Association between serum vitamin D deficiency and knee osteoarthritis

Abstract

Background Insufficient levels of serum 25-hydroxyvitamin D (25-OHD) influence the knee joint cartilage and lead to development and progression of knee osteoarthritis (OA). The purpose of this study was to determine the status of serum 25-OHD levels in patients with knee OA compared with controls. Methods A total of 148 patients with knee OA and 150 controls were studied. Serum 25-OHD was measured by the ELISA method and concentrations<20 ng/ml were considered as deficient levels. Mann-Whitney U test was used for comparisons of means and logistic regression analysis with calculation of odds ratio (OR) was applied to determine association. Results The mean ages of patients and controls were 60.2± 12.9 and 60.1±10.2 years, respectively (P=0.23). In the entire population the mean serum 25-OHD in OA patients was not significantly lower than controls (P=0.28), but in subgroup analysis the mean 25-OHD in OA patients aged <60 years was significantly lower than controls (23.8±18.8 vs. 34.5.±29.6 ng/ml, P=0.01). In this age group knee OA was significantly associated with serum 25-OHD deficiency which remained significant after adjusting for age and sex (adjusted OR=2.26, 95% CI 1.15-4.4, P=0.018). A greater association was observed in patients aged<55 years (OR=2.63, 95% CI 1.16-5.95, P= 0.01); whereas the association between OA and serum 25-OHD deficiency in patients aged ≥60 years did not reach a significant level. Conclusion These findings indicate a significant association between serum 25-OHD deficiency and knee OA in patients aged < 60 years and suggest serum 25-OHD measurement in any patient with symptoms suggestive of knee OA particularly at the initial stage of disease.

Vitamin D deficiency showed association with knee osteoarthritis in Tamilnadu population – A pilot study

“…14,[16][17][18][19] All these epidemiological suggests that by achieving normal serum vitamin D level may prevent or delay loss of cartilage loss and reduce the pain and other symptoms of OA. [15][16][17][18] Observation from studies on knee osteoarthritis evaluated by Cao et al suggested that serum 25-OH vitamin D level play an important role in structural changes of knee osteoarthritis. 17 In another study done by Bergink et al also, reported three times increased risk of knee OA and disease progress was associated with serum 25-OH vitamin D <20 ng/ml in the Rotterdam Study.…”

“…12,16 In a recent study, decreased serum level of 25-hydroxy vitamin D was reported in a significant proportion of patients with OA of hip and knee joints. 14,[16][17][18][19] All these epidemiological suggests that by achieving normal serum vitamin D level may prevent or delay loss of cartilage loss and reduce the pain and other symptoms of OA. [15][16][17][18] Observation from studies on knee osteoarthritis evaluated by Cao et al suggested that serum 25-OH vitamin D level play an important role in structural changes of knee osteoarthritis.…”

“…4,9,8,11 At this stage, bone resorption markers are higher and bone formation markers are lower. 6,8,13,16 Low serum 25-OH vitamin D increases osteoblastic activity and bone turnover. 1,9,14,17 Many mechanisms were put forwarded to explain role of vitamin D and alterations in properties of bones in the progression of the disease osteoarthritis.…”

“…Reports and observations from earlier studies provided a rationale for the measurement of serum 25-OH vitamin D levels with appearance of knee OA in elderly people and encourage supplementation to raise the serum vitamin D concentration to adequate levels. [14][15][16] Epidemiological studies showed an association between dietary intake and serum levels of 25-hydroxy vitamin D and the progression of hip 14,15 and knee OA. 12,16 In a recent study, decreased serum level of 25-hydroxy vitamin D was reported in a significant proportion of patients with OA of hip and knee joints.…”

“…[14][15][16] Epidemiological studies showed an association between dietary intake and serum levels of 25-hydroxy vitamin D and the progression of hip 14,15 and knee OA. 12,16 In a recent study, decreased serum level of 25-hydroxy vitamin D was reported in a significant proportion of patients with OA of hip and knee joints. 14,[16][17][18][19] All these epidemiological suggests that by achieving normal serum vitamin D level may prevent or delay loss of cartilage loss and reduce the pain and other symptoms of OA.…”