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Prevalence of vitamin D deficiency in chronic and subacute low back pain patients in India: a triple-arm controlled study

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Abstract

Vitamin D is vital for musculoskeletal health and may be associated with subacute and chronic low back pain. The objective of this study was to estimate the prevalence of vitamin D deficiency among chronic low back pain (CLBP) and subacute low back pain (SLBP), and compare the same with healthy controls. This study was designed as triple-arm case-control study comprising of CLBP, SLBP, and controls. SLBP and CLBP cases were consecutively enrolled over 3 months of winter season from November 2016 to January 2017. Serum 25- (OH) vitamin D was estimated for the study subjects and categorical comparison of severity of vitamin D deficiency was done for the cases and controls. A total of 250 CLBP, 177 SLBP cases, and 248 controls were included in the study. Mean (± SD) serum vitamin D levels among CLBP, SLBP, and controls were 20.36 (± 12.56), 21.42 (± 13.20), and 20.84 (± 6.93) ng/ml respectively, the difference being statistically insignificant. There was no significant difference in the prevalence of vitamin D deficiency among CLBP, SLBP, and controls which was 53.6, 50.8, and 51.6% respectively, in the three arms. However, the categorical analysis revealed that CLBP and SLBP cases had a significantly higher prevalence of worse categories of vitamin D deficiency. Cases had significantly larger frequency (CLBP vs. controls, 43.6 vs 20.1%, P<0.001; SLBP vs. controls, 43.5 vs 20.1%, P = 0.001) of individuals with vitamin D levels ≤ 16 ng/ml (moderate deficiency upper threshold level). Thus, the severe forms of vitamin D deficiency may be causally associated with CLBP and SLBP. The results of the present study revealed that increasing severity of vitamin D deficiency may have a pathogenetic association with chronic low back pain and subacute low back pain. These results may prove to be of significance in framing of future management guidelines for the above clinical conditions.

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Authors and Affiliations

  1. Department of Neurology, Kakatiya Medical College and Mahatma Gandhi Memorial Hospital, Warangal, 506007, India

    Ajay Panwar & Madhavarao Veeramalla

  2. Department of Medicine, Kakatiya Medical College and Mahatma Gandhi Memorial Hospital, Warangal, India

    Chandrasekhar Valupadas

  3. Department of Clinical Pharmacy, Talla Padmavathi College of Pharmacy, Warangal, India

    Hunsur N. Vishwas

Authors
  1. Ajay Panwar
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  2. Chandrasekhar Valupadas
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  3. Madhavarao Veeramalla
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  4. Hunsur N. Vishwas
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Contributions

Dr. Ajay Panwar contributed in data analysis, data interpretation, literature search, writing the manuscript, and study design. Dr. Chandrasekhar Valupadas contributed in literature search, study design, data collection, data analysis, and data interpretation. Dr. Madhavarao Veeramalla contributed in data analysis, literature search, writing the manuscript, and study design. Dr. Hunsur N Vishwas contributed in data analysis and literature search.

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Correspondence to Ajay Panwar.

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Ethical statement and informed consent

This study was carried out in accordance with the recommendations of “Institutional ethics committee” of Kakatiya Medical College, Warangal, and the study protocol was registered with the same. A written informed consent was taken from all the study subjects.

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Panwar, A., Valupadas, C., Veeramalla, M. et al. Prevalence of vitamin D deficiency in chronic and subacute low back pain patients in India: a triple-arm controlled study. Clin Rheumatol 37, 1367–1374 (2018). https://doi.org/10.1007/s10067-017-3798-z

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  • DOI: https://doi.org/10.1007/s10067-017-3798-z

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