Assessment of Bone Metabolism in Male Patients With Benign Paroxysmal Positional Vertigo

Abstract

Objective: Several studies have suggested a probable association between benign paroxysmal positional vertigo (BPPV) and both reduction of bone mineral density (BMD) and serum vitamin D levels, but none of these studies have explored their findings by examining bone turnover markers (BTM) in male idiopathic BPPV patients. This study aimed to evaluate the relationship between BMD and serum 25-hydroxyvitamin D (25(OH) D), with the occurrence of BPPV along with the characteristics of bone metabolism in male idiopathic BPPV patients.Methods: This retrospective study comprised 60 male idiopathic BPPV patients and 92 age-matched healthy controls referred to Ningbo No.2 Hospital during the period of February 2016 to February 2018. All subjects' serum levels of 25(OH) D, bone formation marker amino-terminal propeptide of type I procollagen (PINP), and bone resorption marker β-isomerized carboxy-terminal telopeptide of type I collagen (β-CTX) were measured. BMD was determined by dual energy X-ray absorption at the lumbar spine and hip.Results: Among male patients with BPPV, the prevalence of BMD reduction was 35.0%, which was similar to that of 27.2% in healthy controls. There were significant differences in the mean serum 25(OH) D level and prevalence of vitamin D deficiency between the two groups, with p-values of 0.049 and 0.009, respectively. The bone turnover markers of PINP and β-CTX in BPPV patients were lower than those in healthy controls. Logistic regression showed that vitamin D deficiency were associated with BPPV with an odds ratio of 3.8 (95% confidence interval = 1.25–11.73).Conclusion: Our study found that decreased serum vitamin D may be a risk factor for BPPV in male patients. The level of bone turnover among male patients with BPPV was lower than that among healthy controls.

Increased Otolin-1 in Serum as a Potential Biomarker for Idiopathic Benign Paroxysmal Positional Vertigo Episodes

“…The otoconial complex forms via a dynamic turnover process that occurs throughout an individual's lifetime. Otoconial degeneration and displaced otoconia falling into the canal are the leading causes of BPPV (1,2,7). It is known that most episodes of BPPV, even in untreated patients, recover spontaneously within 1-4 weeks because the dislodged otoconia can be dissolved in the endolymph (15,18,32).…”

“…Benign paroxysmal positional vertigo (BPPV) is one of the most common otoconia-related balance disorders, accounting for 36.5% of all dizziness complaints in the Chinese population (1,2). BPPV is characterized by transient vertigo, nausea and nystagmus provoked by head position changes.…”

Risk Factors for the Occurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis

“…However, the underlying causes of BPPV remain unclear. In recent decades, many studies have investigated risk factors for the occurrence of BPPV, including female gender, serum vitamin D deficiency, osteoporosis, vascular risk factors, head trauma, and other potential risk factors (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). However, there are some controversies among these studies.…”

Risk factors for residual dizziness in patients successfully treated for unilateral benign posterior semicircular canal paroxysmal positional vertigo

“…Calcium metabolism is involved in the synthesis and absorption of otoliths, and thus defects in systemic calcium/bone metabolism may also have an impact in the inner ear. [36][37][38] Thus, a significant loss of BMD, indicating osteopenia or osteoporosis, might increase the probability that debris persists in the canal, to an extent that is insufficient to provoke noticeable positional nystagmus, but sufficient to induce RD. 28 The present study had a few limitations.…”