Association of Benign Paroxysmal Positional Vertigo with Osteoporosis and Vitamin D Deficiency – A Case-Control Study

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) is a common type of vertigo involving the peripheral vestibular system. Consensus on the factors causing BPPV is limited. Due to the uncertainty of etiological factors causing BPPV, most cases are accepted as idiopathic. Calcium metabolism plays a primary role in the synthesis and absorption of otoconia primarily made of calcium carbonate and, thus, might be an etiological factor in the onset of BPPV. Objective: To study the role of osteoporosis and vitamin D deficiency in the etiology of BPPV. Study Design: Case-control study. Methods: This is a case-control study comparing the prevalence of osteoporosis and vitamin D deficiency in 100 patients diagnosed with idiopathic BPPV and 100 hospital-based controls. Mean T scores and serum vitamin D levels were compared in the two groups. The groups were substratified based on age, sex, and menopausal status in order to avoid selection bias. Results: There was a high prevalence of osteoporosis and vitamin D deficiency among the patients with BPPV (60 and 76%, respectively). Postmenopausal patients with BPPV had a significantly higher prevalence of vitamin D deficiency and osteoporosis (57 and 64%, respectively). Conclusion: The prevalence of osteoporosis and vitamin D deficiency is reasonably high in the postmenopausal population. Menopausal patients with suspected BPPV may be empirically treated with vitamin D. However, other known factors causing BPPV should be investigated, and the patients should be treated accordingly.

Association of Serum Calcium and Vitamin D with Benign Paroxysmal Positional Vertigo

“…There was a preponderance of female patients among the cases, with 33(67.3%) female patients, and 16 (32.7%) male patients. This was in line with a previous study, 11 which reported that BPPV is common among females.…”

“…The mean age of the patients in our study was 44.39 years. This observation is in line with past researches, 11,12 which indicated that BPPV is not a common disease among the younger age group.…”

“…Different studies have demonstrated the relationship between bone metabolism and BPPV. 6,11 Studies have shown a similar relationship between the otoconia and bone biomineralization; the organization of the matrix is identical in the two tissues, 5,18 and they share the majority of the constituents of the proteins. Like the teeth and bones, the biomineralization of the otoconia involvesa tight regulation of the organic matrix formation at specific sites, and the deposition of mineral crystallites in an orderly manner.…”

“…Thoug rare, tere may be a combinations of posterior and lateral SCCs. 11 There is no unanimity regarding the laterality of BPPV, as few studies reported the disease to be common on the right side, while the others, on the left side. 8,16 In the present research, we found that among the 49 cases, 48 (97.9%) had unilateral BPPV.…”

Investigating the Association Between Serum Vitamin D Deficiency and Idiopathic Benign Paroxysmal Positional Vertigo

“…A statistically significant difference was observed in the mean serum vitamin D3 levels and the deficiency prevalence between the two groups. 18 Ca 2+ and carbonate ions are of crucial importance for vertebrate otoconia production. Besides, Ca 2+ is required to mineralize otoconia and to maintain any turnover in the otolith, because the otoconia has a dynamic state.…”