The role of low levels of vitamin D as a co-factor in the relapse of benign paroxysmal positional vertigo (BPPV)

Elmoursy, Mohamed Mohamed; Abbas, Afroze

doi:10.1016/j.amjoto.2021.103134

Cited by 9 publications

(14 citation statements)

References 31 publications

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“…This evidence and the outcomes of some recent trials [ 17 , 18 , 19 , 20 , 41 ] and meta-analysis [ 22 , 42 ] support the therapeutic effectiveness of the correction of hypovitaminosis D in patients with recurrent BPPV.…”

Section: Discussionmentioning

confidence: 58%

“…In recent literature, serum 25 (OH) D levels were correlated with higher BPPV occurrence, although some Authors have provided controversial results [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Otoconia in mammals’ inner ears are composed of calcium carbonate crystals and glycoproteins. In recent years, several studies suggested that calcium metabolism disorders related to vitamin D deficiency might affect otoconia homeostasis, increasing the BPPV recurrence and the incidence of complicated forms [ 12 , 13 , 14 , 15 , 16 , 17 ]. An increasing number of studies investigated the efficacy of 1,25-dihydroxyvitamin D (or vitamin D3) supplementation in reducing BPPV recurrence [ 13 , 18 , 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants

et al. 2022

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Benign paroxysmal positional vertigo (BPPV) usually has a favorable course, although it is possible to observe BPPV with a high recurrence rate. Previous studies suggested that vitamin D deficiency might affect BPPV recurrences, and oxidative stress might play a complementary role in BPPV pathogenesis. This multicentric trial aimed to evaluate the effectiveness of oral nutritional supplementation with a compound of alpha-lipoic acid, Carnosine, and Zinc (LICA® (Difass International, Coriano (RN), Italy)), vitamins of group B and vitamin D in preventing BPPV recurrences. A total of 128 patients with high recurrence-BPPV were randomized in three arms: Arm 1 consisted of subjects with “insufficient” or “deficient” vitamin D blood levels, treated with daily oral supplementation of LICA®, vitamins of group B and vitamin D3 (800 UI), Arm 2 included BPPV subjects with “sufficient” vitamin D who did not receive any nutritional support, and Arm 3 included subjects with a “sufficient” serum concentration of vitamin D who received supplementation with a compound of LICA® and Curcumin. After six months of follow-up, a significant reduction of BPPV relapses compared to the baseline was found only in Arm 1 (−2.32, 95% CI: 3.41–1.62, p-value < 0.0001). Study results suggested that oral nutritional supplementation with vitamin D3 plus antioxidants can prevent relapses in patients suffering from high recurrence-BPPV.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants

et al. 2022

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“…However, based on our data, low vitamin D status existed in BPPV patients and vitamin D deficiency was a risk predictor for BPPV. According to earlier studies, vitamin D supplementation is beneficial in preventing BPPV, 4,28 and treatment is needed only in BPPV patients with reduced vitamin D levels, not all patients. 27 UA is a metabolite of purine and acts as a strong endogenous protective antioxidant in neurodegenerative diseases.…”

Section: Discussionmentioning

confidence: 99%

Low vitamin D and uric acid status in patients with benign paroxysmal positional vertigo

Ren,

Wang,

et al. 2023

Science Progress

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Purpose Growing evidence reported that vitamin D and uric acid metabolism played roles in the occurrence of benign paroxysmal positional vertigo, an otoconia-related vestibular disorder. We aimed to investigate the serum 25-hydroxy vitamin D (25(OH)D) and uric acid in patients with benign paroxysmal positional vertigo and to determine the risk factor for benign paroxysmal positional vertigo. Methods This case-control study comprised 182 patients with benign paroxysmal positional vertigo and 182 age- and gender-matched controls. All subjects’ age, body mass index, systolic blood pressure, diastolic blood pressure, 25-hydroxyvitamin D (25(OH)D), uric acid and serum calcium measurements were analyzed. Results We found a female preponderance of benign paroxysmal positional vertigo patients, with a median of 60 (52–66) years old. The results showed low vitamin D status both in benign paroxysmal positional vertigo and controls, with no significant difference of 25(OH)D levels between benign paroxysmal positional vertigo patients and controls ( P > 0.05). Compared with the control group, patients with benign paroxysmal positional vertigo had a higher prevalence of vitamin D deficiency and a lower prevalence of vitamin D sufficiency ( P < 0.05). Uric acid was significantly lower in the benign paroxysmal positional vertigo groups ( P < 0.05). Logistic regression analysis revealed that age and uric acid were considered higher risk predictors for benign paroxysmal positional vertigo. Conclusion Our study observed low vitamin D status in patients with benign paroxysmal positional vertigo, with no significant differences of the 25(OH)D level in patients with benign paroxysmal positional vertigo and controls. Elderly, vitamin D deficiency and low uric acid levels may be risk factors for benign paroxysmal positional vertigo occurrence.

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“…The relationship between BPPV recurrence and serum 25-hydroxyvitamin D was examined in 12 studies, with 9 studies reporting lower serum vitamin D levels in patients with recurrent BPPV compared with those experiencing an initial attack1 31 35–37 42 45 46 and 3 reporting no significant difference in vitamin D levels between the 2 groups 38 47 48. Three studies41 49 50 reported that vitamin D supplementation reduced the number of recurrent episodes of BPPV. Vitamin D supplementation was seen to improve the bone mineral density of BPPV patients in one study, however, the effects on BPPV recurrence were not reported 51…”

Section: Quality Assessmentmentioning

confidence: 99%

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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The role of low levels of vitamin D as a co-factor in the relapse of benign paroxysmal positional vertigo (BPPV)

Cited by 9 publications

References 31 publications

Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants

Prevention of Recurrent Benign Paroxysmal Positional Vertigo: The Role of Combined Supplementation with Vitamin D and Antioxidants

Low vitamin D and uric acid status in patients with benign paroxysmal positional vertigo

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

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