Table 1.
Basic characteristics of the 13 articles included in the meta-analysis
| Author, publication year, country | Study design, Follow up | Source of parcipant | Conducted season | Cases/N | Definition of AF, measurement of vitamin D | Mean age (years), male (%) | Expose level | RR (95%CI) | Adjustment for confounders |
|---|---|---|---|---|---|---|---|---|---|
| Rienstra, 2011, USA [12] | Prospective cohort, 9.9 years | Framingham Heart Study | NA | 425/2930 | ECG, competitive protein-binding assay and radioimmunoassay | 65, 44 | Continuous variable | 0.99 (0.89–1.10) | Age, sex, BMI, PR interval, and cardiac murmur. |
| Chen, 2014, China [9] | Case-control, NA | Chinese PLA General Hospital | Winter | 162/322 | ECG, chemilumiscence assay | 65, 45 | < 20 ng/ml 21–29 ng/ml ≥ 30 ng/ml continuous variable | 1.97 (1.31–2.97) 1.32 (1.06–1.66) ref. 0.4 (0.30–0.80) | Age, systolic blood pressure, hsCRP, LAD, LV end diastolic diameter, LVEF, and PASP. |
| Demir, 2014, Turkey [10] | Case-control, NA | Bursa Education and Research Hospital | Winter | 198/298 | NA, BioSource 25-OH Vit.D3-Ria-CT Kit | 62, 40 | Continuous variable | 0.86 (0.786–0.94) | Medications, age, gender, and BMI. |
| Mathew, 2014, USA [14] | Prospective cohort, 7.7 years | MESA Study | NA | 291/6398 | ECG, hospital discharge diagnoses, inpatient and outpatient physician claims data | 62, 53.5 | Per 10 ng/mL | 0.92 (0.81–1.03) | Age, gender, race/ethnicity, study site, attained education, low density, cholesterol, use of lipid-lowering medications, current smoking, diabetes, physical, activity, height, height squared, weight, urine albumin-creatinine-ratio, eGFR, systolic blood pressure, and use of hypertension medication. |
| Prospective cohort, 8.0 years | CHS Study | NA | 229/1350 | 77, 71.3 | Per 10 ng/ml | 1.00 (0.88–1.14) | |||
| Ozcan,2015, Turkey [11] | Prospective case-control, NA | Ankara University Hospital | Winter and Spring | 90/227 | ECG, chemiluminescent immunoassay | 68, 58 | < 20 ng/ml ≥ 20 ng/ml Continuous variable | 1.68 (1.18–2.64) Ref 0.86 (0.66–1.05) | Age, gender, BMI, smoking status, hyperlipidemia, medications, serum levels of creatinine, calcium, LAD, LAEF, and PASP |
| Vitezova, 2015, Netherlands [13] | Prospective cohort, 12 years | The Rotterdam Study | NA | 263/3295 | ECG, electrochemiluminescence immunoassay | 71, 41 | < 50 nmol/l 50–74 nmol/l ≥ 75 nmol/l | ref 0.82 (0.60–1.11) 0.76 (0.52–1.12) | Age, gender, income, education, BMI, physical activity, diet quality score, smoking status and season and year when the blood was drawn. |
| Emren, 2016, Turkey [17] | Prospective case-control study, NA | Residents in Afyonkarahisar | Winter and Spring | 71/212 | ECG, direct chemiluminescence immuno assay | 63, 75 | < 11.5 ng/ml ≥ 11.5 ng/ml | ref 0.95 (0.91–0.99) | Age, male sex, chronic HF, AF episodes, COPD, chronic renal failure, DM, rheumatic heart disease, metabolic syndrome, obesity, and inadequate use of beta blockers or RAS blockers. |
| Alonso, 2016, USA [7] | Prospective cohort, 18 years | Communities Study | NA | 1866/12,303 | ECG and Hospital discharge codes, high-sensitivity mass spectrom eter | 57, 43 | < 20 ng/ml 21–29 ng/ml ≥ 30 ng/ml | 1.10 (0.96–1.26) 1.09 (0.97–1.22) ref | Age, sex, race, study centre, education, alcohol consumption, height, BMI, smoking status, physical activity, systolic and diastolic BPs, medication, DM, coronary heart disease, HF, hsCRP, NT-pro-BNP, and eGFR. |
| Belen, 2016, Turkey [8] | Case-control, NA | Hospital in Okmeydan | NA | 96/180 | ECG, high-performance liquid chroma tography | 66, 54 | Continuous variable | 0.854 (0.805–0.907) | Age, gender, BMI, etiology and chronic HF stage. |
| Gode, 2016, Turkey [19] | Prospective case-control study, 5 day | Hospital in Istanbul | Winter | 15/90 | ECG, analysed in biochemistry laboratory | 58, 78 | ≤ 30 ng/mL > 30 ng/mL | ref 0.856 (0.751–0.976) | LAD, creatinine, cholesterol and DM. |
| Skuladottir, 2016, Iceland [29] | Prospective case-control study, 72 h | The National University Hospital of Iceland | NA | 66/118 | Holter monitoring, MS/MS Vitamin D Kit | NA, 80 | < 47.1 nmol/l ≥ 47.1 nmol/l | 1.31 (0.54–3.16) ref | Age, BMI, smoking, peak postoperative C-reactive protein, preoperative plasma DHA level and valvular surgery or complex surgical procedure |
| Turin, 2018, USA [16] | Retrospective cohort, NA | Loyola University Medical Center | All seasons | 2697/47,062 | ICD-9 code data, liquid chromatography-MS | NA, 28 | < 20 ng/ml ≥ 20 ng/ml | 1.08 (0.95–1.22) ref | ACEI/ARB use |
| Özsin, 2018, Turkey [18] | Prospective randomized clinical, NA | Hospital in Bursa | Winter | 50/100 | ECG, Architect 25-OH vitamin D- Reagent Kit | 60, 70 | < 7.65 ng/dl ≥ 7.65 ng/dl | ref 0.855 (0.780–0.938) | Age, gender, history of hypertension, DM, preoperative drug use, EF, LAD, BMI, body surface area, aortic cross clamp time, cardiopulmonary bypass time. |
Abbreviations: AF Atrial fibrillation, HF Heart failure, hsCRP high-sensitivity C-reactive protein, LAD Left atrium diameter, LAVI Left atrial volume index, LV Left ventricle, LVEF Left ventricular ejection fraction, PASP Pulmonary artery systolic pressure, BMI Body mass index, BP Blood pressure, DM Diabetes mellitus, NT-proBNP N-terminal of the prohorme B-type natriuretic peptide, eGFR estimated glomerular filtration rate, HDL-C High-density lipoprotein cholesterol, LDL-C Low-density lipoprotein cholesterol, COPD Chronic obstructive pulmonary disease, RAS Renin-angiotensin system, POAF Postoperative atrial fibrillation, ECG, Electrocardiography, MESA, Multi-Ethnic Study of Atherosclerosis, CHS Cardiovascular Health Study, PLA People’s Liberation Army, ICD International classification of diseases, ACEI Angiotensin-Converting Enzyme Inhibitors, ARB Angiotensin receptor blocker, MS/MS Cascade mass spectrometry, DHA Docosahexaenoic acid