Effect of Vitamin D Supplementation on Depressive Symptoms in Patients With Knee Osteoarthritis

Zheng, Shuang; Tu, Liudan; Cicuttini, Flavia Maria; Han, Weiyu; Zhu, Zhaohua; Antony, Benny; Wluka, Anita E.; Winzenberg, Tania; Meng, Tao; Aitken, Dawn; Blizzard, Leigh; Jones, Graeme; Ding, Changhai

doi:10.1016/j.jamda.2018.09.006

Cited by 22 publications

(18 citation statements)

References 31 publications

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“…Additionally, the generalisbility may be limited to OA patients recruited into trials, because of inherent issuses of secondary analysis of a RCT. Nevertheless, the findings from this study were plausible as we found that vitamin D supplementation reduced visual analog scale knee pain, improved physical function and decreased depessive symptoms [41,42]. In this study, depression was associated with reduced knee pain and dysfunction over 2 years only in vitamin D supplemented group.…”

Section: Discussionmentioning

confidence: 49%

Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Zheng

Cicuttini

et al. 2021

BMC Musculoskelet Disord

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Background To describe demographic and clinical factors associated with the presence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods Three hundred ninety-seven participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.3 ± 7.1 year, 48.6% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results The presence and incidence of depression was 25.4 and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher presence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the presence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA. Trial registration ClinicalTrials.gov identifier: NCT01176344. Anzctr.org.au identifier: ACTRN12610000495022.

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Section: Discussionmentioning

confidence: 49%

Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Zheng

Cicuttini

et al. 2021

BMC Musculoskelet Disord

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“…11 In addition, depressive symptoms is interrelated to joint pain in OA, 12 and maintaining sufficient serum vitamin D may improve depression symptoms in patients with knee OA. 13 However, evidence from randomised controlled trials (RCTs) have been conflicting. [14][15][16][17] A pilot RCT in India found a small but statistically significant clinical benefit for 12-month vitamin D treatment on pain and function in patients with knee OA, compared with placebo.…”

Section: Introductionmentioning

confidence: 99%

“…Another possible reason is that vitamin D may have an effect only in some OA phenotypes, such as those with BMLs (predominant bone abnormality), 20 effusionsynovitis (inflammatory) 21 or depressive symptoms (psychological distress). 13 Post hoc analyses within these RCTs 15 21 were frequently underpowered, and hence unreliable to determine the effect of vitamin D treatment on subgroups of knee OA patients. A metaanalysis using individual patient data (IPD) can increase the power of subgroup analysis by combining individual data from included trials 22 and therefore can quantify potential effect modifier of vitamin D treatment in subgroups.…”

Section: Introductionmentioning

confidence: 99%

Effect of vitamin D supplementation on pain and physical function in patients with knee osteoarthritis (OA): an OA Trial Bank protocol for a systematic review and individual patient data (IPD) meta-analysis

et al. 2020

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IntroductionObservational data suggest that vitamin D deficiency is associated with the onset and progression of knee osteoarthritis (OA). However, randomised controlled trials (RCTs) to date investigating the efficacy of vitamin D supplementation in knee OA have reported conflicting results. Further research is needed to clarify the effects of vitamin D on patient-reported outcomes and determine whether there are patient subgroups who may benefit from the supplementation. The aim of this individual patient data (IPD) meta-analysis is to identify patient-level predictors of treatment response to vitamin D supplementation on pain and physical function.Methods and analysisA systematic literature search will be conducted for RCTs of vitamin D supplementation on knee OA. Authors of original RCTs will be contacted to obtain the IPD. The primary outcomes will include long-term (≥12 months) pain and physical function. Secondary outcomes will include medium-term (≥6 months and <12 months) and short-term (<6 months) pain and physical function, as well as patient global assessment, quality of life and adverse events. Potential treatment effect modifiers to be examined in the subgroup analyses include age, gender, body mass index, baseline knee pain severity and physical function, baseline vitamin D level, radiographic stage, presence of bone marrow lesions on MRI, presence of clinical signs of local inflammation and concomitant depressive symptoms. Both one-step and two-step modelling methods will be used to determine the possible modifiable effect of each subgroup of interest.Ethics and disseminationResearch ethical or governance approval is exempt for this study as no new data are being collected. This study will be the first IPD meta-analysis to clarify the effect of vitamin D supplementation on clinical symptoms in different subgroups of patients with knee OA. The findings will be disseminated through peer-review publications and conference presentations.PROSPERO registration numberCRD42018107740.

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“…Several foods or substances with functional properties have been studied for their anti-inflammatory effects and/or their possible treatment of pain, such as omega-3 present in fish oil [ 13 , 14 , 15 , 16 ], olive oil [ 17 , 18 ], turmeric [ 19 ], and green tea [ 20 ]; resveratrol in grapes and wine [ 21 ]; capsaicin in pepper; and several flavonoids [ 22 ] in cabbage [ 23 ], cocoa [ 24 ], apple, and citrus fruits [ 25 ]. Furthermore, other studies have shown an association between the progression of osteoarthritis and vitamin D [ 26 , 27 , 28 ] and vitamin K [ 29 ] deficiencies and on the use of omega-3 and polyunsaturated fatty acids in the diet, positively affecting the biochemical composition of the cartilage of individuals with osteoarthritis [ 30 ]. Dietary habits are related to several chronic diseases and may be a major contributor to mortality and morbidity worldwide [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review

2020

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Food consumption has significant positive effects on an individual’s health status, including the reduction of symptoms associated with musculoskeletal pain. However, specific food groups indicated for the treatment of pain are not yet determined. Hence, this review aimed to analyze the effects of nutritional interventions with specific diets, oils and/or fatty acids, and foodstuffs in natura in the reduction of musculoskeletal pain. An integrative review was conducted in the following databases: Embase, PubMed, LILACS, and Google Scholar. Clinical trials written in English, Spanish, and Portuguese and published between 2000 and March 2020 were included in this review. Seventeen studies were included. Among these, a reduction of musculoskeletal pain with different types of nutritional interventions, such as vegan and Mediterranean diets and the consumption of blueberry, strawberry, passion fruit peel extract, argan oil, fish oil (omega-3), olive oil, and undenatured type II collagen and vitamin D gel capsules, was observed in 14 studies. Eight studies evaluated the profiles of several inflammatory markers, and of these, decreased interleukin (IL)-6, IL-1β, and tumor necrosis factor-α levels were observed in two studies. This review suggests that different nutritional interventions with specific diets, oils and/or fatty acids, and foodstuffs in natura reduce musculoskeletal pain, specifically in adults with osteoarthritis. Besides pain improvement, nutritional interventions, including the consumption of strawberry and vitamin D gel capsules, decrease the levels of several inflammatory markers.

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Effect of Vitamin D Supplementation on Depressive Symptoms in Patients With Knee Osteoarthritis

Cited by 22 publications

References 31 publications

Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

Effect of vitamin D supplementation on pain and physical function in patients with knee osteoarthritis (OA): an OA Trial Bank protocol for a systematic review and individual patient data (IPD) meta-analysis

Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review

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