Effect of vitamin D levels on radiographic knee osteoarthritis and functional status

Bedriye Mermerci Başkan, Fatma Gül Yurdakul, Ezgi Aydın, Filiz Sivas, Hatice Bodur, Bedriye Mermerci Başkan, Fatma Gül Yurdakul, Ezgi Aydın, Filiz Sivas, Hatice Bodur

Abstract

Objectives: This study aims to investigate the effect of serum levels of 25 hydroxyvitamin D (25(OH)D) in patients with primary knee osteoarthritis (OA) and to assess its relationship with the radiographic grading and functional status.

Patients and methods: Serum 25(OH)D levels were measured in 107 patients (90 females, 17 males; mean age 63.0±9.6 years; range, 40 to 86 years) with primary knee OA. Radiographic grading was based on the Kellgren-Lawrence Grading Scale and the Osteoarthritis Research Society International (OARSI) Atlas Grading Scale, while the functional status was assessed using the Lequesne indices and Turkish version of the Knee Injury and Osteoarthritis Outcome Score-Physical Function Short-Form (KOOS-PS). Pain was evaluated using the Visual Analog Scale for Pain (VAS-Pain). Data including age, sex, disease duration, body mass index (BMI), and pain severity were recorded.

Results: The mean 25(OH)D level was 13.4±10.6 ng/mL, and 90 patients (84.1%) had vitamin D deficiency. The presence of severe osteophytes was observed in 67 patients (62.6%) and 85 patients (79.4%) had Grade 2-3 joint space narrowing (JSN). The mean KOOS-PS and Lequesne scores were 40.1±12.3 and 12.9±3.6, respectively. There was no correlation between serum 25(OH)D levels and functional status.

Conclusion: Our study results show that serum 25(OH)D level is not related to the severity of the radiographic knee OA grading or to the functional assessment. Age and BMI are the factors affecting the radiological knee OA severity, while age, sex, BMI, and pain severity are the main determinants of the functional status.

Keywords: Functional status; knee osteoarthritis; radiographic grading; vitamin D.

Conflict of interest statement

Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

References

    1. Samuels J, Krasnokutsky S, Abramson SB. Osteoarthritis: a tale of three tissues. Bull NYU Hosp Jt Dis. 2008;66:244–250.
    1. Kwan Tat S, Lajeunesse D, Pelletier JP, Martel-Pelletier J. Targeting subchondral bone for treating osteoarthritis: what is the evidence. Best Pract Res Clin Rheumatol. 2010;24:51–70.
    1. Fidan F, Alkan BM, Tosun A. Pandemic era: Vitamin D deficiency and insufficiency. Turkish Journal of Osteoporosis. 2014;20:71–74.
    1. McAlindon TE, Felson DT, Zhang Y, Hannan MT, Aliabadi P, Weissman B, et al. 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. 1996;125:353–359.
    1. Heidari B, Heidari P, Hajian-Tilaki K. Association between serum vitamin D deficiency and knee osteoarthritis. Int Orthop. 2011;35:1627–1631.
    1. Al-Jarallah KF, Shehab D, Al-Awadhi A, Nahar I, Haider MZ, Moussa MA. Are 25(OH)D levels related to the severity of knee osteoarthritis and function. Med Princ Pract. 2012;21:74–78.
    1. Felson DT, Niu J, Clancy M, Aliabadi P, Sack B, Guermazi A, et al. Low levels of vitamin D and worsening of knee osteoarthritis: results of two longitudinal studies. Arthritis Rheum. 2007;56:129–136.
    1. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29:1039–1049.
    1. Kellgren JH, Lawrence JS. Radiological assessment of osteo- arthrosis. Ann Rheum Dis. 1957;16:494–502.
    1. Altman RD, Hochberg M, Murphy WA Jr, Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage. 1995;3:3–70.
    1. D'Agostino MA, Conaghan P, Le Bars M, Baron G, Grassi W, Martin-Mola E, et al. EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: prevalence of inflammation in osteoarthritis. Ann Rheum Dis. 2005;64:1703–1709.
    1. Lequesne MG. The algofunctional indices for hip and knee osteoarthritis. J Rheumatol. 1997;24:779–781.
    1. Gul ED, Yilmaz O, Bodur H. Reliability and validity of the Turkish version of the knee injury and osteoarthritis outcome score-physical function short-form (KOOS-PS) J Back Musculoskelet Rehabil. 2013;26:461–466.
    1. Cherniack EP, Florez H, Roos BA, Troen BR, Levis S. Hypovitaminosis D in the elderly: from bone to brain. J Nutr Health Aging. 2008;12:366–373.
    1. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–281.
    1. Cao Y, Winzenberg T, Nguo K, Lin J, Jones G, Ding C. Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. Rheumatology (Oxford) 2013;52:1323–1334.
    1. Bergink AP, Uitterlinden AG, Van Leeuwen JP, Buurman CJ, Hofman A, Verhaar JA, et al. Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: The Rotterdam Study. J Clin Rheumatol. 2009;15:230–237.
    1. Greene-Finestone LS, Berger C, de Groh M, Hanley DA, Hidiroglou N, Sarafin K, et al. 25-Hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates. Osteoporos Int. 2011;22:1389–1399.
    1. Rodriguez A, Santa Marina L, Jimenez AM, Esplugues A, Ballester F, Espada M, et al. Vitamin D Status in Pregnancy and Determinants in a Southern European Cohort Study. Paediatr Perinat Epidemiol. 2016;30:217–228.
    1. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006;81:353–373.
    1. Santos MJ, Fernandes V, Garcia FM. Vitamin D Insufficiency in a Hospital Population: A Photograph from the Laboratory Perspective. Acta Med Port. 2015;28:726–734.
    1. Al-Faris NA. High Prevalence of Vitamin D Deficiency among Pregnant Saudi Women. Nutrients. 2016;8:77–77.
    1. Altınova AE, Aktürk M, Törüner F, Kaya M, Bukan N, Yetkin İ, et al. Tip 2 diyabetli hastalarda D vitamini eksikliği prevalansı ve CRP, fibrinojen, glisemik kontrol ve insülin direnci ile ilişkisi. Gazi Tıp Dergisi. 2010;21:117–120.
    1. Öztürk G, Bulut E, Akyol S, Taşlıpınar MY, Giniş Z, Uçar F, et al. The effect of serum 25(OH) vitamin D on hemogram parameters. Dicle Medical Journal. 2014;40:332–334.
    1. Çolak AA, Doğan N, Bozkurt Ü, Avcı R, Karademirci I. Vitamin D status in women in İzmir. Tepecik Eğit ve Araşt Hast Dergisi. 2015;25:38–42.
    1. Çidem M, Kara S, Hakan S, Özkaya M, Karacan İ. Prevalence and risk factors of vitamin D deficiency in patients with widespread musculoskeletal pain. Journal of Clinical and Experimental Investigations. 2013;4:488–491.
    1. Muraki S, Dennison E, Jameson K, Boucher BJ, Akune T, Yoshimura N, et al. Association of vitamin D status with knee pain and radiographic knee osteoarthritis. Osteoarthritis Cartilage. 2011;19:1301–1306.
    1. Ding C, Cicuttini F, Parameswaran V, Burgess J, Quinn S, Jones G. Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the Tasmanian older adult cohort study. Arthritis Rheum. 2009;60:1381–1389.
    1. Hunter DJ, Hart D, Snieder H, Bettica P, Swaminathan R, Spector TD. Evidence of altered bone turnover, vitamin D and calcium regulation with knee osteoarthritis in female twins. Rheumatology (Oxford) 2003;42:1311–1316.
    1. McAlindon TE, Cooper C, Kirwan JR, Dieppe PA. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis. 1993;52:258–262.
    1. Creamer P, Lethbridge-Cejku M, Hochberg MC. Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology (Oxford) 2000;39:490–496.
    1. Jordan JM, Luta G, Renner JB, Linder GF, Dragomir A, Hochberg MC, et al. Self-reported functional status in osteoarthritis of the knee in a rural southern community: the role of sociodemographic factors, obesity, and knee pain. Arthritis Care Res. 1996;9:273–278.
    1. Mabey T, Honsawek S. Role of Vitamin D in Osteoarthritis: Molecular, Cellular, and Clinical Perspectives. Int J Endocrinol. 2015;2015:383918–383918.
    1. Sanghi D, Mishra A, Sharma AC, Singh A, Natu SM, Agarwal S, et al. Does vitamin D improve osteoarthritis of the knee: a randomized controlled pilot trial. Clin Orthop Relat Res. 2013;471:3556–3562.
    1. Glover TL, Goodin BR, King CD, Sibille KT, Herbert MS, Sotolongo AS, et al. A Cross-sectional Examination of Vitamin D, Obesity, and Measures of Pain and Function in Middle-aged and Older Adults With Knee Osteoarthritis. Clin J Pain. 2015;31:1060–1067.

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