Association between vitamin D concentrations and knee pain in patients with osteoarthritis.

Murat Cakar,Haluk Cabuk,Suleyman Semih Dedeoglu,Semih Ayanoglu,Hakan Gurbuz,Metin Seyran

doi:10.7717/peerj.4670

Murat Cakar, Haluk Cabuk + Show 4 more

Open Access

https://doi.org/10.7717/peerj.4670

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Journal: PeerJ	Publication Date: Apr 24, 2018
Citations: 15	License type: CC BY 4.0

Affiliation: Okmeydanı Eğitim ve Araştırma Hastanesi

Abstract

ObjectivesOsteoarthritis (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 MethodsVitamin 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).ResultsOf 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.ConclusionSerum vitamin D concentration is not associated with knee pain in patients with osteoarthritis.

Highlights

The incidence of vitamin D deficiency is 25% in the general population and more than 40% in the elderly population in US and it is a common health problem (Heath & Elovic, 2006)
Age was weakly but significantly correlated with Kellgren-Lawrence grade, vitamin D concentration, WOMAC score, and body mass index (BMI) (Table 3)
Large cohort studies demonstrated that serum vitamin D levels is an independent predictor of knee pain progression (Muraki et al, 2011), small to moderate effect on pain control revealed by Diao, Yang & Yu (2017)

Summary

Introduction

The incidence of vitamin D deficiency is 25% in the general population and more than 40% in the elderly population in US and it is a common health problem (Heath & Elovic, 2006). Insufficient concentrations of vitamin D adversely effect calcium metabolism, osteoblastic activity, matrix ossification, bone density, and articular cartilage turnover (Gröber et al, 2013; Corvol et al, 1981; Cranney et al, 2008; Norman, Roth & Orci, 1982; Tetlow & Woolley, 2001; Heath & Elovic, 2006). Epidemiological studies showed that low serum 25-hydroxyvitamin D levels were associated with greater knee pain a higher prevalence of radiographic knee osteoarthritis and higher risk of progression (McAlindon et al, 1996; Bergink et al, 2009). It has anti-inflammatory properties, proinflammatory cytokine production in states of vitamin D deficiency might alter central pain processing, thereby increasing mechanical pain sensivity (Müller et al, 1992). A cross-sectional study reported that the prevalence of vitamin D deficiency was 72% in patients with widespread musculoskeletal pain (Çidem et al, 2013)

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