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Semin Thromb Hemost 2023; 49(05): 453-470
DOI: 10.1055/s-0042-1756701
Review Article

Is Vitamin D Deficiency Prothrombotic? A Systematic Review

Isabella Hangaard Rüdiger‡   *
1   Department of Obstetrics and Gynecology, Regional Hospital of Randers, Randers, Denmark
,
Matilde Kanstrup Andersen‡   *
1   Department of Obstetrics and Gynecology, Regional Hospital of Randers, Randers, Denmark
2   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
Anna Louise Vestergaard
1   Department of Obstetrics and Gynecology, Regional Hospital of Randers, Randers, Denmark
2   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
Pinar Bor
3   Department of Biomedicine, Aarhus University, Aarhus, Denmark
,
Agnete Larsen
4   Department of Regional Health Research, Thrombosis Research, University of Southern Denmark, Odense, Denmark
5   Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
,
Mustafa Vakur Bor
4   Department of Regional Health Research, Thrombosis Research, University of Southern Denmark, Odense, Denmark
5   Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
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Abstract

Observational studies indicate a relationship between vitamin D deficiency and an increased risk of venous and arterial thrombotic events, but the underlying mechanisms behind this association are uncertain. This systematic review explores if there is an association between decreased vitamin D levels and a prothrombotic profile. The systematic literature search initially identified 3,214 studies (published until December 21, 2021) investigating the relationship between vitamin D and numerous hemostatic parameters. After the screening process, 18 observational and intervention studies fulfilled the inclusion criteria and were included in this systematic review. Parameters of primary hemostasis, secondary hemostasis, and fibrinolysis were investigated in six, thirteen, and fifteen of these studies, respectively. Most of the eligible studies did not identify significant associations between decreased vitamin D levels and hemostatic parameters. Some conflicting results were found between decreased vitamin D levels and thrombin generation parameters and the tissue factor pathway inhibitor. Conflicting results were also found between decreased vitamin D levels and fibrinolytic parameters, although the evidence may point toward weak associations with some regulators of fibrinolysis, mostly decreased tissue type plasminogen activator. Overall, our systematic review did not identify any definitive link between vitamin D deficiency and a prothrombotic profile, which might otherwise help explain the observed association between vitamin D deficiency and increased risk of thrombotic events. Moreover, there is no clinical evidence to confirm or refute a possible antithrombotic effect of vitamin D. Larger high-quality randomized controlled trials are needed to better elucidate the link between vitamin D deficiency and a prothrombotic risk profile.

Keywords

vitamin D deficiency - hemostasis - prothrombotic profile

* These authors contributed equally to this work.


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Artikel online veröffentlicht:
29. September 2022

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