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Elbashir M, Shubayr N, Alghathami A, Ali S, Alyami A, Alumairi N, Abdelrazig A, Omer AM, Elbasheer O. Investigation of Vitamin D Status, Age, and Body Mass Index as Determinants of Knee Osteoarthritis Severity Using the Kellgren-Lawrence Grading System in a Saudi Arabian Cohort: A Cross-Sectional Study. Cureus 2023; 15:e47523. [PMID: 38021605 PMCID: PMC10664693 DOI: 10.7759/cureus.47523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background Knee osteoarthritis (OA) is a common and disabling condition affecting millions worldwide. This cross-sectional study endeavors to investigate the relationship between vitamin D status, age, body mass index (BMI), and knee OA in a cohort of individuals in Saudi Arabia. Methods In this cross-sectional study, we assessed vitamin D serum levels, conducted knee radiographs, and evaluated the severity of knee OA using the Kellgren-Lawrence grading system (KLGS). The analysis incorporated both descriptive and inferential statistics, including chi-square tests and a regression model to investigate the relationship between KLGS grades as indicators of knee OA severity and vitamin D levels, considering demographics as covariants. Results The study included 93 participants with suspected knee OA, of which a substantial portion of the sample population presented with knee OA (58 [62.4%]). Knee OA exhibited a higher prevalence among females, comprising 47 (50.54%) of the total, while 11 (11.83%) were male. The largest age group with knee OA was those older than 58 years, 27 (29.03%), followed by the age group of 48-58 years, 19 (20.43%). Obesity was a prevalent factor among knee OA patients (36 [38.7%]), with grade 2 (17 [18.3%]) and grade 3 (24 [25.8%]) being the most frequent. Vitamin D deficiency was prevalent in 54 (58%) of patients. Among knee OA cases, bilateral involvement was predominant in 46 (79%), with a substantial portion, 36 (62%), presenting deficient vitamin D levels. The regression model revealed that age (95% CI: 0.54-1.03, p < 0.001) and BMI (95% CI: 0.01-0.60, p = 0.04) significantly predict higher KLGS grades, indicating that increasing age and higher BMI are associated with higher KLGS grades. However, Vitamin D levels did not show a significant impact on the severity of knee OA. Conclusions The findings from this study highlight the importance of monitoring and maintaining adequate vitamin D levels to potentially reduce the risk of knee OA and the need for early detection and intervention to manage knee OA, particularly in females, older poplulation, and obese adults. They may guide healthcare providers in developing comprehensive approaches to reduce the risk of this condition.
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Affiliation(s)
- Meaad Elbashir
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Nasser Shubayr
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Azhar Alghathami
- Department of Radiology, King Abdul Aziz Specialist Hospital, Taif, SAU
| | - Sara Ali
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Ali Alyami
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Neda Alumairi
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Ali Abdelrazig
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Awatif M Omer
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah, SAU
| | - Ohood Elbasheer
- Department of Radiology, Olaya Polyclinic Complex, Riyadh, SAU
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Shi JW, Wu JN, Zhu XY, Zhou WH, Yang JY, Li MQ. Association of serum 25-hydroxyvitamin D levels with all-cause and cause-specific mortality among postmenopausal females: results from NHANES. J Transl Med 2023; 21:629. [PMID: 37715212 PMCID: PMC10504740 DOI: 10.1186/s12967-023-04413-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/02/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is common among the population, but its relationship with mortality of postmenopausal females is unclear. The aim of this study is to explore the association between serum 25-Hydroxyvitamin D (25(OH)D) and all-cause and cause-specific mortality among postmenopausal women in the United States. METHODS 6812 participants of postmenopausal females from the National Health and Nutrition Examination Survey (2001-2018) were included in this study. The mortality status of the follow-up was ascertained by linkage to National Death Index (NDI) records through 31 December 2019. We used cox proportional hazards models to estimate the association of serum 25(OH)D concentrations and mortality of postmenopausal females. RESULTS The mean level of serum 25(OH)D was 72.57 ± 29.93 nmol/L, and 65.34% had insufficient vitamin D. In postmenopausal females, low serum 25(OH)D concentrations were significantly associated with higher levels of glycohemoglobin, glucose, and lower levels of HDL. During follow-up, 1448 all-cause deaths occurred, including 393 cardiovascular disease (CVD)-related deaths and 263 cancer deaths. After multivariate adjustment, higher serum 25(OH)D levels were significantly related with lower all-cause and CVD mortality. In addition, serum 25(OH)D presented a L-shaped relationship with all-cause mortality, while appeared a U-shaped with CVD mortality, and the cut-off value is 73.89 nmol/L and 46.75 nmol/L respectively. CONCLUSIONS Low serum 25(OH)D levels are associated with the higher risk of all-cause and CVD mortality in postmenopausal females. These findings provide new ideas and targets for the health management of postmenopausal women.
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Affiliation(s)
- Jia-Wei Shi
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200080, People's Republic of China
- Longgang District Maternity &, Child Healthcare Hospital of Shenzhen City, Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, 518172, People's Republic of China
| | - Jiang-Nan Wu
- Clinical Epidemiology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, People's Republic of China
| | - Xiao-Yong Zhu
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200080, People's Republic of China.
| | - Wen-Hui Zhou
- Medical Center for Human Reproduction, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100043, People's Republic of China.
| | - Jin-Ying Yang
- Longgang District Maternity &, Child Healthcare Hospital of Shenzhen City, Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, 518172, People's Republic of China.
- Longgang Maternity and Child Clinical Institute of Shantou University Medical College, Shenzhen, Guangdong, 518172, People's Republic of China.
| | - Ming-Qing Li
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200080, People's Republic of China.
- Laboratory for Reproductive Immunology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200080, People's Republic of China.
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Naoum S. The Role of Vitamin D in the Development and Progression of Osteoarthritis. ROMANIAN JOURNAL OF MILITARY MEDICINE 2023. [DOI: 10.55453/rjmm.2023.126.3.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
"Low levels of vitamin D in patients with osteoarthritis (ΟΑ) rather adversely affect the structure and function of articular cartilage. Low levels of vitamin D are also associated with joint pain, limited physical activity, quality of life, as well as decreased muscle strength, primarily in the lower extremities with adverse OA progression. A high percentage of low vitamin D levels was found in patients with OA and joint arthroplasty as well as a less satisfactory postoperative follow-up in patients with low vitamin D levels. The administration of vitamin D supplementation in patients with knee osteoarthritis has been associated with improved articular cartilage architecture, and reduced joint pain, combined with improved functionality and quality of life in patients with OA. "
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Xiao Q, Cai B, Yin A, Huo H, Lan K, Zhou G, Shen L, He B. L-shaped association of serum 25-hydroxyvitamin D concentrations with cardiovascular and all-cause mortality in individuals with osteoarthritis: results from the NHANES database prospective cohort study. BMC Med 2022; 20:308. [PMID: 36127705 PMCID: PMC9490951 DOI: 10.1186/s12916-022-02510-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/02/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The relationship between vitamin D status and mortality in patients with osteoarthritis (OA) is unknown. This study investigated the associations of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among American adults with OA. METHODS This study included 2556 adults with OA from the National Health and Nutrition Examination Survey (2001-2014). Death outcomes were ascertained by linkage to National Death Index (NDI) records through 31 December 2015. Cox proportional hazards model and two-piecewise Cox proportional hazards model were used to elucidate the nonlinear relationship between serum 25(OH)D concentrations and mortality in OA patients, and stratified analyses were performed to identify patients with higher mortality risk. RESULTS During 16,606 person-years of follow-up, 438 all-cause deaths occurred, including 74 cardiovascular disease (CVD)-related and 78 cancer deaths. After multivariable adjustment, lower serum 25(OH)D levels were significantly and nonlinearly associated with higher risks of all-cause and CVD mortality among participants with OA. Furthermore, we discovered L-shaped associations between serum 25(OH)D levels and all-cause and CVD mortality, with mortality plateauing at 54.40 nmol/L for all-cause mortality and 27.70 nmol/L for CVD mortality. Compared to participants with 25(OH)D levels below the inflection points, those with higher levels had a 2% lower risk for all-cause mortality (hazard ratio [HR] 0.98, 95% confidence interval [CI] 0.96-0.99) and 17% lower risk for CVD mortality (HR 0.83, 95% CI 0.72-0.95). CONCLUSIONS Nonlinear associations of serum 25(OH)D levels with all-cause and CVD mortality were observed in American patients with OA. The thresholds of 27.70 and 54.40 nmol/L for CVD and all-cause mortality, respectively, may represent intervention targets for lowering the risk of premature death and cardiovascular disease, but this needs to be confirmed in large clinical trials.
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Affiliation(s)
- Qingqing Xiao
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Cai
- Department of Rheumatology and Immunology, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Anwen Yin
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huanhuan Huo
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Keke Lan
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guo Zhou
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linghong Shen
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Ben He
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Namutebi F, Kayima J, Kaddumukasa M. Vitamin D and its association with symptom severity in knee osteoarthritis: a cross sectional study at a national referral hospital in Uganda. BMC Rheumatol 2021; 5:56. [PMID: 34955099 PMCID: PMC8711200 DOI: 10.1186/s41927-021-00228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is highly prevalent among patients with osteoarthritis. It is associated with joint pain, stiffness and worse physical function. Whether vitamin D deficiency is associated with osteoarthritis is controversial. We investigated serum vitamin D levels and its association with symptom severity in patients with knee osteoarthritis. METHODS Between January 2020 to March and May 2020, we conducted a cross sectional study at a national referral hospital in Uganda. Using the American College of Rheumatology clinical criteria, 107 consenting adults were diagnosed with knee osteoarthritis. A questionnaire captured patient demographics and clinical characteristics. Joint pain, stiffness and physical function severity were assessed and graded based on the Western Ontario and McMaster Universities Arthritis Index (WOMAC). We determined serum vitamin D levels by electrochemilumniscence immunoassay. The data were analysed and adjusted for age, sex, education, occupation, family history, body mass index (BMI) and calcium supplementation. RESULTS Of the 107 patients, 92 (86%) patients were females, mean (SD) age was 58.1 (12.6) years. Nearly 65% of the patients had suboptimal serum vitamin D levels < 30 ng/ml. The median (Q1, Q3) WOMAC joint scores were as follows: pain 8.0 (5, 11), stiffness 1 (0, 2), physical function 29.0 (16, 41) and total WOMAC 39.0 (21, 54). Spearman correlations between serum vitamin D levels with symptom severity were as follows: joint pain (r = 0.18, p = 0.06), stiffness (r = 0.13, p = 0.17), physical function (r = 0.09, p = 0.36) and total WOMAC (r = 0.13, p = 0.19). CONCLUSION Serum vitamin D levels are not associated with joint pain, stiffness and physical function severity. Older age and higher BMI are associated with vitamin D deficiency in patients with knee osteoarthritis attending a national referral hospital rheumatology clinic in Uganda. Suboptimal vitamin D is an independent risk factor for total mortality in the general population. Clinical guidelines and further studies to determine age and BMI ranges required for vitamin D screening are needed in patients with osteoarthritis in Uganda. Patients are advised to keep a normal BMI.
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Affiliation(s)
- Fiona Namutebi
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda.
| | - James Kayima
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda.,Uganda Heart Institute, Kampala, Uganda
| | - Mark Kaddumukasa
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
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Rai V, Radwan MM, Agrawal DK. IL-33, IL-37, and Vitamin D Interaction Mediate Immunomodulation of Inflammation in Degenerating Cartilage. Antibodies (Basel) 2021; 10:41. [PMID: 34842603 PMCID: PMC8628513 DOI: 10.3390/antib10040041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/14/2021] [Accepted: 10/22/2021] [Indexed: 12/25/2022] Open
Abstract
Chronic joint inflammation due to increased secretion of pro-inflammatory cytokines, the accumulation of inflammatory immune cells (mainly macrophages), and vitamin D deficiency leads to cartilage degeneration and the development of osteoarthritis (OA). This study investigated the effect of vitamin D status on the expression of mediators of inflammation including interleukin (IL)-33, IL-37, IL-6, tumor necrosis factor (TNF)-α, toll-like receptors (TLRs), damage-associated molecular patterns (DAMPs), and matrix metalloproteinases (MMPs) in degenerating the cartilage of hyperlipidemic microswine. Additionally, in vitro studies with normal human chondrocytes were conducted to investigate the effect of calcitriol on the expression of IL-33, IL-37, IL-6, TNF-α, TLRs, DAMPs, and MMPs. We also studied the effects of calcitriol on macrophage polarization using THP-1 cells. The results of this study revealed that vitamin D deficiency is associated with an increased expression of IL-33, IL-37, IL-6, TNF-α, TLRs, DAMPs, and MMPs, while vitamin D supplementation is associated with a decreased expression of the former. Additionally, vitamin D deficiency is associated with increased M1, while vitamin D-supplemented microswine cartilage showed increased M2 macrophages. It was also revealed that calcitriol favors M2 macrophage polarization. Taken together, the results of this study suggest that modulating expression of IL-33, IL-6, TNF-α, TLRs, DAMPs, and MMPs with vitamin D supplementation may serve as a novel therapeutic to attenuate inflammation and cartilage degeneration in osteoarthritis.
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Affiliation(s)
| | | | - Devendra K. Agrawal
- Department of Translational Research, Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA 91766, USA; (V.R.); (M.M.R.)
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Sakr BR, Al-Ashmory NM, Hassan SZ, Al-Akwa AA, Shaker OG. Vitamin D deficiency in Egyptian and Yemeni primary knee osteoarthritis patients: Relation to physical function and radiographic severity. THE EGYPTIAN RHEUMATOLOGIST 2021. [DOI: 10.1016/j.ejr.2020.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Tripathy SK, Gantaguru A, Nanda SN, Velagada S, Srinivasan A, Mangaraj M. Association of vitamin D and knee osteoarthritis in younger individuals. World J Orthop 2020; 11:418-425. [PMID: 33134104 PMCID: PMC7582112 DOI: 10.5312/wjo.v11.i10.418] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of primary osteoarthritis knee is gradually increasing among young individuals. The increasing prevalence of obesity, sedentary lifestyle, sporting activity, and vitamin D deficiency (VDD) has been hypothesized for this shifting disease trend. This study was designed to look for the association of serum vitamin D among these young arthritic patients.
AIM To look for the association of serum vitamin D in younger knee osteoarthritis (KOA) patients.
METHODS In a 2-year observational study, 146 non-obese KOA patients of 35-60 years were evaluated clinically (Knee injury and Osteoarthritis Outcome Score, KOOS) and radiologically (Kellegren-Lawrence stage, KL). The serum 25(OH)D level of these patients and 146 normal healthy individuals of same age group were estimated.
RESULTS Both the groups were comparable in terms of age and sex. The average serum 25(OH)D level in healthy individuals and KOA patients was 45.83 ng/mL and 34.58 ng/mL, respectively (P < 0.001). Inadequate serum 25(OH)D level (< 30 ng/mL) was found in 46.57% of KOA patients and 24% of normal healthy participants indicating a significant positive association (odds ratio 2.77, 95%CI: 1.67-4.54, P < 0.001). The 25(OH)D level in KL grade I, II, III and IV was 43.40, 30.59, 31.56 and 33.93 ng/mL respectively (no difference, P = 0.47). Similarly, the KOOS score in sufficient, insufficient and deficient groups were 65.31, 60.36 and 65.31, respectively (no difference, P = 0.051).
CONCLUSION The serum 25(OH)D level is significantly low in younger KOA patients. However, the clinical and radiological severities have no association with serum vitamin D level.
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Affiliation(s)
- Sujit Kumar Tripathy
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Amrit Gantaguru
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Saurav Narayan Nanda
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Sandeep Velagada
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Anand Srinivasan
- Department of Pharmacology, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Manaswini Mangaraj
- Department of Biochemistry, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
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Duan BL, Mao YR, Xue LQ, Yu QY, Liu MY. Determination of vitamin D and analysis of risk factors for osteoporosis in patients with chronic pain. World J Clin Cases 2020; 8:2150-2161. [PMID: 32548145 PMCID: PMC7281063 DOI: 10.12998/wjcc.v8.i11.2150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/10/2020] [Accepted: 04/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is common in patients with chronic pain and healthy people, but the difference between the two has not been reported; thus, whether there is a relationship between vitamin D deficiency and chronic pain remains to be confirmed. Osteoporosis is a common disease in chronic pain disorders. Understanding the relationship between vitamin D and osteoporosis will provide a basis for the rational supplementation of vitamin D to prevent osteoporosis, and to understand the risk factors of bone mass change to provide a new treatment plan for early prevention of osteoporosis.
AIM To determine 25 hydroxy vitamin D (25OHD) level in patients with chronic pain to clarify its clinical significance. The relationship between vitamin D and bone mineral density (BMD) and the risk factors for bone mass change were also evaluated.
METHODS In this study, 184 patients with chronic pain were included in the study group, and 104 healthy individuals who underwent routine health checkups during the same period were included in the control group. 25OHD level was detected in both groups by enzyme-linked immunosorbent assay. According to the BMD test results, the patients in the study group were further classified into three subgroups: Normal BMD group, reduced BMD group, and osteoporosis group. Age, sex, ethnicity, living altitude, body mass index, 25OHD level, parathyroid hormone (PTH), calcium (Ca) and phosphorus levels were analyzed statistically in both groups.
RESULTS The vitamin D level in the study group was lower than that in the control group at 53.8% vs 57.7%, with no significant difference between the two groups. The proportion of patients with severe vitamin D deficiency in the study group was higher than that in the control group. The mean age was greater in the osteoporosis subgroup, and the youngest in the normal BMD subgroup. Vitamin D level in the osteoporosis subgroup was lower than that in the other two subgroups, and was not specific for the diagnosis of bone mass reduction and osteoporosis. The above results were analyzed statistically and showed significant differences (P < 0.05). There was a positive correlation between age and BMD in patients with chronic pain (R = 0.567, P < 0.001). Age, PTH and Ca were risk factors for bone mass reduction, while age, ethnicity and altitude were risk factors for osteoporosis.
CONCLUSION Vitamin D deficiency is a common phenomenon in patients with chronic pain, and severe vitamin D deficiency is not uncommon. Vitamin D level is not a risk factor for bone mass reduction and osteoporosis. Bone mass reduction is correlated with age, PTH and Ca, while osteoporosis is correlated with age, ethnicity and altitude.
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Affiliation(s)
- Bao-Lin Duan
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Yuan-Rong Mao
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Li-Qi Xue
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Qing-Yuan Yu
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
| | - Mei-Yi Liu
- Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
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Anari H, Enteshari-Moghaddam A, Abdolzadeh Y. Association between serum Vitamin D deficiency and Knee Osteoarthritis. Mediterr J Rheumatol 2020; 30:216-219. [PMID: 32467872 PMCID: PMC7241660 DOI: 10.31138/mjr.30.4.216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/30/2019] [Accepted: 12/08/2019] [Indexed: 02/07/2023] Open
Abstract
Objective:
Levels of Vitamin D may influence the development of knee osteoarthritis (OA), which is one of the most common joint diseases. The aim of this study was to investigate the association between serum Vitamin D deficiency and knee OA in Ardabil and Iran. Methods: One hundred fifty-eight consecutive patients referred to rheumatology clinic of Ardabil City Hospital were recruited in the study. All the participants underwent x-rays in two anterior-posterior and side views of the knees. Staging of knee OA was done according to Kellgren-Lawrence criteria. Seventy-nine individuals with clinical and radiographic signs of knee OA were defined as the case group, and those without clinical and radiographic signs of the disease were defined as a control group. Haematology and biochemical profile including measurement of 25-hydroxyvitamin D serum level was performed in the participants. Results: The mean age of patients and controls were 54.12 ± 4.67 and 55.37 ± 5.12 years, respectively. The average serum vitamin D in OA patients and controls were 26.8±6.2 ng/ml and 28.1±5.3ng/ml, respectively (p=0.36). There was a significant association between serum vitamin D and staging of knee OA (p=0.001). Based on vitamin D levels, most of patients with vitamin D deficiency were in stages III and IV. Conclusion: The findings of the study suggest that vitamin D deficiency should be considered in patients with OA and treated accordingly.
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Affiliation(s)
- Hasan Anari
- Department of Radiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Yu Y, Liu D, Feng D, Zhao J. Association between Vitamin D and Knee Osteoarthritis: A PRISMA-Compliant Meta-analysis. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2020; 159:281-287. [PMID: 32150754 DOI: 10.1055/a-1098-8815] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous investigations showed inconsistent results for associations between vitamin D and knee osteoarthritis (OA). The present study aimed to make a systematic review and meta-analysis for the association between vitamin D and knee OA. METHODS We systematically searched for articles published in the databases PubMed, Web of Science, EMBASE, Medline, and Google Scholar through July 2019. All statistical analyses were made using STATA 12.0 software. The Q test and I2 were applied to examine heterogeneities between studies. RESULTS The study indicated that there were no significant associations between serum levels of 25-hydroxy (OH) vitamin D and prevalence, incidence or progression of knee radiographic OA (ROA), and joint space narrowing (JSN). However, a subgroup study showed significant associations of low vitamin D levels with the progression of knee OA. Additionally, the present study showed no significant effect of vitamin D supplementation on knee OA. CONCLUSIONS The results do not support that serum levels of 25(OH) vitamin D are associated with the risks of knee OA, except perhaps with progression of knee OA. In addition, vitamin D supplementation may not have a clinically significant effect on pain control or structure (tibial cartilage volume and JSW) progression in patients with knee OA. Longer-term clinical trials are essential to explore the effect of vitamin D supplementation on knee OA.
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Affiliation(s)
- Yinghao Yu
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Dongcheng Liu
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Dehong Feng
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Jijun Zhao
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
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Heidari B, Babaei M. Therapeutic and Preventive Potential of Vitamin D Supplementation in Knee Osteoarthritis. ACR Open Rheumatol 2019; 1:318-326. [PMID: 31777808 PMCID: PMC6857993 DOI: 10.1002/acr2.1042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 05/15/2019] [Indexed: 12/14/2022] Open
Abstract
Objective Vitamin D deficiency is linked with pain, function, and radiographic progression of knee osteoarthritis (KOA), but the results of studies addressing the association and effect of vitamin D supplementation for pain, function, quality of life, radiographic disease, and progression are inconsistent. The aim of this review is to determine the therapeutic and preventive potential of vitamin D supplementation in KOA. Method Eligible pertinent English language studies published in 2000 and thereafter in Medline/PubMed, Scopus, and Google Scholar were selected by using keywords that include “knee osteoarthritis,” “vitamin D supplementation,” “pain,” “structural abnormalities,” “treatment,” and “progression.” Results The results of a few studies showed a preventive potential for vitamin D in KOA, but most of the randomized clinical trials that assessed the therapeutic efficacy of vitamin D supplementation in KOA found no clear therapeutic effect, with the exception of one study that found a small but significant effect of vitamin D on pain and knee function. Nonetheless, the results of a few longitudinal studies as well as systematic reviews are promising and thus encourage further studies. Inconsistent results on the effect of vitamin D on KOA may be attributed to factors such as severity of KOA, baseline level of serum vitamin D, duration of treatment, and vitamin D dosages. Conclusion Given the multiple skeletal and extraskeletal benefits of vitamin D supplementation in elderly people, the issue of vitamin D supplementation in KOA requires further study to elucidate the dosage and duration of treatment that provides the most effective therapeutic effect.
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Vaishya R, Vijay V, Lama P, Agarwal A. Does vitamin D deficiency influence the incidence and progression of knee osteoarthritis? - A literature review. J Clin Orthop Trauma 2019; 10:9-15. [PMID: 30705525 PMCID: PMC6349580 DOI: 10.1016/j.jcot.2018.05.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/12/2018] [Accepted: 05/19/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Vitamin D has been believed to have a bearing in the pathogenesis of knee osteoarthritis (OA). This study was done to search the literature and review the correlation between vitamin D levels in knee OA in the adult population and the outcome of vitamin D supplementation in knee OA. METHODS An exhaustive search of Pub Med and Cochrane library database was done with keywords vitamin D, knee and osteoarthritis for a period from Jan 2005 to December 2015. All Randomized Control Trials (RCT), Cohort, Case-control, cross-sectional studies were included in the present systematic review. RESULTS The search resulted in a total of 86 studies; out of which 11 studies were included in the current review. There were two Randomized Control Trial (RCT), one case-control, four cross-sectional and four cohort studies. These studies comprised of a total of 5137 participants (ranging from 46 to 1248) Our results suggested there was a moderate evidence of positive association in vitamin D deficiency (VDD) and progression of radiographic OA (ROA), as assessed by Kellgren and Lawrence (KL) grading. However, VDD was not associated with the incidence of ROA and MRI-detected change in focal cartilage defect. However, this study has a limited evidence for a positive correlation in VDD and the cartilage volume loss. There was also limited evidence showing no role of vitamin D therapy in reducing cartilage volume loss and knee pain in Knee OA. CONCLUSION The VDD is common and has been associated with knee OA, in an adult population. However, there is still inconsistent evidence regarding the prevention of incidence and progression of ROA after vitamin D therapy. There is a need for multicentric and well-conducted randomized studies with larger samples to conclude the positive effect of Vitamin D therapy.
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Affiliation(s)
| | - Vipul Vijay
- Corresponding author at: Room no 1210, Department of Orthopaedics, Joint Replacement & Arthroscopy, Indraprastha Apollo Hospital, New Delhi, 110076, India.
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Veronese N, La Tegola L, Mattera M, Maggi S, Guglielmi G. Vitamin D Intake and Magnetic Resonance Parameters for Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Calcif Tissue Int 2018; 103:522-528. [PMID: 29943188 DOI: 10.1007/s00223-018-0448-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/19/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE There is evidence that vitamin D may play a role in the osteoarthritis (OA) pathogenesis, but the few data available are limited to X-rays and clinical findings. The aim of this study was to investigate whether a higher intake of vitamin D was associated with a better architecture of the cartilage of the knee, assessed with magnetic resonance (MRI), in a large cohort from North America. METHODS 783 participants (59.8% females; mean age: 62.3 years) with an MRI assessment from the Osteoarthritis Initiative were included. Vitamin D dietary intake was calculated as the sum of food and oral supplementation. A coronal 3D FLASH with Water Excitation MR sequence of the right knees was used. The strength of the association between dietary vitamin D intake and knee MRI parameters was investigated through an adjusted linear regression analysis, reported as standardized betas with 95% confidence intervals (CIs). RESULTS Using a linear regression analysis, adjusted for ten potential confounders, higher vitamin D intake (reported as an increase in one standard deviation, = 250 IU) corresponded to significantly higher values of mean cartilage thickness and volume of cartilage at medial tibia, volume of cartilage and mean cartilage thickness at central lateral femur, volume of cartilage and mean cartilage thickness at central medial femur, and volume of cartilage and mean cartilage thickness at central medial tibial-femoral compartment. CONCLUSIONS Higher vitamin D intake is associated with a significantly better architecture of the cartilage of the knee, also independently taking in account from several potential confounders.
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Affiliation(s)
- Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Luciana La Tegola
- Department of Radiology, Università degli Studi di Foggia Scuole di Specializzazione di Area Medica, Viale Luigi Pinto 1, Foggia, Puglia, 71120, Italy
| | - Maria Mattera
- Department of Radiology, Università degli Studi di Foggia Scuole di Specializzazione di Area Medica, Viale Luigi Pinto 1, Foggia, Puglia, 71120, Italy
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, Università degli Studi di Foggia Scuole di Specializzazione di Area Medica, Viale Luigi Pinto 1, Foggia, Puglia, 71120, Italy.
- Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy.
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Gao B, Zhu B, Wu C. Preoperative Serum 25-Hydroxyvitamin D Level, a Risk Factor for Postoperative Cognitive Dysfunction in Elderly Subjects Undergoing Total Joint Arthroplasty. Am J Med Sci 2018; 357:37-42. [PMID: 30611318 DOI: 10.1016/j.amjms.2018.10.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/20/2018] [Accepted: 10/24/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Postoperative cognitive dysfunction (POCD) is a very common postoperative complication occurring mainly after high-risk surgery, especially in the elderly individuals. This study aimed to investigate potential risk factors for POCD in elderly patients after total joint arthroplasty (TJA). MATERIALS AND METHODS A total of 257 eligible elderly patients (≥65 years) who were scheduled for elective TJA for osteoarthritis with general anesthesia were enrolled. An experienced psychiatrist was invited to evaluate the cognitive function at baseline (1 day before the surgery) and at day 7 after the surgery. Univariate and multiple logistic regression analyses were performed to screen risk factors associated with POCD. Receiver-operating characteristic curve analysis was performed to assess the predictive value of serum 25-hydroxyvitamin D [25(OH)D] expression for POCD. RESULTS Of all the 257 enrolled patients, 55 (21.4%) developed POCD within 7 days after the surgery. Serum 25(OH)D level was the only independent risk factor associated with POCD (odds ratio: 1.77, 95% confidence interval: 1.13-2.78, P = 0.016) by multiple logistic regression analysis. The area under the curve of 25(OH)D for POCD was 0.687, with the cut-off value of 11.2 ng/mL, sensitivity of 41.82% and specificity of 78.71% respectively (95% confidence interval: 0.617-0.757, P < 0.001). CONCLUSIONS Our results revealed that preoperative serum 25(OH)D level was an independent risk factor for POCD in elderly subjects after TJA.
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Affiliation(s)
- Bin Gao
- Department of Anesthesiology, Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang, China
| | - Binbin Zhu
- Department of Anesthesiology, Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang, China
| | - Chunxian Wu
- Department of Anesthesiology, Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang, China.
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Cakar M, Ayanoglu S, Cabuk H, Seyran M, Dedeoglu SS, Gurbuz H. Association between vitamin D concentrations and knee pain in patients with osteoarthritis. PeerJ 2018; 6:e4670. [PMID: 29707434 PMCID: PMC5922228 DOI: 10.7717/peerj.4670] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 04/06/2018] [Indexed: 12/27/2022] Open
Abstract
Objectives Osteoarthritis (OA) and vitamin D deficiency are common health conditions in older people. Whether vitamin D concentration is associated with knee OA is controversial. In this study, we aimed to determine the association between serum concentrations of vitamin D and osteoarthritic knee pain. Subjects and Methods Vitamin D concentrations were measured with the 25 hydroxyvitamin D test in patients presenting with clinical symptoms of primary knee osteoarthritis. Osteoarthritis was graded on the Kellgren-Lawrence grading scale from anteroposterior and lateral radiographs. Height, weight, and body mass index (BMI) were recorded. Patients completed a 10-cm visual analogue scale (VAS) for indicating pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Vitamin D concentration was defined as severely deficient (<10 ng/mL), insufficient (10 to 19 ng/mL), or normal (20 to 50 ng/mL). Results Of 149 patients (133 women), the mean age was 63.6 years. Mean vitamin D concentration was 11.53 ng/mL, and 90% patients were vitamin D deficient. Mean WOMAC score was 57.2, and VAS pain score was 7.5. Kellgren-Lawrence grade was 2 for 10 patients, grade 3 for 61, and grade 4 for 88. Mean BMI was 33.4. Mean values of VAS, WOMAC, and BMI did not differ by vitamin D status. Conclusion Serum vitamin D concentration is not associated with knee pain in patients with osteoarthritis.
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Affiliation(s)
- Murat Cakar
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Semih Ayanoglu
- Department of Orthopaedics and Traumatology, Medipol Universty Hospital, Istanbul, Turkey
| | - Haluk Cabuk
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Metin Seyran
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Suleyman Semih Dedeoglu
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Hakan Gurbuz
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
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Hong L, Shanjiang Y, Qian W, Chunguo L, Fei Z, Jinming Y, Jiyou G, Na L, Yang L, Feng D. Expression of the deubiquitinase cylindromatosis in articular cartilage and subchondral bone is associated with the severity of knee osteoarthritis. Exp Ther Med 2017; 14:5990-5996. [PMID: 29285147 PMCID: PMC5740750 DOI: 10.3892/etm.2017.5326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/01/2017] [Indexed: 01/13/2023] Open
Abstract
Cylindromatosis (CYLD) is a deubiquitinating enzyme that regulates multiple key signaling pathways involved in the pathophysiology of knee osteoarthritis (KOA). Previous studies have indicated that the expression of CYLD in the articular cartilage of patients with KOA is significantly higher than in healthy controls. However, limited data are available regarding the association between CYLD expression and the severity of KOA. The aim of the present study was to investigate the association between CYLD expression in joint tissues and the severity of KOA. A total of 156 individual tibial plateau samples were obtained between January 2011 and January 2016 from patients that had undergone total knee arthroplasty due to KOA or from healthy controls. The severity of KOA was evaluated using the Kellgren Lawrence (KL) and Mankin scoring systems. Additionally, CYLD expression in the articular cartilage and subchondral bone was analyzed using immunohistochemistry. Compared with the healthy controls, patients with KOA exhibited significantly increased CYLD levels in the articular cartilage (6.53±2.01 vs. 28.69±13.23, P<0.001) and significantly decreased CYLD levels in the subchondral bone (11.46±2.34 vs. 3.50±2.54, P<0.001). Correlation analysis indicated that CYLD expression in the articular cartilage was positively correlated with the KL (r=0.837, P<0.001) and Mankin scores (r=0.925, P<0.001), while its expression in the subchondral bone was negatively correlated with the KL (r=−0.802, P<0.001) and Mankin scores (r=−0.844, P<0.001). The results of the present study demonstrate that CYLD levels in the articular cartilage and subchondral bone are associated with the severity of KOA. Thus, CYLD may be a potential diagnostic and predictive biomarker for KOA and a novel target in its treatment.
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Affiliation(s)
- Liu Hong
- Department of Orthopedics, People's Hospital of Linzi, Zibo, Shandong 255400, P.R. China
| | - Yu Shanjiang
- Department of Orthopedics, People's Hospital of Linzi, Zibo, Shandong 255400, P.R. China
| | - Wang Qian
- Department of Orthopedics, People's Hospital of Linzi, Zibo, Shandong 255400, P.R. China
| | - Li Chunguo
- Department of Orthopedics, People's Hospital of Linzi, Zibo, Shandong 255400, P.R. China
| | - Zhou Fei
- Department of Orthopedics, People's Hospital of Linzi, Zibo, Shandong 255400, P.R. China
| | - Yu Jinming
- Department of Orthopedics, People's Hospital of Linzi, Zibo, Shandong 255400, P.R. China
| | - Gao Jiyou
- Department of Orthopedics, Shandong Provincial Hospital, Jinan, Shandong 250021, P.R. China
| | - Li Na
- Department of Orthopedics, Shandong Provincial Hospital, Jinan, Shandong 250021, P.R. China
| | - Li Yang
- Department of Orthopedics, Central Hospital of Zibo Mining Group, Zibo, Shandong 255120, P.R. China
| | - Du Feng
- Department of Orthopedics, People's Hospital of Linzi, Zibo, Shandong 255400, P.R. China
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Effect of vitamin D levels on radiographic knee osteoarthritis and functional status. Turk J Phys Med Rehabil 2017; 64:1-7. [PMID: 31453483 DOI: 10.5606/tftrd.2018.986] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/26/2016] [Indexed: 12/17/2022] Open
Abstract
Objectives This study aims to investigate the effect of serum levels of 25 hydroxyvitamin D (25(OH)D) in patients with primary knee osteoarthritis (OA) and to assess its relationship with the radiographic grading and functional status. Patients and methods Serum 25(OH)D levels were measured in 107 patients (90 females, 17 males; mean age 63.0±9.6 years; range, 40 to 86 years) with primary knee OA. Radiographic grading was based on the Kellgren-Lawrence Grading Scale and the Osteoarthritis Research Society International (OARSI) Atlas Grading Scale, while the functional status was assessed using the Lequesne indices and Turkish version of the Knee Injury and Osteoarthritis Outcome Score-Physical Function Short-Form (KOOS-PS). Pain was evaluated using the Visual Analog Scale for Pain (VAS-Pain). Data including age, sex, disease duration, body mass index (BMI), and pain severity were recorded. Results The mean 25(OH)D level was 13.4±10.6 ng/mL, and 90 patients (84.1%) had vitamin D deficiency. The presence of severe osteophytes was observed in 67 patients (62.6%) and 85 patients (79.4%) had Grade 2-3 joint space narrowing (JSN). The mean KOOS-PS and Lequesne scores were 40.1±12.3 and 12.9±3.6, respectively. There was no correlation between serum 25(OH)D levels and functional status. Conclusion Our study results show that serum 25(OH)D level is not related to the severity of the radiographic knee OA grading or to the functional assessment. Age and BMI are the factors affecting the radiological knee OA severity, while age, sex, BMI, and pain severity are the main determinants of the functional status.
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Which Predicts Quadriceps Muscle Strength in Knee Osteoarthritis: Biological Markers or Clinical Variables? Arch Rheumatol 2016; 32:32-38. [PMID: 30375528 DOI: 10.5606/archrheumatol.2017.5919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 05/28/2016] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to evaluate the relationship between biological markers and quadriceps muscle strength, the correlation of clinical variables with quadriceps muscle strength, and the results according to the radiological severity in patients with knee osteoarthritis. Patients and methods A total of 152 patients (22 males, 130 females; mean age 57.3±7.5 years; range 40 to 70 years) with primary knee osteoarthritis were included in the study. We evaluated biological markers of C-telopeptide of type I collagen, C-telopeptide of type II collagen, leptin, and osteocalcin along with 25-hydroxy vitamin D. We measured quadriceps muscle strength both by manual muscle tester and computerized isokinetic dynamometer. We evaluated pain and functional status of the patients by visual analog scale and Western Ontario and McMaster Universities Osteoarthritis Index. We analyzed the correlation between biological markers and quadriceps muscle strength along with clinical variables. We classified the strength of correlations as no-very weak, weak-moderate, moderate-strong, and excellent. Results Of the patients, 76.9% (n=117) were obese. Quadriceps muscle strength measures were significantly lower in females than that in males. There was no-very weak correlation between biological marker levels and quadriceps muscle strength. However, weak-moderate correlations were found between clinical variables (pain and Western Ontario and McMaster Universities Osteoarthritis Index scores) and quadriceps muscle strength measures. Conclusion Among the measured biological markers, none had any influence on quadriceps muscle strength in patients with knee osteoarthritis. However, pain and functional status of the patients might affect quadriceps muscle strength.
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Rai V, Dietz NE, Dilisio MF, Radwan MM, Agrawal DK. Vitamin D attenuates inflammation, fatty infiltration, and cartilage loss in the knee of hyperlipidemic microswine. Arthritis Res Ther 2016; 18:203. [PMID: 27624724 PMCID: PMC5022245 DOI: 10.1186/s13075-016-1099-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/22/2016] [Indexed: 12/19/2022] Open
Abstract
Background Osteoarthritis (OA) of the knee joint is a degenerative process resulting in cartilage loss. Recent evidence suggests that OA is not merely a disease of cartilage but a disease of the entire knee joint and that inflammation may play an important role. OA has been associated with vitamin D deficiency. Vitamin D as an immunomodulator and anti-inflammatory agent may attenuate inflammation in the knee. The aim of this study was to assess the anti-inflammatory effect of vitamin D on inflammation in the knee. Methods This study was conducted with 13 microswine on a high cholesterol diet categorized into three groups of vitamin D-deficient, vitamin D-sufficient, and vitamin D supplementation. After 1 year, microswine were killed, and their knee joint tissues were harvested. Histological and immunofluorescence studies were carried out on the tissue specimens to evaluate the effect of vitamin D status. Results Histological and immunofluorescence studies of the knee joint tissues showed (1) increased inflammation in the knee joint tissues, (2) fatty infiltration in quadriceps muscle, patellar tendon, and collateral ligaments, and (3) chondrocyte clustering in the vitamin D-deficient and vitamin D-sufficient groups compared with the vitamin D supplementation group. Architectural distortion of the quadriceps muscle, patellar tendon, and collateral ligaments was also seen in the areas of inflammatory foci and fatty infiltration in the vitamin D-deficient group. Conclusions Decreased inflammation and fatty infiltration in the vitamin D supplementation group suggest the potential role of vitamin D in attenuating inflammation and fatty infiltration as well as in protecting the architecture of the tissue in the knee joint. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1099-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vikrant Rai
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Nicholas E Dietz
- Department of Pathology, Creighton University School of Medicine, 601 North 30th Street, Omaha, NE, 68131, USA
| | - Matthew F Dilisio
- Department of Orthopedic Surgery, Creighton University School of Medicine, Omaha, NE, 68178, USA.,CHI Health Alegent Creighton Clinic, 601 North 30th Street, Suite 2300, Omaha, NE, 68131, USA
| | - Mohamed M Radwan
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Devendra K Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA.
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Bergink AP, Zillikens MC, Van Leeuwen JP, Hofman A, Uitterlinden AG, van Meurs JB. 25-Hydroxyvitamin D and osteoarthritis: A meta-analysis including new data. Semin Arthritis Rheum 2016; 45:539-46. [DOI: 10.1016/j.semarthrit.2015.09.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 09/28/2015] [Accepted: 09/28/2015] [Indexed: 12/15/2022]
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Veronese N, Maggi S, Noale M, De Rui M, Bolzetta F, Zambon S, Corti MC, Sartori L, Musacchio E, Baggio G, Perissinotto E, Crepaldi G, Manzato E, Sergi G. Serum 25-Hydroxyvitamin D and Osteoarthritis in Older People: The Progetto Veneto Anziani Study. Rejuvenation Res 2015; 18:543-53. [PMID: 26540555 DOI: 10.1089/rej.2015.1671] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Recent work has shown that low 25-hydroxyvitamin D (25OHD) levels are associated with the presence of osteoarthritis (OA), but these studies focused on radiographical changes of OA, investigated only one joint, and did not consider the association with OA-related pain. In this study, we aimed to examine the relationship between 25OHD levels and any presence of OA and pain in a cohort of older people. This study was part of the Progetto Veneto Anziani (Pro.V.A), a population-based cohort study in older people. In this cross-sectional work, we considered 2756 subjects (1102 males and 1654 females) with a mean age of 74.2 ± 7.1 years. OA and OA-related pain were defined using a standardized algorithm investigating disease history, medical documentation, symptoms, and physical examination of the joints. On logistic regression analysis, taking those in the highest 25OHD quartile for reference, those in the lowest quartile had significantly higher odds of OA involving the hands (odds ratio [OR] = 1.26, 95% confidence interval [CI] 1.15-1.38 in the sample as whole; 1.36, 95% CI 1.15-1.60 in men and 1.22, 95% CI 1.09-1.37 in women), and pain (OR = 1.18, 95% CI 1.06-1.32 in the sample as whole; 1.52, 95% CI 1.21-1.90 in men and 1.15, 95% CI 1.03-1.29 in women). Similar results were found for the hip. For the knee, low 25OHD levels were associated with the presence of OA in the sample as a whole, and in women, and with the presence of pain in the sample as a whole. In conclusion, low 25OHD levels are associated with the presence of OA and with OA-related pain, particularly when the hand and hip are involved.
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Affiliation(s)
- Nicola Veronese
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy
| | - Stefania Maggi
- 2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy
| | - Marianna Noale
- 2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy
| | - Marina De Rui
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy
| | - Francesco Bolzetta
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy
| | - Sabina Zambon
- 2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy .,3 Department of Medicine (DIMED), Clinica Medica I, University of Padova , Italy
| | - Maria Chiara Corti
- 4 Division of Health Care Planning and Evaluation of the Regione Veneto , Venice, Italy
| | - Leonardo Sartori
- 3 Department of Medicine (DIMED), Clinica Medica I, University of Padova , Italy
| | - Estella Musacchio
- 3 Department of Medicine (DIMED), Clinica Medica I, University of Padova , Italy
| | | | - Egle Perissinotto
- 6 Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padova , Padova, Italy
| | - Gaetano Crepaldi
- 2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy
| | - Enzo Manzato
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy .,2 National Research Council, Neuroscience Institute , Aging Branch, Padova, Italy
| | - Giuseppe Sergi
- 1 Department of Medicine (DIMED), Geriatrics Division, University of Padova , Italy
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Mabey T, Honsawek S. Role of Vitamin D in Osteoarthritis: Molecular, Cellular, and Clinical Perspectives. Int J Endocrinol 2015; 2015:383918. [PMID: 26229532 PMCID: PMC4503574 DOI: 10.1155/2015/383918] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 05/28/2015] [Accepted: 06/09/2015] [Indexed: 12/11/2022] Open
Abstract
Osteoarthritis is a debilitating and degenerative disease which affects millions of people worldwide. The causes and mechanisms of osteoarthritis remain to be fully understood. Vitamin D has been hypothesised to play essential roles in a number of diseases including osteoarthritis. Many cell types within osteoarthritic joints appear to experience negative effects often at increased sensitivity to vitamin D. These findings contrast clinical research which has identified vitamin D deficiency to have a worryingly high prevalence among osteoarthritis patients. Randomised-controlled trial is considered to be the most rigorous way of determining the effects of vitamin D supplementation on the development of osteoarthritis. Studies into the effects of low vitamin D levels on pain and joint function have to date yielded controversial results. Due to the apparent conflicting effects of vitamin D in knee osteoarthritis, further research is required to fully elucidate its role in the development and progression of the disease as well as assess the efficacy and safety of vitamin D supplementation as a therapeutic strategy.
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Affiliation(s)
- Thomas Mabey
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Sittisak Honsawek
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
- *Sittisak Honsawek:
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Goula T, Kouskoukis A, Drosos G, Tselepis AS, Ververidis A, Valkanis C, Zisimopoulos A, Kazakos K. Vitamin D status in patients with knee or hip osteoarthritis in a Mediterranean country. J Orthop Traumatol 2014; 16:35-9. [PMID: 25736606 PMCID: PMC4348522 DOI: 10.1007/s10195-014-0322-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 09/21/2014] [Indexed: 11/25/2022] Open
Abstract
Background Vitamin D plays an important role in bone mineralization, remodeling, and maintenance and therefore its deficiency may be implicated in the pathogenesis of osteoarthritis (OA). Vitamin D status was evaluated in patients with knee or hip OA scheduled for joint replacement. The impact of anthropometric parameters such as gender, age, and body mass index on vitamin D levels was also examined. The study was conducted in a Mediterranean country (Greece). Materials and methods We included 164 patients with knee or hip OA scheduled for joint replacement in this study. Serum levels of 25-hydroxyvitamin D (vitamin D) were measured in routine blood samples taken from the patients at their pre-admission visit, a week before the operation, using radioimmunoassay. Results The majority of patients were vitamin D deficient (81.7 %); 15.2 % of them were vitamin D insufficient (hypovitaminosis). Only 3 % of patients were vitamin D sufficient. There was a significantly positive association between vitamin D levels and male gender. Conclusion These findings indicate a large percentage of vitamin D deficient patients with knee or hip OA, which is unexpected considering the high annual insolation in northern Greece. Many other possible predisposing factors for OA should be taken into consideration. Whether treatment with vitamin D supplements may provide beneficial effects to these patients and the stage of disease in which this treatment should commence remains an issue for further scientific investigation. Level of evidence Level IV.
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MESH Headings
- Aged
- Aged, 80 and over
- Arthroplasty, Replacement, Hip
- Arthroplasty, Replacement, Knee
- Female
- Greece/epidemiology
- Humans
- Male
- Middle Aged
- Osteoarthritis, Hip/blood
- Osteoarthritis, Hip/complications
- Osteoarthritis, Hip/surgery
- Osteoarthritis, Knee/blood
- Osteoarthritis, Knee/complications
- Osteoarthritis, Knee/surgery
- Prevalence
- Retrospective Studies
- Risk Factors
- Vitamin D/analogs & derivatives
- Vitamin D/blood
- Vitamin D Deficiency/blood
- Vitamin D Deficiency/complications
- Vitamin D Deficiency/epidemiology
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Affiliation(s)
- Thomais Goula
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
| | - Alexandros Kouskoukis
- Department of Nuclear Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Georgios Drosos
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
| | | | - Athanasios Ververidis
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
| | - Christos Valkanis
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
| | - Athanasios Zisimopoulos
- Department of Nuclear Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Konstantinos Kazakos
- Department of Orthopaedics, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana, Alexandroupolis, 68100 Greece
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25
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A AL, Abdel-Magied RA, El-Shereef RR, Saedii AA, AbdelGawad EA. Relationship between serum 25-hydroxy vitamin D levels, knee pain, radiological osteoarthritis, and the Western Ontario and McMaster Universities Osteoarthritis Index in patients with primary osteoarthritis. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2014. [DOI: 10.4103/1110-161x.132459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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Barker T, Henriksen VT, Rogers VE, Aguirre D, Trawick RH, Lynn Rasmussen G, Momberger NG. Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis. Redox Biol 2014; 2:466-74. [PMID: 24624336 PMCID: PMC3949095 DOI: 10.1016/j.redox.2014.01.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 01/31/2014] [Accepted: 01/31/2014] [Indexed: 12/16/2022] Open
Abstract
Knee osteoarthritis (OA) is a degenerative joint condition and a leading cause of physical disability in the United States. Quadriceps weakness and inflammatory cytokines contribute to the pathogenesis of knee OA, and both of which, increase with vitamin D deficiency. Other micronutrients, such as vitamins C and E and β-carotene, modulate inflammatory cytokines and decrease during inflammation. The purpose of this study was to test the hypothesis that vitamin D deficiency associates with quadriceps weakness, an increase in serum cytokines, and a decrease in circulating micronutrients in subjects with knee OA. Subjects (age, 48±1 y; serum 25(OH)D, 25.8±1.1 ng/mL) with knee OA were categorized as vitamin D deficient (n=17; serum 25(OH)D≤20 ng/mL), insufficient (n=21; serum 25(OH)D 20–29 ng/mL), or sufficient (n=18; serum 25(OH)D≥30 ng/mL). Single-leg strength (concentric knee extension–flexion contraction cycles at 60 °/s) and blood cytokine, carotene (α and β), ascorbic acid, and tocopherol (α and γ) concentrations were measured. Quadriceps peak torque, average power, total work, and deceleration were significantly (all p<0.05) impaired with vitamin D deficiency. Serum γ-tocopherol concentrations were significantly (p<0.05) increased with vitamin D deficiency. In the vitamin D sufficient group, γ-tocopherol inversely correlated (r=−0.47, p<0.05) with TNF-α, suggesting a pro-inflammatory increase with a γ-tocopherol decrease despite a sufficient serum 25(OH)D concentration. We conclude that vitamin D deficiency is detrimental to quadriceps function, and in subjects with vitamin D sufficiency, γ-tocopherol could have an important anti-inflammatory role in a pathophysiological condition mediated by inflammation. We investigated the vitamin D association with mediators of knee osteoarthritis. Vitamin D deficiency associated with quadriceps dysfunction. Vitamin D deficiency was not associated with serum cytokines. Vitamin D deficiency associated with increased plasma γ-tocopherol concentrations. γ-Tocopherol inversely correlated with TNF-α in vitamin D sufficient subjects.
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Affiliation(s)
- Tyler Barker
- The Orthopedic Specialty Hospital, 5848 S., Fashion Blvd., Murray, UT 84107, USA
| | - Vanessa T Henriksen
- The Orthopedic Specialty Hospital, 5848 S., Fashion Blvd., Murray, UT 84107, USA ; The Orthopedic Specialty Clinic, Murray, UT 84107, USA
| | - Victoria E Rogers
- The Orthopedic Specialty Hospital, 5848 S., Fashion Blvd., Murray, UT 84107, USA
| | - Dale Aguirre
- The Orthopedic Specialty Hospital, 5848 S., Fashion Blvd., Murray, UT 84107, USA
| | - Roy H Trawick
- The Orthopedic Specialty Hospital, 5848 S., Fashion Blvd., Murray, UT 84107, USA ; The Orthopedic Specialty Clinic, Murray, UT 84107, USA
| | - G Lynn Rasmussen
- The Orthopedic Specialty Hospital, 5848 S., Fashion Blvd., Murray, UT 84107, USA ; The Orthopedic Specialty Clinic, Murray, UT 84107, USA
| | - Nathan G Momberger
- The Orthopedic Specialty Hospital, 5848 S., Fashion Blvd., Murray, UT 84107, USA ; The Orthopedic Specialty Clinic, Murray, UT 84107, USA
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27
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Al-Jarallah K, Shehab D, Abraham M, Mojiminiyi OA, Abdella NA. Musculoskeletal pain: should physicians test for vitamin D level? Int J Rheum Dis 2014; 16:193-7. [PMID: 23773644 DOI: 10.1111/1756-185x.12066] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to evaluate vitamin D levels using a reliable method in patients with regional and generalized musculoskeletal (MSK) pain in comparison to healthy controls. METHODS A consecutive prospective case control cohort was recruited. Patients with generalized MSK pain, for example, fibromyalgia (FM), and regional MSK pain, for example, nonspecific low back pain (LBP) and knee osteoarthritis (OA) were screened for 25 hydroxy-vitamin D [25(OH)D₃ ] levels over a period of 9 months in a hospital-based setting. RESULTS One hundred and twenty-four patients and 82 age-sex matched controls were evaluated. The mean age for patients was 41.71 ± 13.86 years. Of the 124 patients, 118 (95%) were female, 77 (62.6%) had FM, 18 (14.6%) had LBP and 28 (22.8%) had knee OA. All patients had normal muscle power; 83.7% of females wore long garments, 11.4% wore veils, 95.5% had sun exposure < 10 min/day and 58.5% were multiparaous; 7.3% were strict vegetarians, 45.5% took inadequate dairy products. The mean calcium, parathyroid hormone, alkaline phosphatase and albumin levels were within normal limits for all study subjects. The vitamin D level was deficient in all patients. There was no statistical difference between the mean vitamin D values of the patients and controls, 27.61 ± 13.06 and 25.82 ± 15.06 nmol/L respectively, (P = 0.368). CONCLUSION Our findings suggest that it is unlikely that measuring vitamin D will be of diagnostic value in the routine assessment of regional and generalized MSK pain.
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Affiliation(s)
- Khaled Al-Jarallah
- Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait.
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28
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Colombini A, Cauci S, Lombardi G, Lanteri P, Croiset S, Brayda-Bruno M, Banfi G. Relationship between vitamin D receptor gene (VDR) polymorphisms, vitamin D status, osteoarthritis and intervertebral disc degeneration. J Steroid Biochem Mol Biol 2013; 138:24-40. [PMID: 23500379 DOI: 10.1016/j.jsbmb.2013.03.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 02/26/2013] [Accepted: 03/01/2013] [Indexed: 02/07/2023]
Abstract
The vitamin D endocrine system is involved in bony and cartilaginous metabolisms and alterations in the homeostasis of this system could be associated to pathological conditions of cartilaginous tissue. In this context, the presence of polymorphisms in the vitamin D receptor gene (VDR), in association with the susceptibility to common osteochondral diseases, was largely investigated. The aim of this review was to summarize data present in literature, analyzing the association of the VDR polymorphisms, vitamin D status and knee cartilage and intervertebral disc pathologies, trying to suggest links between the different specific pathologies analyzed. Concerning the association between VDR polymorphisms and cartilaginous tissue diseases, we found controversial reports. However, the great majority of papers reported an association with lumbar disc degeneration, whereas about half of the studies found an association with osteoarthritis. A further association between VDR polymorphisms (in linkage disequilibrium) and the presence of specific characteristics of these diseases, in particular the formation of osteophytes, was evidenced. Finally, the influence of vitamin D status on these pathologies was evaluated, trying to evidence the relation between the presence of particular genetic variants in the VDR and vitamin D levels or to show whether a particular vitamin D status could predispose to the development or progression of such diseases, however, no significant associations were found. In the future, given the role of vitamin D system in the cartilaginous tissue metabolism, it could be interesting to perform functional and tissue specific studies to analyze the interplay between the different VDR variants and its ligand.
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Affiliation(s)
- Alessandra Colombini
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy.
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29
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Chlebowski RT, Pettinger M, Johnson KC, Wallace R, Womack C, Mossavar-Rahmani Y, Stefanick M, Wactawski-Wende J, Carbone L, Lu B, Eaton C, Walitt B, Kooperberg CL. Calcium plus vitamin D supplementation and joint symptoms in postmenopausal women in the women's health initiative randomized trial. J Acad Nutr Diet 2013; 113:1302-10. [PMID: 23954097 PMCID: PMC4108192 DOI: 10.1016/j.jand.2013.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 06/05/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Low vitamin D intake and levels have been associated with increased joint symptoms in some observational studies but the findings are mixed and evidence from randomized trials sparse. OBJECTIVE To evaluate the influence of supplemental calcium and vitamin D on joint symptoms in the Women's Health Initiative randomized, placebo-controlled, clinical trial. DESIGN In post hoc analyses, the results of the Women's Health Initiative randomized clinical trial in which 36,282 postmenopausal women were randomized to receive calcium carbonate (1,000 mg as elemental calcium) with vitamin D-3 (400 IU) daily or placebo were examined in the 6% subgroup of 1,911 participants, oversampled for minorities, who had serial joint symptom assessment. Qualitative information on joint pain and joint swelling was collected by questionnaire before entry and 2 years after randomization. Logistic regression models were used to compare the occurrence and severity of joint symptoms across randomization groups. RESULTS At baseline, total calcium and vitamin D intakes from diet and supplements were similar in the two randomization groups. In addition, both joint pain (reported by 73%) and joint swelling (reported by 34%) were commonly reported and comparable in the supplement and placebo groups. Two years after randomization, no statistically significant differences between supplement and placebo groups were seen for joint pain frequency (74.6% compared with 75.1% [P=0.79] for supplement and placebo groups, respectively) or joint swelling frequency (34.6% compared with 32.4% [P=0.29], respectively) or in severity scores for either outcome. Subgroup analyses suggested study participants also using nonprotocol calcium supplements at study entry may have less joint pain with supplement group randomization (interaction P=0.02). CONCLUSIONS Joint symptoms are relatively common in postmenopausal women. However, daily supplementation with 1,000 mg calcium carbonate and 400 IU vitamin D-3 in a randomized, placebo-controlled clinical trial setting did not reduce the self-reported frequency or severity of joint symptoms.
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Cao Y, Winzenberg T, Nguo K, Lin J, Jones G, Ding C. Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. Rheumatology (Oxford) 2013; 52:1323-34. [PMID: 23542678 DOI: 10.1093/rheumatology/ket132] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To systematically review the evidence for association between serum 25-hydroxyvitamin D (25-(OH)D) and OA and the effect of vitamin D therapy on OA. METHODS An English Medline, EMBASE and Cochrane Library search for vitamin D and OA from January 1980 to June 2012 was performed. Randomized controlled trials (RCTs), cohort, case-control and cross-sectional studies in adults were included. The methodological quality of the selected studies was assessed and a best-evidence synthesis was used to summarize the results due to the heterogeneity of the studies. RESULTS Of the 86 evaluated articles, 2 RCTs and 13 observational studies were included in the final analyses. The number of participants ranged from 64 to 1644 (0-100% women). The RCTs were only reported in abstract form and showed inconsistent results, most likely due to variations in their study design. There was insufficient or limited evidence for associations between 25-(OH)D and hand or hip OA. For knee radiographic OA as assessed by the Kellgren and Lawrence (KL) score, there was moderate evidence showing that low levels of 25-(OH)D were associated with increased progression of radiographic OA. Strong evidence for an association between 25-(OH)D and cartilage loss was apparent when joint space narrowing and changes in cartilage volume were considered collectively as cartilage loss. CONCLUSION 25-(OH)D appears to be implicated in structural changes of knee OA rather than symptoms, and further well-designed RCTs are required to determine whether vitamin D supplementation can slow disease progression. There is insufficient evidence for other sites.
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Affiliation(s)
- Yuelong Cao
- Menzies Research Institute Tasmania, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia
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31
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Vitamin D and bone disease. BIOMED RESEARCH INTERNATIONAL 2012; 2013:396541. [PMID: 23509720 PMCID: PMC3591184 DOI: 10.1155/2013/396541] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 08/29/2012] [Indexed: 11/22/2022]
Abstract
Vitamin D is important for normal development and maintenance of the skeleton. Hypovitaminosis D adversely affects calcium metabolism, osteoblastic activity, matrix ossification, bone remodeling and bone density. It is well known that Vit. D deficiency in the developing skeleton is related to rickets, while in adults is related to osteomalacia. The causes of rickets include conditions that lead to hypocalcemia and/or hypophosphatemia, either isolated or secondary to vitamin D deficiency. In osteomalacia, Vit. D deficiency leads to impairment of the mineralisation phase of bone remodeling and thus an increasing amount of the skeleton being replaced by unmineralized osteoid. The relationship between Vit. D and bone mineral density and osteoporosis are still controversial while new evidence suggests that Vit. D may play a role in other bone conditions such as osteoarthritis and stress fractures. In order to maintain a “good bone health” guidelines concerning the recommended dietary intakes should be followed and screening for Vit. D deficiency in individuals at risk for deficiency is required, followed by the appropriate action.
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