Vitamin D status in patients with knee or hip osteoarthritis in a Mediterranean country

Abstract

BackgroundVitamin D plays an important role in bone mineralization, remodeling, and maintenance and therefore its deficiency may be implicated in the pathogenesis of osteoarthritis (OA). Vitamin D status was evaluated in patients with knee or hip OA scheduled for joint replacement. The impact of anthropometric parameters such as gender, age, and body mass index on vitamin D levels was also examined. The study was conducted in a Mediterranean country (Greece).Materials and methodsWe included 164 patients with knee or hip OA scheduled for joint replacement in this study. Serum levels of 25-hydroxyvitamin D (vitamin D) were measured in routine blood samples taken from the patients at their pre-admission visit, a week before the operation, using radioimmunoassay.ResultsThe majority of patients were vitamin D deficient (81.7 %); 15.2 % of them were vitamin D insufficient (hypovitaminosis). Only 3 % of patients were vitamin D sufficient. There was a significantly positive association between vitamin D levels and male gender.ConclusionThese findings indicate a large percentage of vitamin D deficient patients with knee or hip OA, which is unexpected considering the high annual insolation in northern Greece. Many other possible predisposing factors for OA should be taken into consideration. Whether treatment with vitamin D supplements may provide beneficial effects to these patients and the stage of disease in which this treatment should commence remains an issue for further scientific investigation.Level of evidenceLevel IV.

Association Between Preoperative Vitamin D Status and Short-Term Physical Performance after Total Hip Arthroplasty: A Prospective Study

“…Furthermore, a meta-analysis of 13 RCTs reported a beneficial effect of vitamin D supplementation (800-100 IU/day) on measures of muscle strength and balance in individuals aged 60 years and older [9]. A metaanalysis of 30 RCTs in individuals of all ages showed a significant positive effect of vitamin D supplementation on muscle strength, which was most evident in people with a 25-hydroxyvitamin D 3 (25[OH]D 3 ) level < 30 nmol/L and in those who were older than 65 years [10]. Vitamin D plays a direct role on muscle quality via activation of the vitamin D receptors, which are involved in muscle protein synthesis and muscle growth [6,8].…”

Vitamin D deficiency showed association with knee osteoarthritis in Tamilnadu population – A pilot study

“…Increasing bone resorption by the elevated levels of parathyroid hormone (PTH) increasing bone turn over, or effect of vitamin D metabolites directly on articular chondrocytes were some of the mechanisms put forwarded to explain the role of vitamin D deficiency in osteoarthritis. 3,6,9,15 Early structural changes in the joints such as defects in cartilage, decrease in volume of cartilage, expansion of sub-chondral bone, and lesions in bone marrow will appear before the onset of clinical symptoms of OA. Reports and observations from earlier studies provided a rationale for the measurement of serum 25-OH vitamin D levels with appearance of knee OA in elderly people and encourage supplementation to raise the serum vitamin D concentration to adequate levels.…”

“…Reports and observations from earlier studies provided a rationale for the measurement of serum 25-OH vitamin D levels with appearance of knee OA in elderly people and encourage supplementation to raise the serum vitamin D concentration to adequate levels. [14][15][16] Epidemiological studies showed an association between dietary intake and serum levels of 25-hydroxy vitamin D and the progression of hip 14,15 and knee OA. 12,16 In a recent study, decreased serum level of 25-hydroxy vitamin D was reported in a significant proportion of patients with OA of hip and knee joints.…”

“…14,[16][17][18][19] All these epidemiological suggests that by achieving normal serum vitamin D level may prevent or delay loss of cartilage loss and reduce the pain and other symptoms of OA. [15][16][17][18] Observation from studies on knee osteoarthritis evaluated by Cao et al suggested that serum 25-OH vitamin D level play an important role in structural changes of knee osteoarthritis. 17 In another study done by Bergink et al also, reported three times increased risk of knee OA and disease progress was associated with serum 25-OH vitamin D <20 ng/ml in the Rotterdam Study.…”

Vitamin D Status and Patient Outcomes after Knee or Hip Surgery: A Meta-Analysis

“…Therefore, future trials will refine the evidence achieved herein. Vitamin D deficiency is found to be associated with the development and progression of osteoarthritis [36], and a relatively high proportion of patients with osteoarthritis of hip or knee are reported to be vitamin D deficient [37][38][39]. However, in large longitudinal epidemiological studies, the Framingham Osteoarthritis Study and the Boston Osteoarthritis of the Knee Study, no relationship was found between the risk of joint space or cartilage loss in knee osteoarthritis, although the risk of worsening osteoarthritis was rather slightly (not statistically significantly) lower in vitamin D deficient persons [40].…”