Are 25(OH)D Levels Related to the Severity of Knee Osteoarthritis and Function?

Al-Jarallah, Khaled; Shehab, Diaa; Al-Awadhi, Adel; Nahar, Ibrahim; Haider, M.Z.; Moussa, Mohamed

doi:10.1159/000330025

Cited by 40 publications

(19 citation statements)

References 28 publications

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“…In knee OA subjects, studies investigating the association between vitamin D and physical function are scarce. Using Lequesne׳s indices to assess physical function in subjects with knee OA, Al-Jarallah et al [5] reported that serum 25(OH)D concentrations did not associate with physical function. In an intervention study, supplemental vitamin D (2000 IU/d for 2 y) increased serum 25(OH)D concentrations without improving physical function, such as standing from a chair or a 20-m walk, in subjects with knee OA [24].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis

Barker

Henriksen²,

Rogers³

et al. 2014

Redox Biology

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Knee osteoarthritis (OA) is a degenerative joint condition and a leading cause of physical disability in the United States. Quadriceps weakness and inflammatory cytokines contribute to the pathogenesis of knee OA, and both of which, increase with vitamin D deficiency. Other micronutrients, such as vitamins C and E and β-carotene, modulate inflammatory cytokines and decrease during inflammation. The purpose of this study was to test the hypothesis that vitamin D deficiency associates with quadriceps weakness, an increase in serum cytokines, and a decrease in circulating micronutrients in subjects with knee OA. Subjects (age, 48±1 y; serum 25(OH)D, 25.8±1.1 ng/mL) with knee OA were categorized as vitamin D deficient (n=17; serum 25(OH)D≤20 ng/mL), insufficient (n=21; serum 25(OH)D 20–29 ng/mL), or sufficient (n=18; serum 25(OH)D≥30 ng/mL). Single-leg strength (concentric knee extension–flexion contraction cycles at 60 °/s) and blood cytokine, carotene (α and β), ascorbic acid, and tocopherol (α and γ) concentrations were measured. Quadriceps peak torque, average power, total work, and deceleration were significantly (all p<0.05) impaired with vitamin D deficiency. Serum γ-tocopherol concentrations were significantly (p<0.05) increased with vitamin D deficiency. In the vitamin D sufficient group, γ-tocopherol inversely correlated (r=−0.47, p<0.05) with TNF-α, suggesting a pro-inflammatory increase with a γ-tocopherol decrease despite a sufficient serum 25(OH)D concentration. We conclude that vitamin D deficiency is detrimental to quadriceps function, and in subjects with vitamin D sufficiency, γ-tocopherol could have an important anti-inflammatory role in a pathophysiological condition mediated by inflammation.

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Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis

Barker

Henriksen²,

Rogers³

et al. 2014

Redox Biology

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“…While some observational studies suggest a threshold of 25 hydroxyvitamin D levels above 36 ng/ml is needed for lower osteoarthritis risk (2, 7), others find no association (4, 8, 9, 10). In previously reported analyses in WHI CT participants, women with low serum 25-hydroxyvitamin D levels did have statistically significantly higher joint pain scores compared to women with higher 25-hydroxyvitamin D levels but the threshold (seen in the lowest quintile) was a much lower 12 ng/ml (6) than found in some prior studies (2, 7) .The inconsistent observational study findings (25, 26, 27) support the need for randomized clinical trials to definitively address this issue.…”

Section: Discussionmentioning

confidence: 99%

“…Both low vitamin D intake (2, 3, 4) and low 25-hydroxyvitamin D levels, (5, 6, 7) as measures of vitamin D status have been associated with increased joint pain. However, vitamin D status has been associated with knee osteoarthritis in only some (2, 5, 7) but not all (4, 8, 9, 10) observational study reports. In addition, reports from full-scale randomized trials are sparse (11).…”

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confidence: 99%

Calcium Plus Vitamin D Supplementation and Joint Symptoms in Postmenopausal Women in the Women's Health Initiative Randomized Trial

Chlebowski¹,

Pettinger²,

Johnson³

et al. 2013

Journal of the Academy of Nutrition and Dietetics

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Background Low vitamin D intake and levels have been associated with increased joint symptoms in some observational studies but the findings are mixed and evidence from randomized trials sparse. Objective To evaluate the influence of supplemental calcium and vitamin D on joint symptoms in the Women's Health Initiative randomized, placebo-controlled, clinical trial. Design In post hoc analyses, the results of the WHI randomized clinical trial in which 36,282 postmenopausal women were randomized to calcium carbonate (1000 mg as elemental calcium) with vitamin D3 (400 IU) daily or placebo were examined in the 6% subgroup of 1911 participants, over-sampled for minorities, who had serial joint symptom assessment. Qualitative information on joint pain and joint swelling was collected by questionnaire before entry and 2 years after randomization. Logistic regression models were used to compare the occurrence and severity of joint symptoms across randomization groups. Results At baseline, total calcium and vitamin D intakes from diet and supplements were similar in the two randomization groups. In addition, both joint pain (reported by 73%) and joint swelling (reported by 34%) were commonly reported and comparable in the supplement and placebo groups. Two years after randomization, no statistically significant differences between supplement and placebo groups were seen for joint pain frequency (74.6% compared to 75.1%, [P=0.79] for supplement and placebo groups, respectively) or joint swelling frequency (34.6% compared to 32.4%, [P=0.29], respectively) or in severity scores for either outcome. Subgroup analyses suggested study participants also using non-protocol calcium supplements at study entry may have less joint pain with supplement group randomization (interaction P-value=0.02).. Conclusions Joint symptoms are relatively common in postmenopausal women. However, daily supplementation with 1000 mg of calcium carbonate and 400 IU of vitamin D3 in a randomized, placebo-controlled clinical trial setting did not reduce the self-reported frequency or severity of joint symptoms.

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“…A significant association between serum 25-OHD deficiency and knee OA has been found [49, 50]. It has been suggested that serum 25-OHD shall be measured in any patients with symptoms suggestive of knee OA particularly at the initial stage of disease [49].…”

Section: Vitamin D and Osteoarthritismentioning

confidence: 99%

“…It has been suggested that serum 25-OHD shall be measured in any patients with symptoms suggestive of knee OA particularly at the initial stage of disease [49]. Although the level of 25(OH)D seems not to be related to the severity of the knee X-ray grading or to the functional assessment [50]. …”

Section: Vitamin D and Osteoarthritismentioning

confidence: 99%

Vitamin D and Bone Disease

Christodoulou

Goula

Ververidis

et al. 2013

BioMed Research International

120

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Vitamin D is important for normal development and maintenance of the skeleton. Hypovitaminosis D adversely affects calcium metabolism, osteoblastic activity, matrix ossification, bone remodeling and bone density. It is well known that Vit. D deficiency in the developing skeleton is related to rickets, while in adults is related to osteomalacia. The causes of rickets include conditions that lead to hypocalcemia and/or hypophosphatemia, either isolated or secondary to vitamin D deficiency. In osteomalacia, Vit. D deficiency leads to impairment of the mineralisation phase of bone remodeling and thus an increasing amount of the skeleton being replaced by unmineralized osteoid. The relationship between Vit. D and bone mineral density and osteoporosis are still controversial while new evidence suggests that Vit. D may play a role in other bone conditions such as osteoarthritis and stress fractures. In order to maintain a “good bone health” guidelines concerning the recommended dietary intakes should be followed and screening for Vit. D deficiency in individuals at risk for deficiency is required, followed by the appropriate action.

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Are 25(OH)D Levels Related to the Severity of Knee Osteoarthritis and Function?

Cited by 40 publications

References 28 publications

Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis

Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis

Calcium Plus Vitamin D Supplementation and Joint Symptoms in Postmenopausal Women in the Women's Health Initiative Randomized Trial

Vitamin D and Bone Disease

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