Vitamin D and osteoarthritis: disparity between observational studies and clinical trials

Antony, Benny; Ding, Changhai

doi:10.1111/1756-185x.13133

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…However, in OA patients with insufficient vitamin D levels (<30 ng/ml), supplementation HA injections with vitamin D (5 weeks) could significantly reduce the OS levels in synovial fluid, which in turn attenuates knee pain and improves knee function after 3 months of HA injection. This is consistent with previous studies showing that patients with insufficient vitamin D levels may benefit from vitamin D supplementation for joint pain relief ( 13 , 15 , 55 – 58 ). Vitamin D can be regarded as an antioxidant, and vitamin D deficiency can lead to mitochondrial dysfunction, increased ROS production, and oxidative damage ( 18 ).…”

Section: Discussionsupporting

confidence: 93%

Supplementation of hyaluronic acid injections with vitamin D improve knee function by attenuating synovial fluid oxidative stress in osteoarthritis patients with vitamin D insufficiency

Shen

Lin

et al. 2023

Front. Nutr.

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ObjectivesThere is still controversy about the effect of vitamin D supplementation on osteoarthritis (OA). The purpose of this study was to investigate the effects of vitamin D supplementation with Hyaluronic acid (HA) injection on OA.MethodsWe investigated serum vitamin D levels and oxidative stress (OS) in synovial fluid from patients with OA who underwent total knee arthroplasty (grade IV, n = 24) and HA injection (grade II and III, n = 40). The effects of HA injection with or without oral vitamin D supplementation on synovial fluid OS and knee pain and function were then further investigated. Finally, patients underwent HA injection were divided into two groups according to vitamin D levels (vitamin D < or > 30 ng/ml), and the efficacy of the two groups were compared.ResultsThe results showed that the levels of glutathione peroxidase (GSH-PX) (P < 0.05) in the synovial fluid were lower in patients with stage IV OA than that in patients with stage II-III OA, while the levels of malondialdehyde (MDA) (P < 0.05) and lactate dehydrogenase (LDH) (P < 0.01) were significantly higher. Moreover, we found that age, BMI and vitamin D levels were significantly associated with the levels of oxidants and/or antioxidants in synovial fluid, and that vitamin D was significantly negatively correlated with BMI (R = −0.3527, p = 0.0043). Supplementation of HA injections with vitamin D significantly reduced the OS status in synovial fluid, attenuated knee pain and improved knee function in OA patients with vitamin D insufficiency.ConclusionWe conclude that maintenance of vitamin D sufficiency may be beneficial for the treatment of OA by improving OS in synovial fluid.

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Section: Discussionsupporting

confidence: 93%

Supplementation of hyaluronic acid injections with vitamin D improve knee function by attenuating synovial fluid oxidative stress in osteoarthritis patients with vitamin D insufficiency

Shen

Lin

et al. 2023

Front. Nutr.

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“…In Australia, up to 80% of women and 70% of men living in hostels or nursing homes were deficient in vitamin D [ 9 ]. Epidemiological studies have suggested moderate evidence of association between vitamin D deficiency and progression of OA [ 10 , 11 ]. Our systematic review reported a moderate evidence of the association between low vitamin D levels and progression of radiographic knee OA [ 12 ], including knee joint space narrowing (JSN) [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Vitamin D Effects on Osteoarthritis (VIDEO) RCT from our group suggested that vitamin D treatment did not result in significant changes in MRI-measured tibial cartilage volume or knee pain over 2 years in participants with symptomatic knee OA and low serum 25-hydroxyvitamin D levels [ 18 ]. One possible reason for the lack of efficacy in our RCT may be that the VIDEO trial participants were only followed up for 2 years and the vitamin D treatment effect may have a prolonged effect [ 11 ]. Besides, an elevated vitamin D level in the placebo group (62% of participants in the VIDEO trial achieved vitamin D sufficiency over 2 years) could have diluted the differences in effects between vitamin D and placebo groups [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term effects of vitamin D supplementation and maintaining sufficient vitamin D on knee osteoarthritis over 5 years

Wang,

Zhu,

Pan

et al. 2023

Arthritis Res Ther

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Objectives This study aimed to investigate the long-term effect of vitamin D supplementation compared to placebo over 5 years in participants with knee osteoarthritis (OA). We also aimed to describe the effect of maintaining sufficient serum vitamin D levels over five years in knee OA. Methods Participants (n = 173) from the Hobart centre of the Vitamin D Effects on Osteoarthritis (VIDEO) trial were extensively followed up 3 years after the cessation of 2-year investigational treatment. Participants were classified as maintaining sufficient vitamin D (n = 79) and not maintaining sufficient vitamin D (n = 61) groups. Results There was no significant difference in change in the knee symptoms, depression, and serum levels of IL6 and hs-CRP between both comparisons after 3 years of cessation of the clinical trial. However, among participants who reported no knee surgery (KS), there was a significant improvement in WOMAC function (β: − 83.7, 95% CI: − 167.3, 0) and depression scores (β: − 1.3, 95% CI: − 2.3, − 0.2) in vitamin D group compared to the placebo group. Similarly, those who maintained adequate vitamin D levels over 5 years had significantly less WOMAC knee pain (β: − 33.9, 95% CI: − 65.7, − 2) and physical dysfunction (β: − 105.5, 95% CI: − 198.2, − 12.8) than participants with vitamin D deficiency over 5 years. Conclusion Vitamin D supplementation over 2 years or maintaining vitamin D sufficiency for 5 years was not associated with statistically significant differences in change in knee symptom scores over 5 years. However, among participants who did not report KS, 2-year vitamin D supplementation and maintaining sufficient vitamin D was linked to modest improvements in knee symptoms and depression scores in knee OA.

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“…Conversely, vitamin D supplementation could be able to prevent the progression of OA by increasing bone remodeling and also by reducing the abnormal pathophysiological process [14]. Additionally, it was suggested that supplementation may help improve disease progression in patients with vitamin D deficiency but does not have any additional benefits on those with optimal levels of vitamin D [15]. However, recent studies showed that low levels of vitamin D are not associated with the risks of developing knee OA, except perhaps with the progression of knee OA [12,16].…”

Section: Introductionmentioning

confidence: 99%

The Role of Vitamin D in Early Knee Osteoarthritis and Its Relationship with Their Physical and Psychological Status

et al. 2021

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Osteoarthritis (OA) is a common joint condition and one of the greatest causes of disability worldwide. The role of vitamin D in the origin and development of the disease is not clear, although it could have important implications for diagnosis and treatment. For this proposal, a cross-sectional study with a non-probabilistic sample was performed. In total, 48 with early osteoarthritis (EOA) and 48 matched controls were selected, and serum 25(OH)D and parathyroid hormone (PTH) levels were analyzed. In addition, physical and psychological variables were measured to establish their relationship with vitamin D levels. Patients with EOA showed lower levels (22.3 ± 7.3 ng/mL) in comparison to matched controls (29.31 ± 9.2 ng/mL). A statistically significant higher number (Chi-squared = 8.525; p = 0.004) of patients with EOA had deficiency levels (<20 ng/mL) compared to the control group. Patients with lower vitamin D levels showed higher levels of pain intensity, disability, and anxiety, as well as poorer values for sit-to-stand, walking speed, and social participation. Correlation analysis showed a relationship between serum 25(OH)D, PTH and pain intensity, and social participation. These results highlight the relevance of vitamin D in the early diagnosis and prevention of EOA.

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Vitamin D and osteoarthritis: disparity between observational studies and clinical trials

Cited by 6 publications

References 10 publications

Supplementation of hyaluronic acid injections with vitamin D improve knee function by attenuating synovial fluid oxidative stress in osteoarthritis patients with vitamin D insufficiency

Supplementation of hyaluronic acid injections with vitamin D improve knee function by attenuating synovial fluid oxidative stress in osteoarthritis patients with vitamin D insufficiency

Long-term effects of vitamin D supplementation and maintaining sufficient vitamin D on knee osteoarthritis over 5 years

The Role of Vitamin D in Early Knee Osteoarthritis and Its Relationship with Their Physical and Psychological Status

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