Abstract
BACKGROUND: Thyroid cancer (TC) has shown a rising prevalence worldwide. While numerous studies have explored the relationship between vitamin D levels and TC risk, their conclusions remain inconsistent. OBJECTIVE: This meta-analysis aims to evaluate the association between serum vitamin D levels, vitamin D deficiency, and TC based on existing evidence. METHODS: We systematically searched the Embase, Web of Science, and PubMed databases for human studies investigating the relationship between vitamin D and TC including a control group. A random-effects model with forest plots was employed to calculate the mean difference (MD) in serum vitamin D levels, the odds ratio (OR) for vitamin D deficiency, and the risk difference (RD) between TC cases and controls. Meta-regressions and subgroup analyses were conducted based on the season of serum 25(OH)D sampling, source of controls, timing of measurement, study type, and testing methods of 25(OH)D. A p-value <0.05 was considered statistically significant. RESULTS: A total of 23 studies were included. The meta-analysis revealed that TC patients had significantly lower serum vitamin D compared to the controls [SMD = -0.38 (95% CI: -0.62 to -0.14)].Additionally, vitamin D deficiency was significantly more prevalent among TC patients (OR = 1.33, 95% CI: 1.02 to 1.73, P < 0.05). The subgroup analyses demonstrated significant differences across most subgroups, except for post-operative measurements. Seasonal variation in 25(OH)D sampling was identified as a key source of heterogeneity. CONCLUSIONS: The meta-analysis suggests that lower serum vitamin D levels and vitamin D deficiency are significantly associated with an increased risk of TC. However, further studies with standardized protocols for seasonal sampling of vitamin D, source of control, measurement timing, study type, and testing methods of 25(OH)D are needed to clarify this relationship and its underlying mechanisms.