{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:19:18Z","timestamp":1789175958510,"version":"build-2803163510"},"reference-count":66,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The association between vitamin D deficiency and prediabetes has been extensively investigated, yet the findings remain inconsistent, with limited data available on the MENA region. This systematic review aims to assess the relationship between vitamin D deficiency and prediabetes in the Middle East and North Africa (MENA) region, focusing specifically on randomized controlled trials (RCTs). Methods: A comprehensive literature search was performed across four databases, which were Ovid MEDLINE, Cochrane, Scopus, and PubMed. RCTs studies conducted on people with prediabetes aged 15 years and older who live in the MENA region, and receiving vitamin D supplementation were included in the study. Results: From 2194 studies identified from the literature search, only 51 studies were considered eligible for full-text review. Ultimately, seven articles were finalized for inclusion. The findings from these studies showed mixed results, where some studies indicated that vitamin D supplementation had no significant effect on these outcomes. The remaining reported improvements in insulin sensitivity and a reduced risk of progression to type 2 diabetes with vitamin D supplementation. Conclusions: This systematic review examines the complex and contradictory relationship between vitamin D deficiency and prediabetes in the MENA region. Due to the mixed pattern seen in the intervention of vitamin D to prevent the development of type 2 diabetes, further research is necessary to elucidate the underlying mechanisms and potential confounding factors specifically in population of the MENA region.<\/jats:p>","DOI":"10.3390\/jcm14041239","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T08:01:19Z","timestamp":1739433679000},"page":"1239","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating the Role of Vitamin D in Prediabetes Management, Insights from RCTs in the MENA Region: A Comprehensive Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3998-1324","authenticated-orcid":false,"given":"Mohammed A. M. Y.","family":"Al-Hetar","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia"},{"name":"Medical City Complex, The Specialized Clinic for Endocrinology and Diabetes, Ibb 6001196, Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9719-6662","authenticated-orcid":false,"given":"Noradliyanti","family":"Rusli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4163-2234","authenticated-orcid":false,"given":"Mohd Amir","family":"Kamaruzzaman","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-2763","authenticated-orcid":false,"given":"Husni","family":"Al-Goshae","sequence":"additional","affiliation":[{"name":"Department of Anatomy, International Medical School, Management & Science University, Shah Alam 40100, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Zurinah","family":"Wan Ngah","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia"},{"name":"Medical Innovation Research Centre, Shiga University of Medical Sciences, Otsu 520-2192, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0635-1816","authenticated-orcid":false,"given":"Shamsul Azhar","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Mohammed","family":"Al-Matary","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jiblah University for Medical and Health Sciences, Ibb 6001196, Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2364-1429","authenticated-orcid":false,"given":"Qais Mohammed","family":"Al-Hetar","sequence":"additional","affiliation":[{"name":"Medical City Complex, The Specialized Clinic for Endocrinology and Diabetes, Ibb 6001196, Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhya\u2019a Alhaq","family":"Mohammed Senan","sequence":"additional","affiliation":[{"name":"Medical City Complex, The Specialized Clinic for Endocrinology and Diabetes, Ibb 6001196, Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1168-217X","authenticated-orcid":false,"given":"Norasyikin","family":"A. Wahab","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur 56000, Malaysia"},{"name":"Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"ref_1","first-page":"e59267","article-title":"The Non-Conventional Effects of Hypovitaminosis D: A Pandemic Even in Sunlight-Rich Countries","volume":"16","author":"Qureshi","year":"2024","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"AlBlooshi, S., Al Anouti, F., and Hijazi, R. (2023). Knowledge About Vitamin D among Women in the United Arab Emirates. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20021252"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3892\/ijfn.2022.30","article-title":"Pattern of Vitamin D Deficiency in a Middle Eastern Population: A Cross-Sectional Study","volume":"3","author":"Hussein","year":"2022","journal-title":"Int. J. Funct. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"AlFaris, N.A., AlKehayez, N.M., AlMushawah, F.I., AlNaeem, A.N., AlAmri, N.D., and AlMudawah, E.S. (2019). Vitamin D Deficiency and Associated Risk Factors in Women from Riyadh, Saudi Arabia. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-56830-z"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"260","DOI":"10.26719\/emhj.19.084","article-title":"Vitamin D Deficiency in Healthy Children in Bahrain: Do Gender and Age Matter?","volume":"26","author":"Isa","year":"2020","journal-title":"East. Mediterr. Health J."},{"key":"ref_6","first-page":"e95185","article-title":"The Prevalence of Vitamin D Deficiency Among One to Six Year Old Children of Tehran, Iran","volume":"23","author":"Babaniamansour","year":"2019","journal-title":"J. Kermanshah Univ. Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3177\/jnsv.63.284","article-title":"Prevalence and Trends of Vitamin D Deficiency among Iranian Adults: A Longitudinal Study from 2001\u20132013","volume":"63","author":"Sarrafzadegan","year":"2017","journal-title":"J. Nutr. Sci. Vitaminol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4","DOI":"10.26502\/aimr.005","article-title":"Prevalence of Vitamin D Deficiency in Pregnant Diabetic Patients in Western Libya","volume":"2","author":"Murad","year":"2019","journal-title":"Arch. Intern. Med. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4103\/0019-5359.120695","article-title":"Vitamin D Status and Its Association with Antioxidant Profiles in Diabetic Patients: A Cross-Sectional Study in Iran","volume":"67","author":"Saedisomeolia","year":"2013","journal-title":"Indian J. Med. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e15461","DOI":"10.5812\/ircmj.15461","article-title":"Risk Factors and Prevalence of Vitamin D Deficiency Among Iranian Women Attending Two University Hospitals","volume":"16","author":"Alipour","year":"2014","journal-title":"Iran. Red Crescent Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.bonr.2018.03.004","article-title":"Vitamin D in the Middle East and North Africa","volume":"8","author":"Chakhtoura","year":"2018","journal-title":"Bone Rep."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Zhuang, Y., Zhu, Z., Chi, P., Zhou, H., Peng, Z., Cheng, H., Xin, X., Luo, W., Si, S., and Mo, M. (2023). Efficacy of Intermittent Versus Daily Vitamin D Supplementation on Improving Circulating 25(OH)D Concentration: A Bayesian Network Meta-Analysis of Randomized Controlled Trials. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1168115"},{"key":"ref_13","first-page":"594","article-title":"Pathophysiology of Prediabetes","volume":"103","author":"Bhansali","year":"2005","journal-title":"J. Indian Med. Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ecl.2017.10.001","article-title":"Prediabetes and Cardiovascular Disease: Pathophysiology and Interventions for Prevention and Risk Reduction","volume":"47","author":"Brannick","year":"2018","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1177\/1535370216654227","article-title":"Prediabetes as a Toxic Environment for the Initiation of Microvascular and Macrovascular Complications","volume":"241","author":"Brannick","year":"2016","journal-title":"Exp. Biol. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40842-019-0080-0","article-title":"Global Epidemiology of Prediabetes\u2014Present and Future Perspectives","volume":"5","author":"Hostalek","year":"2019","journal-title":"Clin. Diabetes Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Rusli, N., Ng, C.F., Makpol, S., Wong, Y.P., Mohd Isa, I.L., and Remli, R. (2024). Antioxidant Effect in Diabetic Peripheral Neuropathy in Rat Model: A Systematic Review. Antioxidants, 13.","DOI":"10.3390\/antiox13091041"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1016\/S0140-6736(12)60283-9","article-title":"Prediabetes: A High-Risk State for Diabetes Development","volume":"379","author":"Herder","year":"2012","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.mcna.2010.11.005","article-title":"Pathophysiology of Prediabetes","volume":"95","author":"Ferrannini","year":"2011","journal-title":"Med. Clin. N. Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3000605211033384","DOI":"10.1177\/03000605211033384","article-title":"A High Prevalence Of Prediabetes and Vitamin D Deficiency Are More Closely Associated in Women: Results of a Cross-Sectional Study","volume":"49","author":"Lee","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Pie\u0144kowska, A., Janicka, J., Duda, M., Dzwonnik, K., Lip, K., M\u0119dza, A., Szlagatys-Sidorkiewicz, A., and Brzezi\u0144ski, M. (2023). Controversial Impact of Vitamin D Supplementation on Reducing Insulin Resistance and Prevention of Type 2 Diabetes in Patients with Prediabetes: A Systematic Review. Nutrients, 15.","DOI":"10.3390\/nu15040983"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.2337\/dc14-0218","article-title":"No Effect of High-Dose Vitamin D Supplementation on Glycemic Status or Cardiovascular Risk Factors in Subjects with Prediabetes","volume":"37","author":"Sollid","year":"2014","journal-title":"Diabetes Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3721","DOI":"10.1210\/clinem\/dgaa594","article-title":"Vitamin D Supplementation for Prevention of Type 2 Diabetes Mellitus: To D or Not to D?","volume":"105","author":"Pittas","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Pilz, S., Trummer, C., Theiler-Schwetz, V., Gr\u00fcbler, M.R., Verheyen, N.D., Odler, B., Karras, S.N., Zittermann, A., and M\u00e4rz, W. (2022). Critical Appraisal of Large Vitamin D Randomized Controlled Trials. Nutrients, 14.","DOI":"10.3390\/nu14020303"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2813","DOI":"10.1016\/j.dsx.2019.07.043","article-title":"Does Vitamin D Status Correlate with Insulin Resistance in Obese Prediabetic Patients? An Egyptian Multicenter Study","volume":"13","author":"Hetta","year":"2019","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e19034","DOI":"10.1097\/MD.0000000000019034","article-title":"Association between Vitamin D and Prediabetes: A Prisma-Compliant Meta-Analysis","volume":"99","author":"Yu","year":"2020","journal-title":"Medicine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A Revised Tool for Assessing Risk of Bias in Randomised Trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"Grade: An Emerging Consensus on Rating Quality of Evidence and Strength of Recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ansari, M.G.A., Sabico, S., Clerici, M., Khattak, M.N.K., Wani, K., Al-Musharaf, S., Amer, O.E., Alokail, M.S., and Al-Daghri, N.M. (2020). Vitamin D Supplementation Is Associated with Increased Glutathione Peroxidase-1 Levels in Arab Adults with Prediabetes. Antioxidants, 9.","DOI":"10.3390\/antiox9020118"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Al Thani, M., Sadoun, E., Sofroniou, A., Jayyousi, A., Baagar, K.A.M., Al Hammaq, A., Vinodson, B., Akram, H., Bhatti, Z.S., and Nasser, H.S. (2019). The Effect of Vitamin D Supplementation on the Glycemic Control of Pre-Diabetic Qatari Patients in a Randomized Control Trial. BMC Nutr., 5.","DOI":"10.1186\/s40795-019-0311-x"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.diabres.2018.12.008","article-title":"Does High-Dose Vitamin D Supplementation Impact Insulin Resistance and Risk of Development of Diabetes in Patients with Pre-Diabetes? A double-Blind Randomized Clinical Trial","volume":"148","author":"Niroomand","year":"2019","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s13098-020-00549-9","article-title":"The Effect of Omega-3 and Vitamin D Co-Supplementation on Glycemic Control and Lipid Profiles in Reproductive-Aged Women with Pre-Diabetes and Hypovitaminosis D: A randomized Controlled Trial","volume":"12","author":"Dolatian","year":"2020","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_34","first-page":"47","article-title":"The Effects of Oral Vitamin D on Insulin Resistance in Pre-Diabetic Patients","volume":"18","author":"Hoseini","year":"2013","journal-title":"J. Res. Med. Sci."},{"key":"ref_35","first-page":"255","article-title":"Vitamin D Supplementation Influence in Insulin-Resistant Pre-Diabetic Obese Patients","volume":"66","author":"Rashad","year":"2023","journal-title":"Egypt. J. Chem."},{"key":"ref_36","first-page":"e41718","article-title":"The Effect of Vitamin D Supplementation on the Glycemic Status and the Percentage of Body Fat Mass in Adults with Prediabetes: A Randomized Clinical Trial","volume":"36","author":"Zarrin","year":"2017","journal-title":"Iran. Red Crescent Med. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1007\/s00394-020-02464-1","article-title":"Improving the Trustworthiness of Findings from Nutrition Evidence Syntheses: Assessing Risk of Bias and Rating the Certainty of Evidence","volume":"60","author":"Schwingshackl","year":"2020","journal-title":"Eur. J. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1136\/bmjebm-2022-112102","article-title":"Using Risk of Bias 2 to Assess Results from Randomised Controlled Trials: Guidance from Cochrane","volume":"28","author":"Flemyng","year":"2023","journal-title":"BMJ Evid. Based Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"575","DOI":"10.2174\/1573401317666210111105905","article-title":"Transcriptional and Non-Transcriptional Regulation of Glucose Metabolism and Insulin Sensitivity Through Vitamin D","volume":"17","author":"Somayeh","year":"2021","journal-title":"Curr. Nutr. Food Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"117305","DOI":"10.1016\/j.lfs.2020.117305","article-title":"The Molecular Mechanisms by which Vitamin D Improve Glucose Homeostasis: A Mechanistic Review","volume":"244","author":"Yaribeygi","year":"2020","journal-title":"Life Sci."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Argano, C., Mirarchi, L., Amodeo, S., Orlando, V., Torres, A., and Corrao, S. (2023). The Role of Vitamin D and Its Molecular Bases in Insulin Resistance, Diabetes, Metabolic Syndrome, and Cardiovascular Disease: State of the Art. Int. J. Mol. Sci., 24.","DOI":"10.20944\/preprints202309.0595.v1"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1096\/fj.02-0424fje","article-title":"Impaired Insulin Secretory Capacity in Mice Lacking a Functional Vitamin D Receptor","volume":"17","author":"Zeitz","year":"2003","journal-title":"FASEB J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"01848","DOI":"10.1096\/fasebj.2021.35.S1.01848","article-title":"The Vitamin D Receptor and RXR Heteropartner Cooperate via Synergistic Activation to Control Target Gene Expression","volume":"35","author":"Nguyen","year":"2021","journal-title":"FASEB J."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Wu, J., Atkins, A.R., Downes, M., and Wei, Z. (2023). Vitamin D in Diabetes: Uncovering the Sunshine Hormone\u2019s Role in Glucose Metabolism and Beyond. Nutrients, 15.","DOI":"10.3390\/nu15081997"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.2337\/dc19-1708","article-title":"Effects of Vitamin D Supplementation on Prevention of Type 2 Diabetes in Patients with Prediabetes: A Systematic Review and Meta-analysis","volume":"43","author":"Zhang","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1096\/fasebj.29.1_supplement.253.1","article-title":"Vitamin D (VD) Prevents Oxidative Stress via Regulating NOX4\/Nrf2\/Trx Signaling Cascade and Upregulates SIRT1-Mediated AMPK\/IRS1\/GLUT4 Pathway and Glucose Uptake in High Glucose Treated 3T3L1 Adipocytes","volume":"29","author":"Manna","year":"2015","journal-title":"FASEB J."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Vasdeki, D., Tsamos, G., Dimakakos, E., Patriarcheas, V., Koufakis, T., Kotsa, K., Cholewka, A., and Stanek, A. (2024). Vitamin D Supplementation: Shedding Light on the Role of the Sunshine Vitamin in the Prevention and Management of Type 2 Diabetes and Its Complications. Nutrients, 16.","DOI":"10.3390\/nu16213651"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e47921","DOI":"10.1590\/fst.47921","article-title":"Vitamin D Alleviates Skeletal Muscle Loss and Insulin Resistance by Inducing Vitamin D Receptor Expression and Regulating the AMPK\/SIRT1 Signaling Pathway in Mice","volume":"42","author":"Li","year":"2021","journal-title":"Food Sci. Technol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.abb.2017.01.002","article-title":"Vitamin D Supplementation Inhibits Oxidative Stress and Upregulate SIRT1\/AMPK\/GLUT4 Cascade in High Glucose-Treated 3T3L1 Adipocytes and in Adipose Tissue of High Fat Diet-Fed Diabetic Mice","volume":"615","author":"Manna","year":"2017","journal-title":"Arch. Biochem. Biophys."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"451","DOI":"10.3892\/etm.2024.12741","article-title":"Role of Vitamin D in Prevention of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis","volume":"28","author":"Sim","year":"2024","journal-title":"Exp. Ther. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1017\/S0007114521005080","article-title":"Influence of Geographical Latitude on Vitamin D Status: Cross-Sectional Results from the BiomarCaRE Consortium","volume":"128","author":"Oskarsson","year":"2022","journal-title":"Br. J. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"4","DOI":"10.23950\/jcmk\/13760","article-title":"Worsening Air Pollution an Unfamiliar Cause of Low Vitamin D levels: A Systematic Literature Review","volume":"20","author":"Jhamb","year":"2023","journal-title":"J. Clin. Med. Kazakhstan"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Frost, P. (2022). The Problem of Vitamin D Scarcity: Cultural and Genetic Solutions by Indigenous Arctic and Tropical Peoples. Nutrients, 14.","DOI":"10.3390\/nu14194071"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Cui, A., Zhang, T., Xiao, P., Fan, Z., Wang, H., and Zhuang, Y. (2023). Global and Regional Prevalence of Vitamin D Deficiency in Population-Based Studies from 2000 to 2022: A Pooled Analysis of 7.9 Million Participants. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1070808"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"273","DOI":"10.31246\/mjn-2020-0021","article-title":"Dietary Diversity, Vitamin D Intake and Childhood Stunting: A Case-Control Study in Bantul, Indonesia","volume":"26","author":"Nurhayati","year":"2020","journal-title":"Malays. J. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s13679-021-00433-1","article-title":"Vitamin D and Obesity: Current Evidence and Controversies","volume":"10","author":"Karampela","year":"2021","journal-title":"Curr. Obes. Rep."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s11657-018-0461-5","article-title":"Age and Gender Differences in the Prevalence and Correlates of Vitamin D Deficiency","volume":"13","author":"AlQuaiz","year":"2018","journal-title":"Arch. Osteoporos."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e042227","DOI":"10.1136\/bmjopen-2020-042227","article-title":"Socioeconomic Status and Vitamin D Deficiency Among Women of Childbearing Age: A Population-Based, Case-Control Study in Rural Northern China","volume":"11","author":"Lin","year":"2021","journal-title":"BMJ Open"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"8178","DOI":"10.1080\/10408398.2021.1926220","article-title":"Serum Vitamin D Levels in Relation to Type-2 Diabetes and Prediabetes in Adults: A Systematic Review and Dose\u2013Response Meta-Analysis of Epidemiologic Studies","volume":"62","author":"Mohammadi","year":"2021","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_60","unstructured":"Fuleihan, G.E.-H. (2010). Vitamin D Deficiency in the Middle East and Its Health Consequences. Nutrition and Health, Springer."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"274","DOI":"10.4161\/derm.25111","article-title":"Hypovitaminosis D in the Middle East and North Africa","volume":"5","author":"Bassil","year":"2013","journal-title":"Derm. Endocrinol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1177\/1466424008092231","article-title":"Sun safety: What Are the Health Messages?","volume":"128","author":"Hedges","year":"2008","journal-title":"J. R. Soc. Promot. Health"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"729","DOI":"10.3390\/nu6020729","article-title":"Vitamin D Deficiency in India: Prevalence, Causalities and Interventions","volume":"6","author":"Ritu","year":"2014","journal-title":"Nutrients"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1056\/NEJMoa1900906","article-title":"Vitamin D Supplementation and Prevention of Type 2 Diabetes","volume":"381","author":"Pittas","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_65","first-page":"118","article-title":"Vitamin D: The \u201cSunshine\u201d Vitamin","volume":"3","author":"Nair","year":"2012","journal-title":"J. Pharmacol. Pharmacother."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1056\/NEJMra070553","article-title":"Vitamin D Deficiency","volume":"357","author":"Holick","year":"2007","journal-title":"N. Engl. J. 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