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A Systematic Review and Meta-Analysis of the Association between Vitamin D and Cardiorespiratory Fitness
Chen Chen1, Keith T S Tung1, Mickey W K Suen1
1Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, 000000, China.
Context:
Vitamin D is implicated in cardiorespiratory fitness (CRF) through its roles in skeletal muscle metabolism and vascular function. Despite numerous studies linking vitamin D to CRF, no comprehensive meta-analysis has quantified their overall correlation or the effect of vitamin D interventions.
Objective:
The objective of this review was to investigate any association between vitamin D concentration and CRF, and the effect of vitamin D supplementation on CRF.
Data Sources:
PubMed, Embase, and Web of Science were systematically searched from their inception to November 2024.
Data Extraction:
A total of 20 observational studies (14 554 participants) and 9 interventional studies (733 participants) were included in the meta-analysis.
Data Analysis:
The effect size, correlation coefficient r, and a 95% CI (CI) were employed to estimate the correlation between vitamin D concentration and CRF. A random-effects model was used to calculate the standardized mean differences (SMDs) and 95% CIs. A significantly positive yet weak association (r = 0.17; 95% CI: 0.11, 0.24; P < .0001) was found between vitamin D concentration and CRF, with high heterogeneity (I2 = 88.0%, P heterogeneity < .0001). The correlation coefficient in children (r = 0.05; 95% CI: 0.01, 0.09; P = .0273) was smaller than that in adults (r = 0.26; 95% CI: 0.17, 0.34; P < .0001) (Psubgroup < .0001). No significant differences were observed between study subgroups stratified by gender, CRF measurement method, vitamin D assays, or physical activity level (all Psubgroup > .05). Interventional studies revealed that the effect of vitamin D supplementation on CRF is not significant (SMD: 0.03; 95% CI: -0.12, 0.17; P = .8959), with 0% heterogeneity.
Conclusion:
This meta-analysis confirms there is a small but significant positive relationship between vitamin D concentrations and CRF, especially in adults. However, the studies found no improvement in CRF through vitamin D supplementation in interventional trials.
Systematic Review Registration:
PROSPERO registration No. CRD42024574603.
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