Non-Cochrane · umbrella · PM24690624

Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials.

Theodoratou Evropi, Tzoulaki Ioanna, Zgaga Lina, et al. · BMJ (Clinical research ed.) · 2014 · PubMed · doi:10.1136/bmj.g2035

Oral HealthDental cariesAMSTAR 2: not applicable
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
110
current version
GRADE rated
0
No studies
0
Included studies
55
linked below
No studies 0 · 0%Ungraded 110 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

ElementPlanned (methods)Found (results)
PopulationHumans of any age or clinical setting, for associations between circulating vitamin D (25-hydroxyvitamin D or 1,25-dihydroxyvitamin D) and any clinical outcome, or in randomised trials of vitamin D supplementationPopulations across 137 unique outcomes: general adults, children, pregnant women and their offspring, older adults, and patients with chronic kidney disease requiring or not requiring dialysis
InterventionHigher circulating vitamin D concentration (observational); supplementation with vitamin D or active compounds, established or newer (randomised trials)Higher circulating vitamin D (48 non-overlapping observational meta-analyses); vitamin D supplementation (57 non-overlapping randomised-trial meta-analyses)
ComparisonLower circulating vitamin D concentration (observational); placebo or control (randomised trials)Lower circulating vitamin D; placebo or control
OutcomesAny clinical outcome, grouped as autoimmune, cancer, cardiovascular, cognitive, infectious, metabolic, neonatal/infant/child, pregnancy, skeletal (including falls), and other137 unique outcomes (fig 2); 30/48 (63%) observational and 13/57 (23%) randomised-trial meta-analyses nominally significant
Study designsSystematic reviews and meta-analyses of observational studies; meta-analyses of randomised controlled trials107 systematic reviews (24 papers); 74 meta-analyses of observational studies (47 papers); 87 meta-analyses of randomised controlled trials (32 papers)
TimingNot specifiedNot specified

Search date: 11 October 2013. Databases: Medline; Embase; screening of citations and references

Questions and results

Higher circulating 25-hydroxyvitamin D (25(OH)D) concentration vs Lower circulating 25-hydroxyvitamin D (25(OH)D) concentration

Population: Adults (general population)
38 questions
OutcomeEffectEvidenceStatus / GRADE
Type 2 diabetes
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Type 2 diabetes: OR 0.63 (95% CI 0.56 to 0.69), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 2; Fig 3; Results · same question in other reviews
OR 0.63 [0.56, 0.69]16 studies · 72204 participantsUngraded
Ischaemic heart disease
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Ischaemic heart disease: HR 0.72 (95% CI 0.65 to 0.81), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
HR 0.72 [0.65, 0.81]19 studies · 82982 participantsUngraded
Metabolic syndrome (prevalent)
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Metabolic syndrome (prevalent): OR 0.49 (95% CI 0.38 to 0.64), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 2; Fig 3; Results · same question in other reviews
OR 0.49 [0.38, 0.64]8 studies · 31416 participantsUngraded
Cognition
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Cognition: OR 0.42 (95% CI 0.34 to 0.53), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 2; Fig 3; Results · same question in other reviews
OR 0.42 [0.34, 0.53]7 studies · 9004 participantsUngraded
Aggressive prostate cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Aggressive prostate cancer: OR 0.98 (95% CI 0.84 to 1.15), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.98 [0.84, 1.15]6 studies · 4524 participantsUngraded
Cardiovascular disease mortality
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Cardiovascular disease mortality: RR 0.55 (95% CI 0.36 to 0.85), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
RR 0.55 [0.36, 0.85]5 studies · 24387 participantsUngraded
Stroke
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Stroke: RR 0.61 (95% CI 0.50 to 0.75), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 1; Fig 3; Results · same question in other reviews
RR 0.61 [0.50, 0.75]7 studies · 39095 participantsUngraded
Hip fracture
Hospital-based controls
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Hip fracture (Hospital-based controls): log ratio of geometric mean -0.26 (95% CI -0.33 to -0.23), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 2; Results · same question in other reviews
log ratio of geometric mean -0.26 [-0.33, -0.23]8 studies · 2201 participantsUngraded
Cardiovascular disease
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Cardiovascular disease: RR 0.66 (95% CI 0.57 to 0.77), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 1; Fig 3; Results · same question in other reviews
RR 0.66 [0.57, 0.77]19 studies · 66488 participantsUngraded
Sporadic colorectal adenoma recurrence
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Sporadic colorectal adenoma recurrence: OR 0.87 (95% CI 0.57 to 1.33), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.87 [0.57, 1.33]3 studies · 1366 participantsUngraded
Non-Hodgkin's lymphoma
Females
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Non-Hodgkin's lymphoma (Females): OR 0.81 (95% CI 0.39 to 1.70), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.81 [0.39, 1.70]4 studies · 39 participantsUngraded
Cardiovascular disease (prevalent)
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Cardiovascular disease (prevalent): OR 0.67 (95% CI 0.55 to 0.82), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.67 [0.55, 0.82]16 studies · 64722 participantsUngraded
Alzheimer’s disease
Population: Participants in observational studies
The meta-analysis of observational studies reported a SMD (to OR) of 0.08 (95% CI 0.01 to 0.63) for higher versus lower circulating vitamin D concentration.
Source: Fig 3; Table 2 · same question in other reviews
SMD (to OR) 0.08 [0.01, 0.63]7 studies · 1005 participantsUngraded
Aggressive prostate cancer
Population: Participants in observational studies
The meta-analysis of observational studies reported a OR of 0.88 (95% CI 0.68 to 1.15) for higher versus lower circulating vitamin D concentration.
Source: Fig 3; Table 1 · same question in other reviews
OR 0.98 [0.84, 1.15]6 studies · 4524 participantsUngraded
Ovarian cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Ovarian cancer: OR 0.83 (95% CI 0.63 to 1.09), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.83 [0.63, 1.09]10 studies · 2489 participantsUngraded
Colon cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Colon cancer: OR 0.78 (95% CI 0.56 to 1.07), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.78 [0.56, 1.07]10 studies · 4578 participantsUngraded
Colorectal cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Colorectal cancer: RR 0.70 (95% CI 0.58 to 0.84), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 1; Fig 3; Results · same question in other reviews
RR 0.70 [0.58, 0.84]10 studies · 6712 participantsUngraded
Breast cancer
Postmenopausal
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Breast cancer (Postmenopausal): RR 0.99 (95% CI 0.97 to 1.01), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 1; Fig 3; Results · same question in other reviews
RR 0.99 [0.97, 1.01]9 studies · 8766 participantsUngraded
Breast cancer
Premenopausal
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Breast cancer (Premenopausal): RR 1.01 (95% CI 0.97 to 1.06), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 1; Fig 3; Results · same question in other reviews
RR 1.01 [0.97, 1.06]6 studies · 2890 participantsUngraded
Pancreatic cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Pancreatic cancer: OR 2.13 (95% CI 1.02 to 4.47), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 2.13 [1.02, 4.47]6 studies · 2113 participantsUngraded
Prostate cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Prostate cancer: OR 1.04 (95% CI 0.98 to 1.09), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 1.04 [0.98, 1.09]14 studies · 28988 participantsUngraded
Hypertension
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Hypertension: RR 0.70 (95% CI 0.58 to 0.86), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 1; Fig 3; Results · same question in other reviews
RR 0.70 [0.58, 0.86]7 studies · 48633 participantsUngraded
Breast cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Breast cancer: OR 0.55 (95% CI 0.42 to 0.71), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.55 [0.42, 0.71]21 studies · 26317 participantsUngraded
Hip fracture
Population-based controls
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Hip fracture (Population-based controls): log ratio of geometric mean -0.51 (95% CI -0.64 to -0.38), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 2; Results · same question in other reviews
log ratio of geometric mean -0.51 [-0.64, -0.38]9 studies · 1655 participantsUngraded
Tuberculosis
Population: Participants in observational studies
The meta-analysis of observational studies reported a SMD (to OR) of 0.29 (95% CI 0.19 to 0.46) for higher versus lower circulating vitamin D concentration.
Source: Fig 3; Table 2 · same question in other reviews
SMD (to OR) 0.29 [0.19, 0.46]7 studies · 534 participantsUngraded
Depression
Cohort studies
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Depression (Cohort studies): HR 0.44 (95% CI 0.27 to 0.72), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 2; Fig 3; Results · same question in other reviews
HR 0.44 [0.27, 0.72]3 studies · 8815 participantsUngraded
Ischaemic stroke
Hazard ratio (cohort studies)
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Ischaemic stroke (Hazard ratio (cohort studies)): HR 0.66 (95% CI 0.55 to 0.80), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 1; Fig 3; Results · same question in other reviews
HR 0.66 [0.55, 0.80]4 studies · 26596 participantsUngraded
Ischaemic stroke
Odds ratio (case-control studies)
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Ischaemic stroke (Odds ratio (case-control studies)): OR 0.52 (95% CI 0.44 to 0.61), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.52 [0.44, 0.61]5 studies · 31858 participantsUngraded
Kidney cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Kidney cancer: OR 1.01 (95% CI 0.65 to 1.58), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 1.01 [0.65, 1.58]6 studies · 1480 participantsUngraded
Fractures
Population: Participants in observational studies
The meta-analysis of observational studies reported a SMD (to OR) of 0.31 (95% CI 0.23 to 0.42) for higher versus lower circulating vitamin D concentration.
Source: Fig 3; Table 2 · same question in other reviews
SMD (to OR) 0.31 [0.23, 0.42]28 studies · 2956 participantsUngraded
Non-Hodgkin's lymphoma
Males
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Non-Hodgkin's lymphoma (Males): OR 0.65 (95% CI 0.35 to 1.23), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.65 [0.35, 1.23]6 studies · 65 participantsUngraded
Sporadic colorectal adenoma
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Sporadic colorectal adenoma: OR 0.82 (95% CI 0.69 to 0.97), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.82 [0.69, 0.97]9 studies · 6268 participantsUngraded
Body mass index
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Body mass index: Z score -0.15 (95% CI -0.19 to -0.11), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 2; Results · same question in other reviews
Z score -0.15 [-0.19, -0.11]37 studies · 16525 participantsUngraded
All cause mortality (in CKD patients)
Population: Participants in observational studies
The meta-analysis of observational studies reported a RR of 0.88 (95% CI 0.81 to 0.93) for higher versus lower circulating vitamin D concentration.
Source: Fig 3; Table 2 · same question in other reviews
RR 0.86 [0.81, 0.92]10 studies · 6853 participantsUngraded
Depression
Case-control studies
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Depression (Case-control studies): OR 0.77 (95% CI 0.59 to 1.00), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 2; Fig 3; Results · same question in other reviews
OR 0.77 [0.59, 1.00]9 studies · 19807 participantsUngraded
Type 2 diabetes (prevalent)
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Type 2 diabetes (prevalent): OR 0.45 (95% CI 0.25 to 0.82), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 2; Fig 3; Results · same question in other reviews
OR 0.45 [0.25, 0.82]9 studies · 11892 participantsUngraded
All cause mortality
Meta-analysis of observational studies (higher vs lower 25(OH)D) for All cause mortality: HR 0.72 (95% CI 0.66 to 0.78), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 2; Fig 3; Results · same question in other reviews
HR 0.72 [0.66, 0.78]18 studies · 77155 participantsUngraded
Rectal cancer
Meta-analysis of observational studies (higher vs lower 25(OH)D) for Rectal cancer: OR 0.50 (95% CI 0.29 to 0.88), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.50 [0.29, 0.88]9 studies · 2050 participantsUngraded

Higher circulating 1,25-dihydroxyvitamin D (1,25(OH)2D) concentration vs Lower circulating 1,25-dihydroxyvitamin D (1,25(OH)2D) concentration

Population: Adults (general population)
7 questions
OutcomeEffectEvidenceStatus / GRADE
Colorectal cancer
Meta-analysis of observational studies (higher vs lower 1,25(OH)2D) for Colorectal cancer: OR 1.01 (95% CI 0.59 to 1.73), not statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 1.01 [0.59, 1.73]4 studiesUngraded
Breast cancer
Population: Participants in observational studies
The meta-analysis of observational studies reported a OR of 0.99 (95% CI 0.68 to 1.47) for higher versus lower circulating vitamin D concentration.
Source: Fig 3; Table 1 · same question in other reviews
OR 0.99 [0.68, 1.44]3 studies · 3627 participantsUngraded
Prostate cancer
Population: Participants in observational studies
The meta-analysis of observational studies reported a OR of 0.99 (95% CI 0.87 to 1.12) for higher versus lower circulating vitamin D concentration.
Source: Fig 3; Table 1 · same question in other reviews
OR 0.99 [0.87, 1.14]7 studies · 3640 participantsUngraded
Colon cancer
Meta-analysis of observational studies (higher vs lower 1,25(OH)2D) for Colon cancer: OR 0.88 (95% CI 0.57 to 1.35), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.88 [0.57, 1.35]4 studiesUngraded
Breast cancer
Meta-analysis of observational studies (higher vs lower 1,25(OH)2D) for Breast cancer: OR 0.99 (95% CI 0.68 to 1.44), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.99 [0.68, 1.44]3 studies · 3627 participantsUngraded
Aggressive prostate cancer
Meta-analysis of observational studies (higher vs lower 1,25(OH)2D) for Aggressive prostate cancer: OR 0.75 (95% CI 0.48 to 1.17), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.75 [0.48, 1.17]2 studies · 1488 participantsUngraded
Prostate cancer
Meta-analysis of observational studies (higher vs lower 1,25(OH)2D) for Prostate cancer: OR 0.99 (95% CI 0.87 to 1.14), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 1; Fig 3; Results · same question in other reviews
OR 0.99 [0.87, 1.14]7 studies · 3640 participantsUngraded

Higher maternal circulating 25-hydroxyvitamin D (25(OH)D) concentration vs Lower maternal circulating 25-hydroxyvitamin D (25(OH)D) concentration

Population: Pregnant women and their offspring
6 questions
OutcomeEffectEvidenceStatus / GRADE
Pre-eclampsia
Meta-analysis of observational studies (higher vs lower maternal 25(OH)D) for Pre-eclampsia: OR 0.56 (95% CI 0.39 to 0.80), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 2; Fig 3; Results · same question in other reviews
OR 0.56 [0.39, 0.80]9 studies · 3230 participantsUngraded
Birth length
Meta-analysis of observational studies (higher vs lower maternal 25(OH)D) for Birth length: WMD 0.19 (95% CI -0.26 to 0.65), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 2; Results · same question in other reviews
WMD 0.19 [-0.26, 0.65]2 studies · 840 participantsUngraded
Birth weight
Meta-analysis of observational studies (higher vs lower maternal 25(OH)D) for Birth weight: WMD 130.9 (95% CI 75.1 to 186.7), statistically significant. Umbrella review outcome-level evidence grade: Probable.
Source: Table 2; Results · same question in other reviews
WMD 130.9 [75.1, 186.7]4 studies · 5541 participantsUngraded
Small for gestational age
Meta-analysis of observational studies (higher vs lower maternal 25(OH)D) for Small for gestational age: OR 0.54 (95% CI 0.44 to 0.67), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 2; Fig 3; Results · same question in other reviews
OR 0.54 [0.44, 0.67]6 studies · 6851 participantsUngraded
Head circumference
Meta-analysis of observational studies (higher vs lower maternal 25(OH)D) for Head circumference: WMD 0.05 (95% CI -0.24 to 0.34), not statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 2; Results · same question in other reviews
WMD 0.05 [-0.24, 0.34]2 studies · 840 participantsUngraded
Gestational diabetes
Meta-analysis of observational studies (higher vs lower maternal 25(OH)D) for Gestational diabetes: OR 0.67 (95% CI 0.53 to 0.85), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 2; Fig 3; Results · same question in other reviews
OR 0.67 [0.53, 0.85]10 studies · 4112 participantsUngraded

Higher circulating 25-hydroxyvitamin D (25(OH)D) concentration vs Lower circulating 25-hydroxyvitamin D (25(OH)D) concentration

Population: Patients with chronic kidney disease
1 question
OutcomeEffectEvidenceStatus / GRADE
All cause mortality
Meta-analysis of observational studies (higher vs lower 25(OH)D) for All cause mortality, Patients with chronic kidney disease: RR 0.86 (95% CI 0.81 to 0.92), statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 2; Fig 3; Results · same question in other reviews
RR 0.86 [0.81, 0.92]10 studies · 6853 participantsUngraded

Vitamin D supplementation vs Placebo or control

Population: Adults (general population)
9 questions
OutcomeEffectEvidenceStatus / GRADE
Total cholesterol
Meta-analysis of randomised trials of vitamin D supplementation for Total cholesterol: WMD 1.52 (95% CI -1.42 to 4.46), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Results · same question in other reviews
WMD 1.52 [-1.42, 4.46]11 studiesUngraded
Mortality (all cause)
Vitamin D3, general population
Meta-analysis of randomised trials of vitamin D supplementation for Mortality (all cause) (Vitamin D3, general population): RR 0.91 (95% CI 0.82 to 1.02), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.91 [0.82, 1.02]9 studies · 12824 participantsUngraded
Diastolic blood pressure
Meta-analysis of randomised trials of vitamin D supplementation for Diastolic blood pressure: WMD -0.03 (95% CI -1.98 to 1.92), not statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Results · same question in other reviews
WMD -0.03 [-1.98, 1.92]3 studiesUngraded
Mortality (all cause)
Vitamin D2, general population
Meta-analysis of randomised trials of vitamin D supplementation for Mortality (all cause) (Vitamin D2, general population): RR 1.04 (95% CI 0.97 to 1.11), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 1.04 [0.97, 1.11]8 studies · 17079 participantsUngraded
High density lipoprotein
Meta-analysis of randomised trials of vitamin D supplementation for High density lipoprotein: WMD -0.14 (95% CI -0.99 to 0.71), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 3; Results · same question in other reviews
WMD -0.14 [-0.99, 0.71]8 studiesUngraded
Triglycerides
Meta-analysis of randomised trials of vitamin D supplementation for Triglycerides: WMD -1.92 (95% CI -7.72 to 3.88), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Results · same question in other reviews
WMD -1.92 [-7.72, 3.88]8 studiesUngraded
Low density lipoprotein
Meta-analysis of randomised trials of vitamin D supplementation for Low density lipoprotein: WMD 3.23 (95% CI 0.55 to 5.9), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Results · same question in other reviews
WMD 3.23 [0.55, 5.9]7 studiesUngraded
Cardiovascular disease
Meta-analysis of randomised trials of vitamin D supplementation for Cardiovascular disease: RR 0.95 (95% CI 0.86 to 1.05), not statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.95 [0.86, 1.05]2 studiesUngraded
Systolic blood pressure
Meta-analysis of randomised trials of vitamin D supplementation for Systolic blood pressure: WMD -2.39 (95% CI -5.7 to 0.9), not statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Results · same question in other reviews
WMD -2.39 [-5.7, 0.9]3 studiesUngraded

Vitamin D supplementation vs Placebo or control

Population: Pregnant women
7 questions
OutcomeEffectEvidenceStatus / GRADE
Small for gestational age
Meta-analysis of randomised trials of vitamin D supplementation for Small for gestational age: RR 0.67 (95% CI 0.40 to 1.11), not statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.67 [0.40, 1.11]2 studies · 305 participantsUngraded
Mean gestational age at delivery
Meta-analysis of randomised trials of vitamin D supplementation for Mean gestational age at delivery: WMD 0.17 (95% CI -0.16 to 0.51), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Results · same question in other reviews
WMD 0.17 [-0.16, 0.51]2 studiesUngraded
Preterm delivery
Meta-analysis of randomised trials of vitamin D supplementation for Preterm delivery: RR 0.77 (95% CI 0.35 to 1.66), not statistically significant.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.77 [0.35, 1.66]2 studies · 529 participantsUngraded
Head circumference at birth
Meta-analysis of randomised trials of vitamin D supplementation for Head circumference at birth: WMD 0.43 (95% CI 0.06 to 0.79), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Results · same question in other reviews
WMD 0.43 [0.06, 0.79]2 studiesUngraded
Low birth weight
Meta-analysis of randomised trials of vitamin D supplementation for Low birth weight: RR 0.4 (95% CI 0.23 to 0.71), statistically significant. Umbrella review outcome-level evidence grade: Probable.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.4 [0.23, 0.71]3 studies · 507 participantsUngraded
Birth length
Meta-analysis of randomised trials of vitamin D supplementation for Birth length: WMD 0.97 (95% CI -0.41 to 2.34), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 3; Results · same question in other reviews
WMD 0.97 [-0.41, 2.34]2 studiesUngraded
Maternal vitamin D concentrations at term
Meta-analysis of randomised trials of vitamin D supplementation for Maternal vitamin D concentrations at term: WMD 47.08 (95% CI 23.76 to 70.39), statistically significant. Umbrella review outcome-level evidence grade: Probable.
Source: Table 3; Results · same question in other reviews
WMD 47.08 [23.76, 70.39]4 studiesUngraded

Vitamin D supplementation vs Placebo or control

Population: Children
5 questions
OutcomeEffectEvidenceStatus / GRADE
Bone mineral density in forearm
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density in forearm, Healthy children: SMD 0.04 (95% CI -0.36 to 0.45), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 4; Results · same question in other reviews
SMD 0.04 [-0.36, 0.45]3 studiesUngraded
Bone mineral density in lumbar spine
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density in lumbar spine, Healthy children: SMD 0.15 (95% CI -0.01 to 0.31), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Results · same question in other reviews
SMD 0.15 [-0.01, 0.31]5 studiesUngraded
Bone mineral density
Whole body / total
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density (Whole body / total), Healthy children: SMD 0.1 (95% CI -0.06 to 0.26), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 4; Results · same question in other reviews
SMD 0.1 [-0.06, 0.26]5 studiesUngraded
Bone mineral density in hip
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density in hip, Healthy children: SMD 0.06 (95% CI -0.18 to 0.29), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 4; Results · same question in other reviews
SMD 0.06 [-0.18, 0.29]4 studiesUngraded
Dental caries
Meta-analysis of randomised trials of vitamin D supplementation for Dental caries: RR 0.53 (95% CI 0.43 to 0.65), statistically significant. Umbrella review outcome-level evidence grade: Probable.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.53 [0.43, 0.65]38 studies · 1513 participantsUngraded

Vitamin D supplementation vs Placebo or control

Population: Adults with diabetes
3 questions
OutcomeEffectEvidenceStatus / GRADE
Fasting glucose
Diabetes patients with abnormal glucose tolerance
Meta-analysis of randomised trials of vitamin D supplementation for Fasting glucose (Diabetes patients with abnormal glucose tolerance): WMD -0.3 (95% CI -0.9 to 0.3), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 3; Results · same question in other reviews
WMD -0.3 [-0.9, 0.3]NRUngraded
Fasting glucose
Diabetes patients with normal glucose tolerance
Meta-analysis of randomised trials of vitamin D supplementation for Fasting glucose (Diabetes patients with normal glucose tolerance): WMD 0.01 (95% CI -0.21 to 0.23), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 3; Results · same question in other reviews
WMD 0.01 [-0.21, 0.23]NRUngraded
Insulin resistance
Diabetes
Meta-analysis of randomised trials of vitamin D supplementation for Insulin resistance (Diabetes): SMD 0.16 (95% CI -0.11 to 0.42), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Results · same question in other reviews
SMD 0.16 [-0.11, 0.42]5 studiesUngraded

Vitamin D supplementation vs Placebo or control

Population: Older or community-dwelling adults
16 questions
OutcomeEffectEvidenceStatus / GRADE
Performance measures: muscle strength
Meta-analysis of randomised trials of vitamin D supplementation for Performance measures: muscle strength, Older adults: SMD -0.19 (95% CI -0.35 to -0.02), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 4; Results · same question in other reviews
SMD -0.19 [-0.35, -0.02]3 studiesUngraded
Fractures: non-vertebral, non-hip
Meta-analysis of randomised trials of vitamin D supplementation for Fractures: non-vertebral, non-hip, Older women: OR 0.69 (95% CI 0.21 to 1.66), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Results · same question in other reviews
OR 0.69 [0.21, 1.66]2 studiesUngraded
Performance measures: lower extremity strength
Meta-analysis of randomised trials of vitamin D supplementation for Performance measures: lower extremity strength, Older adults: SMD 0.05 (95% CI -0.11 to 0.20), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 4; Results · same question in other reviews
SMD 0.05 [-0.11, 0.20]3 studiesUngraded
Performance measures: balance sway
Meta-analysis of randomised trials of vitamin D supplementation for Performance measures: balance sway, Older adults: SMD -0.20 (95% CI -0.39 to -0.01), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 4; Results · same question in other reviews
SMD -0.20 [-0.39, -0.01]3 studiesUngraded
Bone mineral density in femoral neck
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density in femoral neck, Community-dwelling adults: WMD 1.10 (95% CI 0.40 to 1.90), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 4; Results · same question in other reviews
WMD 1.10 [0.40, 1.90]8 studiesUngraded
Fractures: vertebral or deformity
Meta-analysis of randomised trials of vitamin D supplementation for Fractures: vertebral or deformity, Men aged >65 years and postmenopausal women: RR 0.90 (95% CI 0.42 to 1.92), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Fig 4; Results · same question in other reviews
RR 0.90 [0.42, 1.92]5 studies · 9138 participantsUngraded
Bone mineral density in lumbar spine
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density in lumbar spine, Community-dwelling adults: WMD 0.10 (95% CI -0.60 to 0.70), not statistically significant. Umbrella review outcome-level evidence grade: Substantial effect unlikely.
Source: Table 4; Results · same question in other reviews
WMD 0.10 [-0.60, 0.70]7 studiesUngraded
Fractures: non-vertebral
Meta-analysis of randomised trials of vitamin D supplementation for Fractures: non-vertebral, People aged >65 years: RR 0.79 (95% CI 0.63 to 0.99), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 4; Fig 4; Results · same question in other reviews
RR 0.79 [0.63, 0.99]5 studies · 7130 participantsUngraded
Falls
Meta-analysis of randomised trials of vitamin D supplementation for Falls, Older adults: OR 0.97 (95% CI 0.84 to 1.11), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Results · same question in other reviews
OR 0.97 [0.84, 1.11]10 studiesUngraded
Fractures
Meta-analysis of randomised trials of vitamin D supplementation for Fractures, Men aged >65 years and postmenopausal women: RR 1.01 (95% CI 0.93 to 1.09), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Fig 4; Results · same question in other reviews
RR 1.01 [0.93, 1.09]10 studies · 25016 participantsUngraded
Bone mineral density in forearm
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density in forearm, Community-dwelling adults: WMD -0.70 (95% CI -1.70 to 0.40), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Results · same question in other reviews
WMD -0.70 [-1.70, 0.40]2 studiesUngraded
Bone mineral density in hip
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density in hip, Community-dwelling adults: WMD 0.70 (95% CI -0.10 to 1.60), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Results · same question in other reviews
WMD 0.70 [-0.10, 1.60]6 studiesUngraded
Fractures: hip
Meta-analysis of randomised trials of vitamin D supplementation for Fractures: hip, Men aged >65 years and postmenopausal women: RR 1.15 (95% CI 0.99 to 1.33), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Fig 4; Results · same question in other reviews
RR 1.15 [0.99, 1.33]9 studies · 24749 participantsUngraded
Falls: rate of falls
Older people in care facilities or hospitals
Meta-analysis of randomised trials of vitamin D supplementation for Falls: rate of falls (Older people in care facilities or hospitals): RaR 0.55 (95% CI 0.19 to 1.64), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Results · same question in other reviews
RAR 0.55 [0.19, 1.64]2 studiesUngraded
Bone mineral density
Meta-analysis of randomised trials of vitamin D supplementation for Bone mineral density, Community-dwelling adults: WMD -0.9 (95% CI -2.10 to 0.40), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Results · same question in other reviews
WMD -0.9 [-2.10, 0.40]3 studiesUngraded
Falls: rate of falls
Older people in the community
Meta-analysis of randomised trials of vitamin D supplementation for Falls: rate of falls (Older people in the community): RaR 1.14 (95% CI 1.03 to 1.27), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 4; Results · same question in other reviews
RAR 1.14 [1.03, 1.27]2 studiesUngraded

Vitamin D compounds (supplementation) vs Placebo or control

Population: Adults with chronic kidney disease not requiring dialysis
7 questions
OutcomeEffectEvidenceStatus / GRADE
Creatinine clearance
Meta-analysis of randomised trials of vitamin D supplementation for Creatinine clearance: WMD -1.68 (95% CI -6.92 to 3.56), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Results · same question in other reviews
WMD -1.68 [-6.92, 3.56]4 studiesUngraded
Risk of hypercalcaemia
Meta-analysis of randomised trials of vitamin D supplementation for Risk of hypercalcaemia: RR 3.04 (95% CI 1.17 to 7.90), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 3.04 [1.17, 7.90]7 studies · 612 participantsUngraded
Risk of requiring dialysis
Meta-analysis of randomised trials of vitamin D supplementation for Risk of requiring dialysis: RR 0.76 (95% CI 0.36 to 1.62), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.76 [0.36, 1.62]4 studies · 245 participantsUngraded
Mortality
Meta-analysis of randomised trials of vitamin D supplementation for Mortality: RR 1.40 (95% CI 0.38 to 5.15), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 1.40 [0.38, 5.15]4 studies · 381 participantsUngraded
Parathyroid hormone
Meta-analysis of randomised trials of vitamin D supplementation for Parathyroid hormone: WMD -49.34 (95% CI -85.70 to -12.97), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Results · same question in other reviews
WMD -49.34 [-85.70, -12.97]4 studiesUngraded
Alkaline phosphatase
Meta-analysis of randomised trials of vitamin D supplementation for Alkaline phosphatase: WMD -21.81 (95% CI -40.39 to 3.22), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Results · same question in other reviews
WMD -21.81 [-40.39, 3.22]2 studiesUngraded
Risk of hyperphosphataemia
Meta-analysis of randomised trials of vitamin D supplementation for Risk of hyperphosphataemia: RR 1.58 (95% CI 0.47 to 5.30), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 1.58 [0.47, 5.30]2 studies · 245 participantsUngraded

Vitamin D compounds (supplementation) vs Placebo or control

Population: Adults with chronic kidney disease requiring dialysis
10 questions
OutcomeEffectEvidenceStatus / GRADE
Risk of hypercalcaemia
Meta-analysis of randomised trials of vitamin D supplementation for Risk of hypercalcaemia: RR 3.80 (95% CI 0.90 to 16.12), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 3.80 [0.90, 16.12]5 studies · 382 participantsUngraded
Subperiosteal erosions
Meta-analysis of randomised trials of vitamin D supplementation for Subperiosteal erosions: RR 0.41 (95% CI 0.07 to 2.38), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.41 [0.07, 2.38]3 studies · 120 participantsUngraded
Risk of hyperphosphataemia
Meta-analysis of randomised trials of vitamin D supplementation for Risk of hyperphosphataemia: RR 1.57 (95% CI 0.97 to 2.54), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 1.57 [0.97, 2.54]2 studies · 59 participantsUngraded
Parathyroid hormone
Meta-analysis of randomised trials of vitamin D supplementation for Parathyroid hormone: WMD -196.05 (95% CI -298.43 to -93.66), statistically significant. Umbrella review outcome-level evidence grade: Probable.
Source: Table 3; Results · same question in other reviews
WMD -196.05 [-298.43, -93.66]6 studiesUngraded
Fractures
Meta-analysis of randomised trials of vitamin D supplementation for Fractures: RR 1.00 (95% CI 0.06 to 15.41), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Results · same question in other reviews
RR 1.00 [0.06, 15.41]4 studiesUngraded
Mortality
Meta-analysis of randomised trials of vitamin D supplementation for Mortality: RR 1.34 (95% CI 0.34 to 5.24), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 1.34 [0.34, 5.24]5 studies · 477 participantsUngraded
Vascular calcification
Meta-analysis of randomised trials of vitamin D supplementation for Vascular calcification: RR 1.09 (95% CI 0.45 to 2.67), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 1.09 [0.45, 2.67]2 studies · 128 participantsUngraded
Alkaline phosphatase
Meta-analysis of randomised trials of vitamin D supplementation for Alkaline phosphatase: WMD -27.35 (95% CI -50.69 to -4.01), statistically significant. Umbrella review outcome-level evidence grade: Suggestive.
Source: Table 3; Results · same question in other reviews
WMD -27.35 [-50.69, -4.01]3 studiesUngraded
Parathyroidectomy
Meta-analysis of randomised trials of vitamin D supplementation for Parathyroidectomy: RR 0.82 (95% CI 0.05 to 12.47), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 3; Fig 4; Results · same question in other reviews
RR 0.82 [0.05, 12.47]2 studies · 233 participantsUngraded
Bone pain
Meta-analysis of randomised trials of vitamin D supplementation for Bone pain: RR 0.29 (95% CI 0.03 to 2.63), not statistically significant. Umbrella review outcome-level evidence grade: No conclusion.
Source: Table 4; Fig 4; Results · same question in other reviews
RR 0.29 [0.03, 2.63]4 studies · 109 participantsUngraded

Vitamin D supplementation vs Control

Population: Community dwelling adults
1 question
OutcomeEffectEvidenceStatus / GRADE
Bone mineral density in forearm
The meta-analysis of RCTs reported a WMD of -0.70 (95% CI 1.70 to 0.40) for vitamin d supplementation versus control.
WMD -0.70 [-1.70, 0.40]2 studiesUngraded

Included primary studies 55

Open as a trial list
StudyAlso included byOutcomes it informs hereTrial PICOResults
Afzal 2013
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this review onlynot statednot extracted yetnot extracted yet
Aghajafari 2013
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Anglin 2013
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Annweiler 2013
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Antico 2012
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Avenell 2009
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Barnard 2010
Novel human pathological mutations. Gene symbol: NR0B1. Disease: Adrenal Hypoplasia.
PMID:20108433
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Bauer 2013
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Bergman 2010
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Bischoff-Ferrari 2009
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Bjelakovic 2011
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Brondum-Jacobsen 2012
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Brondum-Jacobsen 2013
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Buttigliero 2011
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Cameron 2012
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Chen 2010
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Chen 2013
Osteoarthritis: mRNA decay in OA.
PMID:25201381
this review onlynot statednot extracted yetnot extracted yet
Christesen 2012
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this review onlynot statednot extracted yetnot extracted yet
Chung 2009
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Cook 2010
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Cranney 2007
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De-Regil 2012
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Dolinsky 2013
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Etgen 2012
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Gallicchio 2010
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this review onlynot statednot extracted yetnot extracted yet
George 2012
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Gilbert 2011
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Gillespie 2012
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Grandi 2010
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Hujoel 2013
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Jolliffe 2013
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Kelly 2009
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Kriegel 2011
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Kunutsor 2013
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Muir 2011
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Murad 2011
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Myung 2013
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Nnoaham 2008
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Palmer 2009
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Parker 2010
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Pilz 2011
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Pittas 2010
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Purdue 2010
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Reid 2014
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Renzaho 2011
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Sakthiswary 2013
Scintigraphic visualization of myocardial infarcts in baboons using thallium-201 and technetium-99m pyrophosphate.
PMID:201381
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Saneei 2013
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Song 2012
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Stolzenberg-Solomon 2010
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Thorne-Lyman 2012
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Wang 2012
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Wang 2012
Gas-phase bioconjugation of peptides via ion/ion charge inversion: Schiff base formation on the conversion of cations to anions.
PMID:20121142
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Weatherall 2000
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Winzenberg 2011
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Yaghjyan 2012
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