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Association between serum vitamin D deficiency and knee osteoarthritis

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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.

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References

  1. Adams JS, Hewison M (2010) Update in vitamin D. J Clin Endocrinol Metab 95:471–476

    Article  PubMed  Google Scholar 

  2. Holick MF (2006) High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 81:353–37

    Article  PubMed  CAS  Google Scholar 

  3. Heidari B, Shokri Shirvani J, Firouzjahi A, Heidari P, Hajian-Tilaki K (2010) Association between nonspecific skeletal pain and vitamin D deficiency. Int J Rheumatol 13:340–346

    Google Scholar 

  4. Pérez-López FR (2007) Vitamin D and its implications for musculoskeletal health in women: an update. Maturitas 58:117–137

    Article  PubMed  Google Scholar 

  5. Bergink AP, Uitterlinden AG, Van Leeuwen JP, Buurman CJ, Hofman A, Verhaar JA, Pols HA (2009) Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: the Rotterdam Study. J Clin Rheumatol 15:230–237

    Article  PubMed  Google Scholar 

  6. Ding C, Cicuttini F, Parameswaran V, Burgess J, Quinn S, Jones G (2009) Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the Tasmanian older adult cohort study. Arthritis Rheum 60:1381–1389

    Article  PubMed  Google Scholar 

  7. Chaganti RK, Parimi N, Cawthon P, Dam TL, Nevitt MC, Lane NE (2010) Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men: the osteoporotic fractures in men study. Arthritis Rheum 62:511–514

    Article  PubMed  CAS  Google Scholar 

  8. Bettica P, Cline G, Hart DJ, Meyer J, Spector TD (2002) Evidence for increased bone resorption in patients with progressive knee osteoarthritis: longitudinal results from the Chingford study. Arthritis Rheum 46:3178–3184

    Article  PubMed  Google Scholar 

  9. von Hurst PR, Stonehouse W, Kruger MC, Coad J (2010) Vitamin D supplementation suppresses age-induced bone turnover in older women who are vitamin D deficient. J Steroid Biochem Mol Biol 121(1–2):293–296 [Epub 2010 Mar 19 ]

    Article  Google Scholar 

  10. Tsaei KS, Wahner HW, Offord KP, Melton LJ, Kumar R, Rigs BL (1987) Effect of aging on vitamin D stores and bone density in women. Calcif Tissue Int 40:241–243

    Article  Google Scholar 

  11. Bischoff-Ferrari HA, Zhang Y, Kiel DP, Felson DT (2005) Positive association between serum 25-hydroxyvitamin D level and bone density in osteoarthritis. Arthritis Rheum 53:821–826

    Article  PubMed  CAS  Google Scholar 

  12. Mäkinen TJ, Alm JJ, Laine H, Svedström E, Aro HT (2007) The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement. Bone 40:1041–1047

    Article  PubMed  Google Scholar 

  13. Altman R, Asch E, Bloch D, Boil G, Borestein D, Brandt K, Cheristy W, Cooke TD, Greenwald R, Hochberg M et al (1986) Development of criteria for classification and reporting of osteoarthritis of the knee. Arthtitis Rheum 29:1039–1049

    Article  CAS  Google Scholar 

  14. McAlindon TE, Felson DT, Zhang Y et al (1996) Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study. Ann Intern Med 125:353–359

    PubMed  CAS  Google Scholar 

  15. Lane NE, Gore LR, Cummings SR, Study of Osteoarthritis Fractures Research Group, et al (1999) Serum vitamin D levels and incident changes of radiographic hip osteoarthritis: a longitudinal study. Arthritis Rheum 42:854–860

    Article  PubMed  CAS  Google Scholar 

  16. Felson DT, Niu J, Clancy M, Aliabadi P, Sack B, Guermazi A, Hunter DJ, Amin S, Rogers G, Booth SL (2007) Low levels of vitamin D and worsening of knee osteoarthritis: results of two longitudinal studies. Arthritis Rheum 56:129–136

    Article  PubMed  CAS  Google Scholar 

  17. Jones G, Ding C, Scott F et al (2004) Early radiographic osteoarthritis is associated with substantial changes in cartilage volume and tibial bone surface area in both males and females. Osteoarthritis Cartilage 12:169–174

    Article  PubMed  CAS  Google Scholar 

  18. Davies-Tuck ML, Wluka AE, Wang Y, Teichtahl AJ, Jones G, Ding C, Cicuttini FM (2008) The natural history of cartilage defects in people with knee osteoarthritis. Osteoarthritis Cartilage 16:337–342

    Article  PubMed  CAS  Google Scholar 

  19. Dore D, Quinn S, Ding C, Winzenberg T, Jones G (2009) Correlates of subchondral BMD: a cross-sectional study. J Bone Miner Res 24:2007–2015

    Article  PubMed  Google Scholar 

  20. Break K, Huang WY, Fraser DR et al (2010) Low vitamin D status is associated with low physical activity, obesity, and low vitamin D intake in a large US sample of healthy middle age men and women. J Steroid Biochem Mol Biol 121:462–466

    Article  Google Scholar 

  21. Heidari B, Hajian K (2004) The role of age, weight and sex in knee osteoarthritis. J Qazvin Univ Med Sci 29:10–15

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Division of Rheumatology, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran

    Behzad Heidari

  2. Azad Islamic University of Karaj, Karaj, Iran

    Parham Heidari

  3. Department of Social Medicine, Babol University of Medical Sciences, Babol, Iran

    Karaim Hajian-Tilaki

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  1. Behzad Heidari
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  2. Parham Heidari
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  3. Karaim Hajian-Tilaki
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Correspondence to Behzad Heidari.

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Heidari, B., Heidari, P. & Hajian-Tilaki, K. Association between serum vitamin D deficiency and knee osteoarthritis. International Orthopaedics (SICOT) 35, 1627–1631 (2011). https://doi.org/10.1007/s00264-010-1186-2

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  • DOI: https://doi.org/10.1007/s00264-010-1186-2

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