ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Immunology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1649825
Comparison of the vitamin D level between children with and without cow’s milk protein allergy: A systematic review with meta-analysis
Provisionally accepted
Xueming Zheng1*
Yi Jin2Jianhong Luo3Fan Jiang4Limin Zhang5Xiaoxue Wang2Hui Zhang2Shaofei Ma2Yejuan Li2- 1Xingtai City People's Hospital, Xingtai, China
- 2Xingtai People's Hospital, Xingtai, China
- 3Hunan Provincial People's Hospital, Changsha, China
- 4Yanching Institute of Technology, Sanhe, China
- 5The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Background: Vitamin D plays an important role in modulating immune responses, which may be associated with cow’s milk protein allergy (CMPA). This meta-analysis aimed to comprehensively compare the vitamin D level between children with CMPA and healthy controls. Methods: Studies comparing the vitamin D level between children with CMPA and healthy controls were comprehensively searched in PubMed, Web of Science, Embase, Wan Fang, CNKI, and VIP until April 2025. Results: A total of 12 studies, involving 605 children with confirmed CMPA (CMPA group) and 558 healthy controls (control group) were included. The vitamin D level was lower in the CMPA group than in the control group [standardized mean difference (SMD) (95% confidence interval): -1.229 (-2.117, -0.340), P=0.007]. Regarding subgroup analysis, the vitamin D level was lower in the CMPA group than in the control group in studies using mass spectrometry or automated immunoassay (P=0.042), and was of no difference in those using enzyme-linked immunosorbent assay (P=0.200) or chemiluminescence (P=0.097). Moreover, the vitamin D level was lower in the CMPA group than in the control group in studies conducted in Asia (P<0.001) or South America (P=0.041), but not in studies conducted in Europe (P=0.500). All included studies were high-quality. No publication bias was found. Sensitivity analyses indicated high robustness of the results. Conclusion: Vitamin D is decreased in children with CMPA, indicating its potential association with CMPA. These findings may enhance the understanding of CMPA and guide the prevention or management of CMPA in children.
Keywords: Cow's milk protein allergy, Vitamin D, Children, Immune function, Meta-analysis
Received: 19 Jun 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Zheng, Jin, Luo, Jiang, Zhang, Wang, Zhang, Ma and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xueming Zheng, Xingtai City People's Hospital, Xingtai, China
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