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Abstract
Hypovitaminosis D (25-hydroxyvitamin D (25(OH)D) <75 nmol/L) is associated with neuropathic pain and varicella-zoster virus (VZV) immunity. A two-part retrospective hospital-based study was conducted. Part I (a case-control study): To investigate the prevalence and risk of hypovitaminosis D in postherpetic neuralgia (PHN) patients compared to those in gender/index-month/age-auto matched controls who underwent health examinations. Patients aged ≥50 years were automatically selected by ICD-9 codes for shingle/PHN. Charts were reviewed. Part II (a cross-sectional study): To determine associations between 25(OH)D, VZV IgG/M, pain and items in the DN4 questionnaire at the first pain clinic visit of patients. Independent predictors of PHN were presented as adjusted odds ratios(AOR) and 95% confidence intervals (CI). Prevalence (73.9%) of hypovitaminosis D in 88 patients was high. In conditional logistic regressions, independent predictors for PHN were hypovitaminosis D (AOR3.12, 95% CI1.73–5.61), malignancy (AOR3.21, 95% CI 1.38–7.48) and Helicobacter pylori-related peptic ulcer disease (AOR3.47, 95% CI 1.71–7.03). 25(OH)D was inversely correlated to spontaneous/brush-evoked pain. Spontaneous pain was positively correlated to VZV IgM. Based on the receiver operator characteristic curve, cutoffs for 25(OH)D to predict spontaneous and brush-evoked pain were 67.0 and 169.0 nmol/L, respectively. A prospective, longitudinal study is needed to elucidate the findings.
Highlights
Vitamin D is essential for musculoskeletal health in humans
In Part, we investigated the prevalence and the risk of hypovitaminosis D in postherpetic neuralgia (PHN) patients compared to those in controls receiving health examinations
Three patients were considered to experience other causes of chronic pain, while 19 patients were determined to suffer from zoster-associated pain which was defined as herpetic pain beyond 30 days but less than 90 days
Summary
Vitamin D is essential for musculoskeletal health in humans. The major circulating form of vitaminDis serum 25-hydroxyvitamin D (25(OH)D)—the main storage form. Vitamin D is essential for musculoskeletal health in humans. Dis serum 25-hydroxyvitamin D (25(OH)D)—the main storage form. Serum total 25(OH)D is considered to be the best marker of vitamin D status among the possible markers [1]. The definition of hypovitaminosis D is a central controversy in vitamin D research [1]. Sufficiency of vitamin D is defined as 25(OH)D ≥ 75 nmol/L (30 ng/mL) as defined by the Endocrine. Society Clinical Practice Guideline [2]. Low vitamin D (hypovitaminosis D) includes insufficiency
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