al.²⁸				p* 0.049			p* 0.495
	High bias risk (1-2)	4	1207	25.4 [17.4; 35.3]	91.0	0.211	46.2 [31.8; 61.4]	97.5	0.3759
	Moderate bias risk (3-5)	16	4897	37.3 [34.5; 42.4]	88.1	0.096	34.6 [25.1; 45.4]	95.9	0.8231
	Low bias risk (≥5)	6	3502	33.7 [23.5; 45.8]	93.6	0.374	26.2 [8.38; 58.0]	98.3	2.8073
Laboratory techniques 25(OH)D				p* 0.838			p* 0.667
	CLIA	14	3509	36.5 [31.1; 42.3]	88.3	0.191	30.9 [21.6; 42.0]	94.5	0.8126
	HPLC	2	294	35.4 [30.1; 41.0]	26	0	14.8 [0.9; 77.2]	97.9	4.4375
	RIA	1	701	32.1 [28.7; 35.6]	0	0	55.3 [51.6; 59.0]	0	0
	ECL	2	842	38.1 [27.4; 50.1]	91.6	0.102	36.8 [28.3; 46.3]	84.7	0.0515
	CMIA	4	3376	41.7 [34.3; 49.6]	90.4	0.093	28.6 [16.8; 44.4]	98.1	0.4786

[TFN1] INS: insufficiency; DEF: deficiency; H: high; M: moderate; L: low; SE: Southeast; S: South; NE: Northeast; MW: Midwest; VR: various regions; BMD: bone mineral density; CV: convenience; RD: randomized; PB: population base; VD: vitamin D; LTI: long-term institution; BMD: bone mineral density.

[TFN2] Source: Authors.