Low 25-Hydroxyvitamin D Levels Are Associated With Residual Dizziness After Successful Treatment of Benign Paroxysmal Positional Vertigo

Wu, Yunqin; Han, Kun; Wei, Han; Fan, Zhenyi; Zhou, Min; Lu, Xiaoxiong; Liu, Xiaoxia; Li, Li; Du, Liwen

doi:10.3389/fneur.2022.915239

Cited by 5 publications

(11 citation statements)

References 30 publications

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“…There is little relevant literature on whether 25(OH)D deficiency is associated with RD. Wu et al (14) recently reported that low 25(OH)D levels are associated with the development of RD in patients with PC-BPPV. In our study, we quantified and stratified the severity of RD by VAS.…”

Section: Discussionmentioning

confidence: 99%

“…Even though accumulating evidence has revealed that the low 25(OH)D level in serum increases the odds of BPPV occurrence and recurrence, whether it also contributes to RD still needs further exploration. Currently, only one study explored its effect on RD in 123 patients with posterior semicircular canal BPPV and found that low vitamin D levels were also associated with RD after successful treatment of BPPV (14). Since there were sex-and agerelated differences in the vitamin D level in BPPV (15), whether these factors may influence the effect of vitamin D level on RD merits investigation.…”

Section: Introductionmentioning

confidence: 99%

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Effect of the serum 25-hydroxyvitamin D level on risk for short-term residual dizziness after successful repositioning in benign paroxysmal positional vertigo stratified by sex and onset age

Jiang

Bai

et al. 2023

Front. Neurol.

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ObjectiveA low serum 25-hydroxyvitamin D (25(OH)D) level is relevant to both the occurrence and recurrence of benign paroxysmal positional vertigo (BPPV). However, whether it also contributes to residual dizziness (RD) after successful repositioning maneuvers is unknown. Therefore, this study aimed to explore the correlation between the serum 25(OH)D level and short-term RD severity in patients with BPPV after successful repositioning maneuvers.MethodsIn total, 251 patients with BPPV after successful repositioning were enrolled and prospectively followed up for 1 week (W1). Serum 25(OH)D values were detected by chemiluminescence immunoassay at enrollment (W0). In addition, we explored the relationship between 25(OH)D values at baseline and RD severity at W1 in different subgroups stratified by sex and onset age (early-onset, ≤50 years; late-onset, >50 years).ResultsThe serum 25(OH)D level of female patients was significantly lower than that of male patients (15.9 ± 6.8 vs. 19.8 ± 6.6 ng/ml, p < 0.001). Its level also decreased in early-onset patients compared to late-onset ones (15.3 ± 5.9 vs. 18.0 ± 7.3 ng/ml, p = 0.003). In addition, early-onset female patients had lower 25(OH)D values than late-onset female patients (14.0 ± 5.5 vs. 17.1 ± 7.2 ng/ml, p = 0.004). However, this difference was not observed between early- and late-onset male patients. Among early-onset female patients, the 25(OH)D values of the moderate-to-severe RD group were lower than those of the minor or no RD group (10.9 ± 3.3 vs. 14.7 ± 5.7 vs. 15.0 ± 5.9 ng/ml, p = 0.046). Multivariate analysis found that decreased 25(OH)D values were related to the occurrence of moderate-to-severe RD in early-onset female patients (OR = 0.801; p = 0.022). This effect did not exist in late-onset female or male patients with BPPV.ConclusionsAge and sex differences in serum 25(OH)D levels exist in patients with BPPV. A decreased 25(OH)D level in early-onset female patients may increase the odds of moderate-to-severe RD 1 week after successful repositioning maneuvers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of the serum 25-hydroxyvitamin D level on risk for short-term residual dizziness after successful repositioning in benign paroxysmal positional vertigo stratified by sex and onset age

Jiang

Bai

et al. 2023

Front. Neurol.

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“…Among cases and controls with osteoporosis and osteopenia, two studies2 43 found no significant difference between cases and controls, although osteoporosis was correlated with low serum vitamin D in BPPV patients 2. Serum vitamin D levels were also reported to be lower in recovering BPPV patients with residual dizziness, compared with those without 44…”

Section: Quality Assessmentmentioning

confidence: 99%

“…These described a total of 7387 participants (2325 cases; 5062 controls), ranging in age from 18 to 88 years and sex distribution from 0% to 100% male. Seven studies were excluded for the following reasons: four because the case and control groups both had BPPV,44 46 49 51 two as SD was not reported28 41 and one as vitamin D levels were not given in ng/mL 43. Combined mean averages and SD were calculated for cases and controls using data provided in three studies1 35 55 as these were initially reported according to groups (age, sex, BPPV recurrence).…”

Section: Meta-analysismentioning

confidence: 99%

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Association between vitamin D deficiency and benign paroxysmal positional vertigo (BPPV) incidence and recurrence: a systematic review and meta-analysis

Wood,

Kluk,

BinKhamis

2024

BMJ Open

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ObjectivesThe objective of this study is to determine the relationship between serum vitamin D level and the risk of developing benign paroxysmal positional vertigo (BPPV) incidence and recurrence in countries in the Northern Hemisphere.DesignSystematic review and meta-analysis.Data sourcesPubMed, Scopus and Web of Science databases were searched for studies published between January 2000 and February 2023.Eligibility criteria for selecting studiesParticipants located in the Northern Hemisphere aged 18 or over with at least one episode of BPPV, serum 25-hydroxyvitamin D levels measured and reported, no comorbidities or history of vitamin D supplementation.Data extraction and synthesisData extraction and synthesis were performed by a single reviewer and checked by a second reviewer. Inclusion and exclusion criteria and risk of bias were assessed by two independent reviewers using the Newcastle Ottawa Tool for Cohort studies and Risk of Bias Assessment Tool for Nonrandomised Studies checklist for case–control studies. Meta-analysis was conducted using random effects models. Standard mean difference with a 95% CI was used to measure the relationship between vitamin D level and BPPV.ResultsThe 35 articles identified by the literature search reported data of 9843 individuals. 19 studies (7387 individuals) were included in the BPPV incidence meta-analysis while 7 studies (622 individuals) were included in the BPPV recurrence meta-analysis. Lower serum vitamin D levels were found in BPPV incidence compared with controls, but the relationship between vitamin D levels in recurrent BPPV compared with non-recurrent disease remained uncertain.ConclusionResults of this systematic review and meta-analysis demonstrated a negative correlation between serum vitamin D and BPPV incidence, while any relationship between serum vitamin D and BPPV recurrence remained uncertain. Risk of bias analysis revealed evidence of variable quality. There were insufficient data available to evaluate seasonal relationships between serum vitamin D and BPPV. Given the potential for this as a confounding factor, future research should aim to investigate this further.PROSPERO registration numberCRD42021271840.

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Randomized Controlled Trial Assessing Vitamin D's Role in Reducing BPPV Recurrence in Older Adults

Chua,

Huang,

Koh

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo determine if the recurrence rates of BPPV in older adults were lower in the vitamin D‐treated group as compared to placebo groups.Study DesignDouble‐blinded randomized control placebo trial.SettingA single‐centre study.MethodsDouble‐blinded randomized controlled trial design with 12 months follow‐up. Vitamin D3 deplete participants were randomized into treatment (Group A) or placebo groups (Group B). Treatment group received 13 weeks of 2000 IU vitamin D3 followed by 1000 IU for the next 13 weeks. Patients who were replete were allocated to a control group (Group C) for observation and follow up. All groups had dietary interventions for vitamin D3 and calcium.ResultsResults showed an 87% reduction in recurrence rates of BPPV in the treatment group (Group A), with 0.75 fewer clinical episodes per 1 person‐year as compared to placebo (Group B). Time to first recurrence was also significantly longer in Group A. There was no statistically significant difference between Group A and C in both recurrence rates and dizziness handicap scores.ConclusionsThis clinical trial has laid the foundation to expand the investigation of vitamin D as standard of care treatment in BPPV patients in future phase IIb and III studies.SummaryA reduction in BPPV episodes in older adults has implications on fall risk, as dizziness from BPPV may cause falls. With fewer BPPV episodes and longer time to recurrence, seniors may have better postural stability and hence reduced risk of falls.Level of Evidence2.

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Low 25-Hydroxyvitamin D Levels Are Associated With Residual Dizziness After Successful Treatment of Benign Paroxysmal Positional Vertigo

Cited by 5 publications

References 30 publications

Effect of the serum 25-hydroxyvitamin D level on risk for short-term residual dizziness after successful repositioning in benign paroxysmal positional vertigo stratified by sex and onset age

Effect of the serum 25-hydroxyvitamin D level on risk for short-term residual dizziness after successful repositioning in benign paroxysmal positional vertigo stratified by sex and onset age

Association between vitamin D deficiency and benign paroxysmal positional vertigo (BPPV) incidence and recurrence: a systematic review and meta-analysis

Randomized Controlled Trial Assessing Vitamin D's Role in Reducing BPPV Recurrence in Older Adults

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