Vitamin D & Mental Health
Influence of Vitamin D Supplementation on Mental Health in Diabetic Patients:
A Systematic Review
Diabetes comprises a group of metabolic diseases that are characterized by chronic hyperglycemia, which is caused by defects in insulin secretion (type 1 diabetes) and/or insulin action (type 2 diabetes), and which may result in lifelong consequences associated with damage to various organs and systems, resulting in complications such as diabetic retinopathy, nephropathy, and neuropathy and various cardiovascular disorders.
Currently, it is one of the major causes of mortality and reduced life expectancy worldwide, while the global trends show an increasing rate of incidence, prevalence, death, and disability-adjusted life-years associated with diabetes, particularly for type 2 diabetes.
The World Health Organization (WHO) emphasizes that there is an urgent need to reverse this trend, and within global noncommunicable disease targets to be obtained by 2025, the WHO has indicated that the number of premature deaths related to diabetes should be reduced, as diabetes is responsible for about 1.5 million deaths every year.
Diabetes is also associated with other complications, including mental health problems. A systematic review and meta-analysis by Chireh et al. and a meta-analysis by Rotella and Mannucci, who analyzed depression, established that diabetes is an independent risk factor for the onset of depressive symptoms and depression and that over 9.5 million global depression cases are potentially attributed to diabetes.
A similar association was observed between diabetes and enhanced risk of anxiety, as the systematic reviews and meta-analyses by Smith et al. and Amiri and Behnezhad showed that diabetes is associated with an increased incidence of elevated anxiety symptoms and anxiety disorders.
In addition, the quality of life of diabetic patients is found to be reduced, and it is indicated by the systematic review and meta-analysis by Jing et al. that a decrease in the quality of life in this group of patients is associated not only with diabetes but also with its consequences, including depression.
The effective management of diabetes includes following a proper and planned diet schedule, which must address existing micronutrients deficiencies, maintaining appropriate body weight, controlling blood glycemic, blood pressure, and lipid levels and delaying or preventing the onset of complications related to prolonged diabetes. Among various potential nutritional deficiencies, vitamin D deficiency is considered to be an important issue in diabetic patients, as a number of large observational studies have suggested an association between this deficiency and the onset of diabetes.
Nowadays, the role of vitamin D supplementation in improving the mental health of patients is extensively discussed, as this nutrient was proven to exert a positive effect on various components of mental health in the population of healthy individuals. The meta-analyses by Vellekkatt and Menon, Shaffer et al., and Spedding suggested that supplementation of vitamin D may be beneficial in reducing the symptoms of depression. Moreover, the meta-analysis by Cheng et al. supported the positive effect of vitamin D supplementation on the alleviation of negative emotions, while a systematic review by Hoffmann et al. revealed its role in improving the quality of life of diabetic patients.
Taking into account the serious mental health problems generally observed in diabetic individuals, combined with vitamin D deficiency in this group, as well as the potential therapeutic value of vitamin D supplementation, which was proven for healthy individuals, there is an urgent need to determine whether vitamin D supplementation may reduce mental health problems in diabetic individuals. The aim of the present study was to conduct a systematic review of the literature presenting data regarding the influence of vitamin D supplementation on mental health status in diabetic adults.
Diabetes is associated with a number of mental health consequences, including enhanced risk of depression and anxiety, as well as decreased quality of life, and vitamin D deficiency is considered to be one of the factors that influence these outcomes in diabetic patients. The aim of the present study was to conduct a systematic review of the literature presenting the data regarding the influence of vitamin D supplementation on mental health in diabetic adults.
This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (Registration number CRD42020155779).
A systematic search of the PubMed and Web of Science databases was performed, and the intervention studies published until September 2021 were included in the review. The human studies were included if an adult sample of diabetic individuals received vitamin D supplementation during the intervention and its effect on any mental health aspect was assessed, but studies presenting the influence of combined supplementation of multiple nutrients were excluded. After removing duplicate records, a total of 8514 publications were screened and assessed independently by two researchers, based on their title, abstract, and full text.
Finally, six studies were included in the current systematic review, and the risk of bias was evaluated using the Newcastle–Ottawa Scale (NOS). The included studies analyzed the influence of a specific dose of vitamin D, or different doses of vitamin D, or compared the results of supplementation with a specific dose of vitamin D against the placebo group.
The supplementation was performed for at least 12 weeks. The mental health outcomes analyzed in these studies included health-related quality of life, depression, anxiety, stress, and general mental health status of adult diabetic patients.
The results of the majority of the studies confirmed the positive influence of vitamin D supplementation on the mental health of diabetic individuals. Those studies that analyzed the influence of vitamin D supplementation on depression and anxiety established the beneficial effect of the vitamin. In some studies, the influence of vitamin D supplementation on the health-related quality of life was not considered unless combined with mindfulness training.
However, it must be emphasized that different dosage regimens and intervention periods were followed in the reviewed studies, and only a small number of studies were randomized against placebo, which should be considered as a limitation of the present study.
The findings of the conducted systematic review demonstrated the positive influence of vitamin D supplementation on the mental health of diabetic patients, which was proved for anxiety and depression, but in the case of health-related quality of life, the positive effect was observed only when the intervention included mindfulness training. These outcomes suggest that supplementation should be recommended to improve the vitamin D status and the mental health of patients in this group.
Πηγή Άρθρου / Story Source:
Nutrients 2021, 13(11), 3678; Influence of Vitamin D Supplementation on Mental Health in Diabetic Patients: A Systematic Review https://doi.org/10.3390/nu13113678 Published: 20 October 2021