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Tekeli SÖ, Köse Ö, Yapar D, Tekeli FY, Asoğlu MM, Kartal EM. Relationship between serum vitamin D levels and the prevalence of knee osteoarthritis: A retrospective study on 3424 subjects. Technol Health Care 2024; 32:3649-3658. [PMID: 38306069 DOI: 10.3233/thc-230802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND The extent of the association between vitamin D deficiency and knee osteoarthritis remains inadequately understood. OBJECTIVE This study aimed to elucidate the relationship between vitamin D levels and knee osteoarthritis through a cross-sectional analysis. METHODS This retrospective study involved an analysis of knee radiographs and serum 25-hydroxyvitamin D3 (25-(OH) vitamin D3) levels in a cohort of 3424 individuals (2901 women and 523 men). Knee osteoarthritis severity was evaluated using the Kellgren-Lawrence radiological scoring system. RESULTS Of the participants, 49.2% (n= 1,683) were diagnosed with knee osteoarthritis. Among these patients, the levels of adjusted 25-(OH) vitamin D3 were significantly lower (p< 0.001). Regression analysis revealed a significant association between vitamin D deficiency and knee osteoarthritis, with an adjusted odds ratio (OR) of 1.7 (95% CI: 1.5-2.0; p< 0.001). Notably, a stronger association was observed between vitamin D deficiency and knee osteoarthritis in women under 65 compared to those aged 65 and above. CONCLUSIONS The findings of this study indicate a higher prevalence of vitamin D deficiency in patients with knee osteoarthritis. Maintaining adequate serum 25-(OH) vitamin D3 levels may prevent knee osteoarthritis, especially in women below 65.
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Affiliation(s)
- Seçkin Özgür Tekeli
- Department of Biochemistry, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Özkan Köse
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
- Department of Anatomy, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Dilek Yapar
- Department of Public Health, Ministry of Health, Antalya, Turkey
| | - Feyza Yağmur Tekeli
- Department of Biochemistry, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Mehmet Melih Asoğlu
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Emre Mücahit Kartal
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
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Annamalai R, Sujhithra A, Danis Vijay D. Association between vitamin D and knee osteoarthritis in Indian population: A systematic review and meta-analysis. J Clin Orthop Trauma 2023; 46:102278. [PMID: 38059053 PMCID: PMC10696121 DOI: 10.1016/j.jcot.2023.102278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/20/2023] [Accepted: 11/03/2023] [Indexed: 12/08/2023] Open
Abstract
Background Vitamin D deficiency (VDD) has been implicated in knee osteoarthritis (KOA) development and progression. Prevalence of hypovitaminosis D and osteoporosis in KOA is widely reported in Indian population. However, there is no attempt to critically evaluate the outcome of these studies. We aimed a systematic review of these studies. Methods Pubmed, Google Scholar and Web of Science last updated March 2023, were searched. We reviewed eligible studies on the association between KOA and vitamin D levels in Indian and Asian population for comparison. The mean difference (MD) of vitamin D levels and odds ratio (OR) of vitamin D status were calculated. Data were interpreted by RevMan 5.4 software. The risk of bias was assessed using the Cochrane Risk of Bias tool. Results A total of 15 studies that involved 1503 KOA cases and 1609 controls were included. There was significantly reduced level of vitamin D in KOA (MD -8.68 ng/mL, 95%CI -12.21 to -5.15; P = <0.00001, I2 = 82 %) in Indian population. Similarly, in other Asian population significantly reduced vitamin D levels in KOA (MD 18.36 ng/mL, 95%CI -34.72 to -2.00; P = <0.00001, I2 = 100 %) was observed in KOA. VDD was found to be positively correlated with an increased risk of KOA. Conclusion Early diagnosis and management of VDD may provide the opportunity to delay the ongoing degenerative process of KOA and this study indicates the importance of screening VDD even in sunlight rich regions.
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Affiliation(s)
- R. Annamalai
- Department of Orthopedics, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, P.O, GST Road, Chinna Kolambakkam, Palayanoor, Maduranthakam, 603 308, Tamilnadu, India
| | - A. Sujhithra
- Department of Cardiology, Allied Health Sciences, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, P.O, GST Road, Chinna Kolambakkam, Palayanoor, Maduranthakam, 603 308, Tamilnadu, India
| | - D. Danis Vijay
- Department of Microbiology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, P.O, GST Road, Chinna Kolambakkam, Palayanoor, Maduranthakam, 603 308, Tamilnadu, India
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Elbashir M, Shubayr N, Alghathami A, Ali S, Alyami A, Alumairi N, Abdelrazig A, Omer AM, Elbasheer O. Investigation of Vitamin D Status, Age, and Body Mass Index as Determinants of Knee Osteoarthritis Severity Using the Kellgren-Lawrence Grading System in a Saudi Arabian Cohort: A Cross-Sectional Study. Cureus 2023; 15:e47523. [PMID: 38021605 PMCID: PMC10664693 DOI: 10.7759/cureus.47523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background Knee osteoarthritis (OA) is a common and disabling condition affecting millions worldwide. This cross-sectional study endeavors to investigate the relationship between vitamin D status, age, body mass index (BMI), and knee OA in a cohort of individuals in Saudi Arabia. Methods In this cross-sectional study, we assessed vitamin D serum levels, conducted knee radiographs, and evaluated the severity of knee OA using the Kellgren-Lawrence grading system (KLGS). The analysis incorporated both descriptive and inferential statistics, including chi-square tests and a regression model to investigate the relationship between KLGS grades as indicators of knee OA severity and vitamin D levels, considering demographics as covariants. Results The study included 93 participants with suspected knee OA, of which a substantial portion of the sample population presented with knee OA (58 [62.4%]). Knee OA exhibited a higher prevalence among females, comprising 47 (50.54%) of the total, while 11 (11.83%) were male. The largest age group with knee OA was those older than 58 years, 27 (29.03%), followed by the age group of 48-58 years, 19 (20.43%). Obesity was a prevalent factor among knee OA patients (36 [38.7%]), with grade 2 (17 [18.3%]) and grade 3 (24 [25.8%]) being the most frequent. Vitamin D deficiency was prevalent in 54 (58%) of patients. Among knee OA cases, bilateral involvement was predominant in 46 (79%), with a substantial portion, 36 (62%), presenting deficient vitamin D levels. The regression model revealed that age (95% CI: 0.54-1.03, p < 0.001) and BMI (95% CI: 0.01-0.60, p = 0.04) significantly predict higher KLGS grades, indicating that increasing age and higher BMI are associated with higher KLGS grades. However, Vitamin D levels did not show a significant impact on the severity of knee OA. Conclusions The findings from this study highlight the importance of monitoring and maintaining adequate vitamin D levels to potentially reduce the risk of knee OA and the need for early detection and intervention to manage knee OA, particularly in females, older poplulation, and obese adults. They may guide healthcare providers in developing comprehensive approaches to reduce the risk of this condition.
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Affiliation(s)
- Meaad Elbashir
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Nasser Shubayr
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Azhar Alghathami
- Department of Radiology, King Abdul Aziz Specialist Hospital, Taif, SAU
| | - Sara Ali
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Ali Alyami
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Neda Alumairi
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Ali Abdelrazig
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan, SAU
| | - Awatif M Omer
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah, SAU
| | - Ohood Elbasheer
- Department of Radiology, Olaya Polyclinic Complex, Riyadh, SAU
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Wang R, Wang ZM, Xiang SC, Jin ZK, Zhang JJ, Zeng JC, Tong PJ, Lv SJ. Relationship between 25-hydroxy vitamin D and knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne) 2023; 10:1200592. [PMID: 37601800 PMCID: PMC10433223 DOI: 10.3389/fmed.2023.1200592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
Objective In order to examine the relationship between 25-hydroxyl vitamin D and knee osteoarthritis (KOA), a meta-analysis of 8 randomized controlled trials (RCTs) publications was hereby performed. Methods For the purpose of finding pertinent research, the databases of PubMed, Embase and the Cochrane Library were searched. Factors including tibial cartilage volume, joint space width (JSW), synovial fluid volume, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were correspondingly evaluated, and the results were expressed using SMD and 95% confidence intervals (CI). Results The present meta-analysis evaluated the effects of vitamin D supplementation in patients with knee osteoarthritis, with 3,077 patients included. The results showed that vitamin D administration had a statistically significant impact on the amount of synovial fluid, Visual Analog Scale (VAS) and tibial cartilage. The pain and function scales of the WOMAC scale presented a statistically significant difference, and there was no discernible difference between the vitamin D and placebo groups in the stiffness scale. Additionally, bone marrow lesions and alterations in the diameter of the joint space were not influenced by the administration of vitamin D, and according to a subgroup study, a daily vitamin D supplement containing more than 2,000 IU significantly slowed the development of synovial tissue. Conclusion Vitamin D supplementation did benefit those suffering from knee discomfort and knee dysfunction. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022332033, identifier: CRD42022332033.
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Affiliation(s)
- Rui Wang
- Guanghua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Orthopedic Surgery, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Zheng-ming Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Si-cheng Xiang
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhao-kai Jin
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jing-jing Zhang
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ji-cheng Zeng
- The First Clinical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Pei-jian Tong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Shuai-jie Lv
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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Szulc M, Świątkowska-Stodulska R, Pawłowska E, Derwich M. Vitamin D 3 Metabolism and Its Role in Temporomandibular Joint Osteoarthritis and Autoimmune Thyroid Diseases. Int J Mol Sci 2023; 24:4080. [PMID: 36835491 PMCID: PMC9964750 DOI: 10.3390/ijms24044080] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
The aim of this review was to present the metabolism of vitamin D3, as well as to discuss the role of vitamin D3 in bone metabolism, temporomandibular joint osteoarthritis (TMJ OA), and autoimmune thyroid diseases (AITD) on the basis of the literature. Vitamin D3 plays a significant role in human health, as it affects the calcium-phosphate balance and regulates the bone metabolism. Calcitriol impresses the pleiotropic effect on human biology and metabolism. Its modulative function upon the immune system is based on the reduction of Th1 cell activity and increased immunotolerance. Vitamin D3 deficiency may lead to an imbalance in the relationship between Th1/Th17 and Th2, Th17/Th reg, and is considered by some authors as one of the possible backgrounds of autoimmune thyroid diseases (AITD), e.g., Hashimoto's thyroiditis or Graves' disease. Moreover, vitamin D3, through its direct and indirect influence on bones and joints, may also play an important role in the development and progression of degenerative joint diseases, including temporomandibular joint osteoarthritis. Further randomized, double blind studies are needed to unequivocally confirm the relationship between vitamin D3 and abovementioned diseases and to answer the question concerning whether vitamin D3 supplementation may be used in the prevention and/or treatment of either AITD or OA diseases.
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Affiliation(s)
- Michał Szulc
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland
| | - Renata Świątkowska-Stodulska
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-952 Gdańsk, Poland
| | - Elżbieta Pawłowska
- Department of Pediatric Dentistry, Medical University of Lodz, 90-419 Łódź, Poland
| | - Marcin Derwich
- Department of Pediatric Dentistry, Medical University of Lodz, 90-419 Łódź, Poland
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Naoum S. The Role of Vitamin D in the Development and Progression of Osteoarthritis. ROMANIAN JOURNAL OF MILITARY MEDICINE 2023. [DOI: 10.55453/rjmm.2023.126.3.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
"Low levels of vitamin D in patients with osteoarthritis (ΟΑ) rather adversely affect the structure and function of articular cartilage. Low levels of vitamin D are also associated with joint pain, limited physical activity, quality of life, as well as decreased muscle strength, primarily in the lower extremities with adverse OA progression. A high percentage of low vitamin D levels was found in patients with OA and joint arthroplasty as well as a less satisfactory postoperative follow-up in patients with low vitamin D levels. The administration of vitamin D supplementation in patients with knee osteoarthritis has been associated with improved articular cartilage architecture, and reduced joint pain, combined with improved functionality and quality of life in patients with OA. "
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Nemati M, Tabrizi R, Rasooli F, Ghafari S. Is the Prevalence of Vitamin D deficiency in Patients with Temporomandibular Disorder Higher than Healthy Control Group? J Maxillofac Oral Surg 2022; 21:1205-1208. [PMID: 36896049 PMCID: PMC9989067 DOI: 10.1007/s12663-021-01522-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/03/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose Vitamin D plays an essential role in subchondral bone, cartilage, and periarticular muscle. This study aims to assess the prevalence of vitamin D deficiency in temporomandibular disorder (TMD) patients. Materials and methods This is a cross-sectional study. Subjects were assigned into two groups based on having signs and symptoms of TMD: Group 1: subjects had TMD, and group 2 healthy group (control group). The serum level of vitamin D was measured in the two groups. The independent t test was used to compare the serum level of vitamin D between the study and control groups. Results One hundred ten subjects were studied into two groups (55 subjects in each group). The mean serum level of vitamin D was 18.13 ± 6.38 ng/mL in the study group and 31.83 ± 7.00 ng/mL in the control group. Analysis of the data demonstrated a significant difference in the mean serum level of vitamin D between the study and control groups (p = 0.001). Conclusion It seems the serum level of vitamin D is lower in TMD patients than in the healthy control group.
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Affiliation(s)
- Majid Nemati
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Tabrizi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faezeh Rasooli
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samin Ghafari
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Amirkhizi F, Asoudeh F, Hamedi-Shahraki S, Asghari S. Vitamin D status is associated with inflammatory biomarkers and clinical symptoms in patients with knee osteoarthritis. Knee 2022; 36:44-52. [PMID: 35500429 DOI: 10.1016/j.knee.2021.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/27/2021] [Accepted: 12/14/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIM The association between vitamin D status and osteoarthritis (OA) and bone remodeling has been shown previously. The present study was conducted to determine the association between vitamin D status and inflammatory biomarkers and clinical symptoms in patients with knee OA. METHODS This case-control study was performed on 124 subjects with mild to moderate knee OA and 65 healthy controls. Demographic data was collected from all participants at baseline. We used Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Index) for evaluating the severity of clinical symptoms in these patients. Serum levels of vitamin D as well as markers of inflammation including interleukin 1-β (IL-1β), interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor-alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and nuclear factor k-B (NF-κB) p65 were evaluated for each participant. RESULTS The results of the present study showed that patients with knee OA had lower levels of vitamin D and higher levels of IL-1β, TNF-α, hs-CRP, and NF-кB p65 compared with healthy controls (P < 0.0001). The levels of IL-1β, TNF-α, and NF-кB p65 in knee OA patients with vitamin D insufficiency were significantly higher compared with the knee OA patients with sufficient vitamin D (P < 0.05). Based on the linear regression analysis, serum vitamin D levels were inversely correlated with IL-1β, TNF-α, hs-CRP, and NF-кB p65 levels (P < 0.0001). Patients with sufficient vitamin D levels had lower total and physical function WOMAC scores compared with patients with vitamin D insufficiency (P = 0.011 and P = 0.010, respectively). CONCLUSION The results suggest a strong link between vitamin D deficiency and increased inflammatory biomarkers as well as increased severity of clinical symptoms in knee OA patients.
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Affiliation(s)
- Farshad Amirkhizi
- Department of Nutrition, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Farzaneh Asoudeh
- Department of Clinical Nutrition, Faculty of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Soudabeh Hamedi-Shahraki
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Somayyeh Asghari
- Department of Clinical Nutrition, Faculty of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Jeon YD, Cho SD, Youm YS, Song JY, Lee KJ, Park KB. The Prevalence of Vitamin D Deficiency in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis. Arch Osteoporos 2022; 17:53. [PMID: 35320426 PMCID: PMC8942953 DOI: 10.1007/s11657-022-01097-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 03/15/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE We investigated and compared the serum 25-OH vitamin D [25(OH)D] level and prevalence of vitamin D deficiency (VDD) between patients who underwent total knee arthroplasty (TKA) and healthy participants through a matched analysis. METHODS The unmatched case group consisted of 824 patients who underwent TKA and the unmatched control group 2,794 healthy participants examined at our institution. The control group was matched on the various characteristics-sex, age, weight, body mass index (BMI), blood chemistry, and season of sampling-through propensity score matching (PSM). After PSM, 501 and 721 patients were matched in the case and control group, respectively. Levels of blood chemistry including 25(OH)D were examined and VDD was defined as < 20 ng/mL. RESULTS The average serum 25(OH)D level was significantly lower in the OA group (15.3 ng/mL) than that in the control group (19.9 ng/mL, p < 0.001). When categorized using a 20 ng/mL cutoff, the VDD prevalence was 75.0% in the OA group and 59.4% in the control group. The prevalence of vitamin D insufficiency was 18.4% in the OA group and 24.5% in the control group. The prevalence of vitamin D sufficiency was 6.8% in the OA group and 15.9% in the control group (p < 0.001). CONCLUSIONS The patients who underwent TKA had lower serum 25(OH)D level and higher VDD prevalence compared to the healthy participants who matched using PSM. There were no differences in VDD rates by sex or obesity and the VDD prevalence was more than 70% during all season. Therefore, in patients undergoing TKA, general attention to VDD is required regardless of sex, obesity, and season. Serum 25-OH vitamin D [25(OH)D] level and vitamin D deficiency (VDD) prevalence were compared between patients undergoing total knee arthroplasty and healthy individuals. The differences in serum 25(OH)D level and VDD prevalence were significant between the two groups after propensity score matching.
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Affiliation(s)
- Young-Dae Jeon
- Department of Orthopaedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea
| | - Sung-Do Cho
- Department of Orthopaedic Surgery, Dongcheondongkang Hospital, Ulsan, Republic of Korea
| | - Yoon-Seok Youm
- Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Joon-Yeon Song
- Department of Orthopaedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea
| | - Kyung-Joo Lee
- Department of Orthopaedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea
| | - Ki-Bong Park
- Department of Orthopaedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
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Jhun J, Woo JS, Kwon JY, Na HS, Cho KH, Kim SA, Kim SJ, Moon SJ, Park SH, Cho ML. Vitamin D Attenuates Pain and Cartilage Destruction in OA Animals via Enhancing Autophagic Flux and Attenuating Inflammatory Cell Death. Immune Netw 2022; 22:e34. [PMID: 36081528 PMCID: PMC9433191 DOI: 10.4110/in.2022.22.e34] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/28/2022] [Accepted: 04/10/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- JooYeon Jhun
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jin Seok Woo
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
| | - Ji Ye Kwon
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
| | - Hyun Sik Na
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Keun-Hyung Cho
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Seon Ae Kim
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Seok Jung Kim
- Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Su-Jin Moon
- Division of Rheumatology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu 11765, Korea
| | - Sung-Hwan Park
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Mi-La Cho
- Rheumatism Research Center, Catholic Research Institute of Medical Science, The Catholic University of Korea, Seoul 06591, Korea
- Department of Medical Life Sciences, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
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Bharat KT, Manhas NS, Gutcho J, Lin J, Bhattacharyya S, Kounang R. Ingredients of a Natural Oral Nutritional Supplement and Their Role in the Treatment of Osteoarthritis. CLINICAL MEDICINE INSIGHTS: ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2022; 15:11795441211063365. [PMID: 35360183 PMCID: PMC8961370 DOI: 10.1177/11795441211063365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/09/2021] [Indexed: 11/30/2022]
Abstract
Osteoarthritis is a prevalent degenerative disease affecting a large portion of
the world’s aging population. Currently, nonsteroidal anti-inflammatory drugs
and acetaminophen are first-line medications for treating osteoarthritis
patients’ pain. However, several studies have noted that while these medications
control pain they do not halt progressive degeneration and tend to have an
unfavorable side-effect profile with prolonged use. Recently, due to their more
favorable side-effect profiles, herbal alternatives for controlling
osteoarthritis symptoms and for alleviating the progression of the disease are
being increasingly studied. Synogesic is a newly developed herbal supplement
blend by renowned orthopedic surgeons and physiatrists consisting of turmeric,
rutin, ginger root, vitamin C, vitamin D, and boswellia extracts. A study by
Sharkey et al. has commented on the efficacy of the blend on the patients with
knee osteoarthritis. So far, a review on the ingredients of the blend has not
yet carried outbeen. By exploring prominent literature databases including
PubMed and ScienceDirect, our aim is to write a narrative review to explore the
individual ingredients of this blend and delve into their characteristics, as
well as the most recent literature on their mechanism and efficacy in patients
with osteoarthritis. Through this, we hope to inform clinicians and patients
alike on relevant up-to-date research on the supplement and provide insight on
the potential for this supplement for alleviating the disease course of patients
with osteoarthritis.
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Affiliation(s)
- Krish Tejas Bharat
- California University of Science and
Medicine, Colton, CA, USA
- Krish Tejas Bharat, California University
of Science and Medicine, 1501 Violet Street, Colton, CA 92324, USA.
| | | | - James Gutcho
- California University of Science and
Medicine, Colton, CA, USA
| | - Joshua Lin
- Keck School of Medicine, University of
Southern California, Los Angeles, CA, USA
| | | | - Robertus Kounang
- Loma Linda University Health,
Department of Physical Medicine & Rehabilitation, Loma Linda, CA, USA
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13
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Caroselli C, Bruno G. A case of severe gout: A differential diagnosis. Arch Rheumatol 2021; 36:464-466. [PMID: 34870180 PMCID: PMC8612483 DOI: 10.46497/archrheumatol.2021.8293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 08/08/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Costantino Caroselli
- IRCCS-INRCA, Acute Geriatric Unit, Geriatric Emergency Room and Aging Research Centre, Ancona, Italy
| | - Guglielmo Bruno
- Policlinico Sant'Andrea, Facoltà di Medicina e Psicologia,"Sapienza, Medicina Interna, Roma, Italy
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14
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Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence. Int J Mol Sci 2021; 22:ijms222312920. [PMID: 34884724 PMCID: PMC8658017 DOI: 10.3390/ijms222312920] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 12/30/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative inflammatory condition of the joint cartilage that currently affects approximately 58 million adults in the world. It is characterized by pain, stiffness, and a reduced range of motion with regard to the arthritic joints. These symptoms can cause in the long term a greater risk of overweight/obesity, diabetes mellitus, and falls and fractures. Although the current guidelines for the treatment of OA suggest, as the gold standard for this condition, pharmacological treatment characterized by non-steroidal anti-inflammatory drugs (NSAID), opioids, and cyclooxygenase (COX)-2-specific drugs, a great interest has been applied to nutraceutical supplements, which include a heterogeneous class of molecules with great potential to reduce inflammation, oxidative stress, pain, and joint stiffness and improve cartilage formation. The purpose of this review is to describe the potential application of nutraceuticals in OA, highlighting its molecular mechanisms of actions and data of efficacy and safety (when available).
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Rai V, Radwan MM, Agrawal DK. IL-33, IL-37, and Vitamin D Interaction Mediate Immunomodulation of Inflammation in Degenerating Cartilage. Antibodies (Basel) 2021; 10:41. [PMID: 34842603 PMCID: PMC8628513 DOI: 10.3390/antib10040041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/14/2021] [Accepted: 10/22/2021] [Indexed: 12/25/2022] Open
Abstract
Chronic joint inflammation due to increased secretion of pro-inflammatory cytokines, the accumulation of inflammatory immune cells (mainly macrophages), and vitamin D deficiency leads to cartilage degeneration and the development of osteoarthritis (OA). This study investigated the effect of vitamin D status on the expression of mediators of inflammation including interleukin (IL)-33, IL-37, IL-6, tumor necrosis factor (TNF)-α, toll-like receptors (TLRs), damage-associated molecular patterns (DAMPs), and matrix metalloproteinases (MMPs) in degenerating the cartilage of hyperlipidemic microswine. Additionally, in vitro studies with normal human chondrocytes were conducted to investigate the effect of calcitriol on the expression of IL-33, IL-37, IL-6, TNF-α, TLRs, DAMPs, and MMPs. We also studied the effects of calcitriol on macrophage polarization using THP-1 cells. The results of this study revealed that vitamin D deficiency is associated with an increased expression of IL-33, IL-37, IL-6, TNF-α, TLRs, DAMPs, and MMPs, while vitamin D supplementation is associated with a decreased expression of the former. Additionally, vitamin D deficiency is associated with increased M1, while vitamin D-supplemented microswine cartilage showed increased M2 macrophages. It was also revealed that calcitriol favors M2 macrophage polarization. Taken together, the results of this study suggest that modulating expression of IL-33, IL-6, TNF-α, TLRs, DAMPs, and MMPs with vitamin D supplementation may serve as a novel therapeutic to attenuate inflammation and cartilage degeneration in osteoarthritis.
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Affiliation(s)
| | | | - Devendra K. Agrawal
- Department of Translational Research, Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA 91766, USA; (V.R.); (M.M.R.)
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16
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Osteoarthritis of the temporomandibular joint: A review of aetiology and pathogenesis. Br J Oral Maxillofac Surg 2021; 60:387-396. [PMID: 35307273 DOI: 10.1016/j.bjoms.2021.06.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/11/2021] [Indexed: 11/21/2022]
Abstract
The aim of this review was to assess the level of evidence for genetic, biological, and functional predictive and predisposing factors for end-stage temporomandibular joint arthritis within the published literature. A comprehensive review based upon PRISMA guidelines was performed from all literature relevant to the topic. Case series and animal studies were included given the rare nature of the disease and goal of finding root-cause predictive factors. Clinical and radiographic measures were used specifically to identify factors which may have contributed to disease onset and progression. A total of 249 abstracts were identified based on search terms of major databases. After application of exclusion and inclusion criteria, 63 full-text articles were included in the analysis of this paper. There were few factors that could be reliably used to predict end-stage temporomandibular joint disease. Limited evidence is available to adequately predict end-stage temporomandibular joint osteoarthritis. No descriptive process exists that explains how and why this process can occur in younger adults. A better understanding of the aetiology and pathogenesis of TMJ-OA may lead to prevention and more effective management strategies that may reduce the need for drastic surgical intervention, particularly in young adults.
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Zhao ZX, He Y, Peng LH, Luo X, Liu M, He CS, Chen J. Does vitamin D improve symptomatic and structural outcomes in knee osteoarthritis? A systematic review and meta-analysis. Aging Clin Exp Res 2021; 33:2393-2403. [PMID: 33783714 DOI: 10.1007/s40520-020-01778-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/08/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To provide evidence on the effects of vitamin D supplementation on knee osteoarthritis (KOA) and new targets for clinical prevention and treatment of KOA. METHOD The PubMed, Embase, Web of science, Wanfang, CNKI and SinoMed databases were retrieved to investigate the effects of vitamin D supplementation on patients with KOA. The search time was from databases establishment to 15 November 2020. RevMan5.3 software was used for meta-analysis. The results were expressed as standardized mean difference (SMD) with 95% confidence interval (CI) or weighted mean difference (WMD) with 95% confidence interval (CI). RESULTS A total of 1599 patients with osteoarthritis of the knee were included in the study, which involved six articles. The results of the meta-analysis showed that vitamin D supplementation is statistically significant for WOMAC score (SMD = - 0.67, 95% CI - 1.23 to - 0.12) in patients with KOA, including WOMAC pain score (SMD = - 0.32, 95% CI - 0.63 to - 0.02), function score (SMD = - 0.34, 95% CI - 0.60 to - 0.08) and stiffness score (SMD = - 0.13, 95% CI - 0.26 to - 0.01). In subgroup analysis, vitamin D supplementation less than 2000 IU was statistically significant for the reduction of stiffness score (SMD = - 0.22, 95% CI - 0.40 to - 0.04). Vitamin D supplements can reduce synovial fluid volume progression in patients with KOA (SMD = - 0.20, 95% CI - 0.39 to - 0.02). There was no statistical significance in improving tibia cartilage volume (SMD = 0.12, 95% CI - 0.05 to 0.29), joint space width (SMD = - 0.10, 95% CI - 0.26 to 0.05) and bone marrow lesions (SMD = 0.03, 95% CI - 0.26 to 0.31). CONCLUSION Vitamin D supplements can improve WOMAC pain and function in patients with KOA. But there is a lack of strong evidence that vitamin D supplementation can prevent structural progression in patients with KOA.
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Affiliation(s)
- Zi-Xia Zhao
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Yue He
- Department of Ophthalmology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Li-Hui Peng
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Xiao Luo
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Mao Liu
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Cheng-Song He
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China
| | - Jie Chen
- Department of Rheumatology and Immunology, Affiliated Hospital of Southwest Medical University, 1 Xianglin Road, Luzhou, 646000, Sichuan, China.
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18
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Zafeiris EP, Babis GC, Zafeiris CP, Chronopoulos E. Association of vitamin D, BMD and knee osteoarthritis in postmenopausal women. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2021; 21:509-516. [PMID: 34854390 PMCID: PMC8672405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to analyze the association of knee OA with bone mineral density (BMD) and vitamin D serum levels in postmenopausal women. METHODS A cross-sectional study including 240 postmenopausal women with knee OA was conducted. Demographic data were recorded along with balance and functionality scores. Knee OA severity was assessed by the radiological Kellgren & Lawrence scale. BMD and T-scores were calculated in hips and lumbar spine. Serum levels of vitamin D were also measured. RESULTS High BMI (p<0.005), high number of children (p=0.022) and family history of hip fracture (p=0.011) are significantly associated with knee OA severity. Lumbar spine OP is negatively associated with knee OA (p<0.005). A significant difference was detected between vitamin D deficiency and severe knee OA, adjusted for BMD [OR (95%CI); 3.1 (1.6-6.1), p=0.001]. BMD does not affect the relationship of vitamin D levels in relation to OA and vitamin D levels do not affect the relationship of BMD with OA. CONCLUSIONS Low BMD has a protective role against knee OA while vitamin D deficiency contributes significantly to knee OA severity. However, the association between OA and OP is not affected by vitamin D deficiency and the association of OA and vitamin D serum levels is not affected by BMD.
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Affiliation(s)
- Evangelos P. Zafeiris
- 2nd Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece;,Corresponding author: Evangelos P. Zafeiris, 2nd Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Agias Olgas 3-5, 14233, Athens, Greece E-mail:
| | - George C. Babis
- 2nd Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Christos P. Zafeiris
- Orthopaedics and Spine Surgery, Metropolitan General Hospital, Athens, Greece,Laboratory for Research of the Musculoskeletal System, School of Medicine University of Athens, Greece
| | - Efstathios Chronopoulos
- 2nd Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece;,Laboratory for Research of the Musculoskeletal System, School of Medicine University of Athens, Greece
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19
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Arima K, Mizukami S, Nishimura T, Tomita Y, Nakashima H, Abe Y, Aoyagi K. Epidemiology of the association between serum 25-hydroxyvitamin D levels and musculoskeletal conditions among elderly individuals: a literature review. J Physiol Anthropol 2020; 39:38. [PMID: 33243295 PMCID: PMC7690203 DOI: 10.1186/s40101-020-00249-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/18/2020] [Indexed: 12/02/2022] Open
Abstract
Background Vitamin D deficiency is associated with osteoporosis, fracture, muscle weakness, falls, and osteoarthritis in adults. Elderly individuals are more likely to present with poor musculoskeletal conditions. Recently, several epidemiological studies have assessed the correlation between serum 25-hydroxyvitamin D (25(OH)D) levels and musculoskeletal conditions in elderly individuals. Main text Osteoporosis is a skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Numerous studies have shown a positive association between serum 25(OH)D levels and bone mineral density. Only a few studies have reported an association between serum 25(OH)D levels and quantitative ultrasound (QUS) parameters. Low serum 25(OH)D level may be a risk factor for hip fracture. However, data on the association between vitamin D deficiency and the incidence of non-hip fracture are contrasting. Falls are a major cause of mortality and morbidity in older adults. Several prospective population-based cohort studies have shown that low 25(OH)D levels are associated with an increased risk of falls. Reduced muscle strength and physical performance are risk factors for adverse events, including disability, institutionalization, and mortality. The role of vitamin D in musculoskeletal functionality (muscle weakness and physical performance) among elderly individuals is still controversial. Osteoarthritis (OA) is the most common form of arthritis and is a leading cause of disability among older adults. Data on the association between serum 25(OH)D levels and OA are contrasting. Conclusion Some studies have shown that vitamin D deficiency may be a risk factor for poor musculoskeletal conditions, such as osteoporosis, fracture, muscle weakness, falls, and osteoarthritis in adults. However, other studies did not find an association between serum 25(OH)D levels and musculoskeletal conditions.
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Affiliation(s)
- Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Satoshi Mizukami
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takayuki Nishimura
- Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
| | - Yoshihito Tomita
- School of Rehabilitation, Department of Physical Therapy, Tokyo Professional University of Health Sciences, Tokyo, Japan
| | - Hiroki Nakashima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yasuyo Abe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
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20
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Tripathy SK, Gantaguru A, Nanda SN, Velagada S, Srinivasan A, Mangaraj M. Association of vitamin D and knee osteoarthritis in younger individuals. World J Orthop 2020; 11:418-425. [PMID: 33134104 PMCID: PMC7582112 DOI: 10.5312/wjo.v11.i10.418] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of primary osteoarthritis knee is gradually increasing among young individuals. The increasing prevalence of obesity, sedentary lifestyle, sporting activity, and vitamin D deficiency (VDD) has been hypothesized for this shifting disease trend. This study was designed to look for the association of serum vitamin D among these young arthritic patients.
AIM To look for the association of serum vitamin D in younger knee osteoarthritis (KOA) patients.
METHODS In a 2-year observational study, 146 non-obese KOA patients of 35-60 years were evaluated clinically (Knee injury and Osteoarthritis Outcome Score, KOOS) and radiologically (Kellegren-Lawrence stage, KL). The serum 25(OH)D level of these patients and 146 normal healthy individuals of same age group were estimated.
RESULTS Both the groups were comparable in terms of age and sex. The average serum 25(OH)D level in healthy individuals and KOA patients was 45.83 ng/mL and 34.58 ng/mL, respectively (P < 0.001). Inadequate serum 25(OH)D level (< 30 ng/mL) was found in 46.57% of KOA patients and 24% of normal healthy participants indicating a significant positive association (odds ratio 2.77, 95%CI: 1.67-4.54, P < 0.001). The 25(OH)D level in KL grade I, II, III and IV was 43.40, 30.59, 31.56 and 33.93 ng/mL respectively (no difference, P = 0.47). Similarly, the KOOS score in sufficient, insufficient and deficient groups were 65.31, 60.36 and 65.31, respectively (no difference, P = 0.051).
CONCLUSION The serum 25(OH)D level is significantly low in younger KOA patients. However, the clinical and radiological severities have no association with serum vitamin D level.
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Affiliation(s)
- Sujit Kumar Tripathy
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Amrit Gantaguru
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Saurav Narayan Nanda
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Sandeep Velagada
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Anand Srinivasan
- Department of Pharmacology, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | - Manaswini Mangaraj
- Department of Biochemistry, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
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Jeon SH, Lee KG, Kim MS. Association of bone mineral density with the development of knee osteoarthritis in men and women: a cross-sectional study using the fourth and fifth Korea National Health and Nutrition Examination Surveys. Arch Osteoporos 2020; 15:117. [PMID: 32720172 DOI: 10.1007/s11657-020-00793-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/21/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Bone mineral density (BMD) and osteoarthritis (OA) were correlated but the relationship was varied according to sex. An association between lumbar spine and femur neck BMDs and OA showed a positive relation in women, while lumbar spine and pelvis BMDs in men were associated with OA with a negative relation. PURPOSE The purpose of this study was to evaluate the association of BMD in various body parts in conjunction with the presence or severity of radiographic knee osteoarthritis (KOA) in relation to sex. METHODS This study was a cross-sectional analysis using Korea National Health and Nutrition Examination Surveys. KOA was graded using the Kellgren-Lawrence (KL) grading system. Radiographic KOA was defined as a KL grade 2 or higher. The associations between KOA and BMD in certain body parts (femur, pelvis, lumbar, lower leg, and whole-body) were assessed. BMD was measured using dual-energy X-ray absorptiometry. The BMD of each body part was divided into quartiles and the relationship between KOA and BMD was examined according to sex. RESULTS BMD did not show a significant tendency according to KL grade in either sex. In men, the severity of KL grade have a statistically significant relationship with total femur (R2 = 0.303, p < 0.05), femur neck (R2 = 0.257, p < 0.05), lumbar (R2 = 0.137, p < 0.05), and pelvis BMD (R2 = 0.185, p < 0.05). In women, total femur (R2 = 0.466, p < 0.05), lumbar (R2 = 0.316, p < 0.05), pelvis (R2 = 0.343, p < 0.05), and lower leg BMD (R2 = 0.133, p < 0.05) were associated with the severity of KL grade. When the BMD was divided into quartiles, lumbar (p < 0.05) and pelvis BMD (p < 0.05) in men had statistically significant association with knee OA as BMD decreased. In women, femur neck (p < 0.05) and lumbar BMD (p < 0.05) were significantly associated with knee OA as BMD increased. CONCLUSION The relationship between BMD and OA severity varied according to sex. In women, there was a positive association between femur neck and lumbar BMD and OA, while BMD of the lumbar and pelvis in men was negatively correlated with OA. LEVEL OF EVIDENCE Cohort study, III.
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Affiliation(s)
- Sang Hyun Jeon
- Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea
| | - Kyoung Geun Lee
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, South Korea
| | - Man Soo Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, South Korea.
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Choi W, Kim JH, Byun SE, Ryu HS, Rojas D. Effect of preoperative vitamin D deficiency on functional outcomes after high tibial osteotomy: a retrospective case control study. BMC Musculoskelet Disord 2020; 21:251. [PMID: 32303230 PMCID: PMC7165410 DOI: 10.1186/s12891-020-03295-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to evaluate the effects of vitamin D deficiency on the functional outcomes following a high tibial osteotomy (HTO). Methods Clinical data of 209 patients (327 knees) who underwent HTO done by a single surgeon were retrospectively registered for the study. Ninety-four patients (94 knees) who underwent HTO were analyzed. Patients were assigned into two groups according to their preoperative serum vitamin D levels (D- Deficiency and S- Sufficient); < 20 ng/ml (group D, N = 48) and ≥ 20 ng/ml (group S, N = 46) respectively. A subjective form of International Knee Documentation Committee (IKDC) score, mechanical alignment, and cartilage status before and 1 year following HTO were studied between groups. Results The mean postoperative IKDC score was significantly higher in group S (p = 0.012). Moreover, the difference of IKDC score between pre- and post- HTO was also significantly higher in group S (p = 0.006). Preoperative vitamin D level and IKDC score did not show a significant correlation. Serum vitamin D level was found to be moderately correlated to postoperative IKDC score (r = 0.342 and, p = 0.001). A moderately positive correlation between serum vitamin D level and improvement of IKDC score following osteotomy was appreciated (r = 0.381 and, p < 0.001). Conclusion Patients with vitamin D deficiency had less satisfactory functional outcomes within 1 year from HTO surgery. Our results suggest that preoperative serum vitamin D level is one of the factors affecting the outcome after HTO. We recommended analyzing serum vitamin D levels as part of the routine workup in patients undergoing HTO.
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Affiliation(s)
- Wonchul Choi
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jae Hwa Kim
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Seong-Eun Byun
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
| | - Han-Seung Ryu
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - David Rojas
- Department of Orthopaedic Surgery, Denver Health Medical Center, Denver, CO, USA
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Anari H, Enteshari-Moghaddam A, Abdolzadeh Y. Association between serum Vitamin D deficiency and Knee Osteoarthritis. Mediterr J Rheumatol 2020; 30:216-219. [PMID: 32467872 PMCID: PMC7241660 DOI: 10.31138/mjr.30.4.216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/30/2019] [Accepted: 12/08/2019] [Indexed: 02/07/2023] Open
Abstract
Objective:
Levels of Vitamin D may influence the development of knee osteoarthritis (OA), which is one of the most common joint diseases. The aim of this study was to investigate the association between serum Vitamin D deficiency and knee OA in Ardabil and Iran. Methods: One hundred fifty-eight consecutive patients referred to rheumatology clinic of Ardabil City Hospital were recruited in the study. All the participants underwent x-rays in two anterior-posterior and side views of the knees. Staging of knee OA was done according to Kellgren-Lawrence criteria. Seventy-nine individuals with clinical and radiographic signs of knee OA were defined as the case group, and those without clinical and radiographic signs of the disease were defined as a control group. Haematology and biochemical profile including measurement of 25-hydroxyvitamin D serum level was performed in the participants. Results: The mean age of patients and controls were 54.12 ± 4.67 and 55.37 ± 5.12 years, respectively. The average serum vitamin D in OA patients and controls were 26.8±6.2 ng/ml and 28.1±5.3ng/ml, respectively (p=0.36). There was a significant association between serum vitamin D and staging of knee OA (p=0.001). Based on vitamin D levels, most of patients with vitamin D deficiency were in stages III and IV. Conclusion: The findings of the study suggest that vitamin D deficiency should be considered in patients with OA and treated accordingly.
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Affiliation(s)
- Hasan Anari
- Department of Radiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Yu Y, Liu D, Feng D, Zhao J. Association between Vitamin D and Knee Osteoarthritis: A PRISMA-Compliant Meta-analysis. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2020; 159:281-287. [PMID: 32150754 DOI: 10.1055/a-1098-8815] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous investigations showed inconsistent results for associations between vitamin D and knee osteoarthritis (OA). The present study aimed to make a systematic review and meta-analysis for the association between vitamin D and knee OA. METHODS We systematically searched for articles published in the databases PubMed, Web of Science, EMBASE, Medline, and Google Scholar through July 2019. All statistical analyses were made using STATA 12.0 software. The Q test and I2 were applied to examine heterogeneities between studies. RESULTS The study indicated that there were no significant associations between serum levels of 25-hydroxy (OH) vitamin D and prevalence, incidence or progression of knee radiographic OA (ROA), and joint space narrowing (JSN). However, a subgroup study showed significant associations of low vitamin D levels with the progression of knee OA. Additionally, the present study showed no significant effect of vitamin D supplementation on knee OA. CONCLUSIONS The results do not support that serum levels of 25(OH) vitamin D are associated with the risks of knee OA, except perhaps with progression of knee OA. In addition, vitamin D supplementation may not have a clinically significant effect on pain control or structure (tibial cartilage volume and JSW) progression in patients with knee OA. Longer-term clinical trials are essential to explore the effect of vitamin D supplementation on knee OA.
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Affiliation(s)
- Yinghao Yu
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Dongcheng Liu
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Dehong Feng
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
| | - Jijun Zhao
- Department of Orthopedic, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China
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Li S, Niu G, Dong XN, Liu Z, Song C, Leng H. Vitamin D Inhibits Activities of Metalloproteinase-9/-13 in Articular Cartilage In Vivo and In Vitro. J Nutr Sci Vitaminol (Tokyo) 2019; 65:107-112. [PMID: 31061278 DOI: 10.3177/jnsv.65.107] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Low levels of serum vitamin D have been shown to accelerate progression of osteoarthritis. However, the role of vitamin D in articular cartilage degradation and osteoarthritis development is still unclear. This study investigated the effects of vitamin D on articular cartilage degradation by testing matrix metalloproteinase (MMPs) activities in articular cartilage using the rat vitamin D deficiency model at the animal level and rat articular chondrocytes at the cell level. The in vivo study showed vitamin D deficiency increased the expressions of MMP-9 and MMP-13 in rat articular cartilage, and the increase was inhibited by 1α,25(OH)2D3 supplementation. The increased production of MMP-9 and MMP-13 in the articular chondrocytes induced by tumor necrosis factor-α (TNF-α) or phorbol-12-myristate-13-acetate (PMA) was significantly suppressed by concomitant treatment with 1α,25(OH)2D3 in vitro. The increased level of C-telopeptide of type II collagen (CTX-II) induced by TNF-α or PMA was also significantly suppressed by concomitant treatment with 1α,25(OH)2D3 in vitro. Thus, vitamin D intake may inhibit MMP activities and take part in the process of articular cartilage degeneration and osteoarthritis progression.
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Affiliation(s)
- Siwei Li
- Department of Orthopedics, Peking University Third Hospital.,Department of Orthopedics, Ansteel Group Hospital
| | - Guodong Niu
- Department of Orthopedics, Peking University Third Hospital.,Beijing Key Lab of Spine Diseases
| | - X Neil Dong
- Department of Health and Kinesiology, The University of Texas at Tyler
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital
| | - Chunli Song
- Department of Orthopedics, Ansteel Group Hospital
| | - Huijie Leng
- Department of Orthopedics, Peking University Third Hospital
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Muller C, Enomoto M, Buono A, Steiner JM, Lascelles BDX. Placebo-controlled pilot study of the effects of an eggshell membrane-based supplement on mobility and serum biomarkers in dogs with osteoarthritis. Vet J 2019; 253:105379. [PMID: 31685140 DOI: 10.1016/j.tvjl.2019.105379] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 08/29/2019] [Accepted: 09/12/2019] [Indexed: 11/30/2022]
Abstract
Osteoarthritis (OA) is a debilitating disease in dogs. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat OA; however, many dogs do not obtain adequate pain relief with an NSAID alone. This pilot study evaluated the systemic anti-inflammatory and mobility enhancing effects of an eggshell membrane-based nutritional supplement in dogs with OA-associated pain and mobility impairment. Twenty-seven dogs with OA-associated pain were enrolled into a randomized, double-masked, placebo-controlled, proof of principle pilot study and received either placebo or an eggshell membrane-based nutritional supplement over a 12-week period. Inflammatory biomarkers (IL-2, IL-6, IL-8, tumor necrosis factor-α, C-reactive protein, S100A12, and N-methylhistamine) were measured at Day 0 and Day 84. Owner questionnaires (CBPI and LOAD) were completed at Day 0, Day 42, and Day 84. Differences between groups over time were calculated. Twenty-two dogs completed the pilot study. Inflammatory biomarker IL-2 decreased in the supplement group, compared to the placebo group. Although small, the difference was statistically significant at an alpha of 0.1 (P=0.069). LOAD scores were numerically lower in the supplement group, but not significantly different from the placebo group at Day 0. Day 84 LOAD scores were significantly lower in the supplement group compared to the placebo group (P=0.034). CBPI results did not show the same pattern. The changes in biomarkers and LOAD scores were small, and do not provide definitive evidence of positive effects. However, these pilot results provide a rationale for performing a larger placebo-controlled study of the potential effects of the eggshell membrane-based nutritional supplement.
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Affiliation(s)
- C Muller
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, USA; Comparative Pain Research and Education Center, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, USA
| | - M Enomoto
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, USA
| | - A Buono
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4475 TAMU, College Station, TX, USA
| | - J M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 4475 TAMU, College Station, TX, USA
| | - B D X Lascelles
- Translational Research in Pain (TRiP) Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, USA; Comparative Pain Research and Education Center, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, USA; Thurston Arthritis Center, UNC School of Medicine, 3300 Thurston Building, Chapel Hill, NC, USA; Center for Translational Pain Research, Department of Anesthesiology, Duke University, 132 Research Dr, Durham, NC, USA.
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Heidari B, Babaei M. Therapeutic and Preventive Potential of Vitamin D Supplementation in Knee Osteoarthritis. ACR Open Rheumatol 2019; 1:318-326. [PMID: 31777808 PMCID: PMC6857993 DOI: 10.1002/acr2.1042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 05/15/2019] [Indexed: 12/14/2022] Open
Abstract
Objective Vitamin D deficiency is linked with pain, function, and radiographic progression of knee osteoarthritis (KOA), but the results of studies addressing the association and effect of vitamin D supplementation for pain, function, quality of life, radiographic disease, and progression are inconsistent. The aim of this review is to determine the therapeutic and preventive potential of vitamin D supplementation in KOA. Method Eligible pertinent English language studies published in 2000 and thereafter in Medline/PubMed, Scopus, and Google Scholar were selected by using keywords that include “knee osteoarthritis,” “vitamin D supplementation,” “pain,” “structural abnormalities,” “treatment,” and “progression.” Results The results of a few studies showed a preventive potential for vitamin D in KOA, but most of the randomized clinical trials that assessed the therapeutic efficacy of vitamin D supplementation in KOA found no clear therapeutic effect, with the exception of one study that found a small but significant effect of vitamin D on pain and knee function. Nonetheless, the results of a few longitudinal studies as well as systematic reviews are promising and thus encourage further studies. Inconsistent results on the effect of vitamin D on KOA may be attributed to factors such as severity of KOA, baseline level of serum vitamin D, duration of treatment, and vitamin D dosages. Conclusion Given the multiple skeletal and extraskeletal benefits of vitamin D supplementation in elderly people, the issue of vitamin D supplementation in KOA requires further study to elucidate the dosage and duration of treatment that provides the most effective therapeutic effect.
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Liu T, Wang E, Li Q, Li L. High prevalence of vitamin D insufficiency in Chinese children with upper limb fractures. Genes Dis 2019; 7:408-413. [PMID: 32884995 PMCID: PMC7452481 DOI: 10.1016/j.gendis.2019.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/21/2019] [Accepted: 05/27/2019] [Indexed: 02/07/2023] Open
Abstract
This study aimed at investigating the vitamin D status of pediatric patients with upper limb fractures and finding out the influences of age, gender, season and fracture sites. 695 patients were admitted for upper limb fractures between November 1st 2014 and October 31st 2015. 224 healthy children were included during the same period. Serum 25(OH)D was measured at the time of visit and their demographic data were recorded. Generally fracture patients had significant lower vitamin D level than the healthy children. The average serum 25(OH)D of the patients was 24.5 ng/ml, compared to 28.1 ng/ml in healthy children. Vitamin D status worsened with the increase of age and adolescents had a deficiency rate of as high as 68.6%. Gender and fracture sites had no influence on vitamin D level. This study revealed high prevalence of vitamin D deficiency and insufficiency in pediatric patients with upper limb fractures. Adolescents had such high rate of vitamin D deficiency that called for vast attention.
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Affiliation(s)
- Tianjing Liu
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, China
| | - Enbo Wang
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, China
| | - Qiwei Li
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, China
| | - Lianyong Li
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, China
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Messina OD, Vidal Wilman M, Vidal Neira LF. Nutrition, osteoarthritis and cartilage metabolism. Aging Clin Exp Res 2019; 31:807-813. [PMID: 30982220 DOI: 10.1007/s40520-019-01191-w] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/02/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. There is no cure for OA and there is no effective treatment to stop its progression. Current pharmacologic treatments such as analgesics and non-steroidal anti-inflammatory drugs may improve the pain and offer some relief but they do not affect the progression of the disease. The chronic intake of these drugs may result in severe adverse events. The aim of this review is to revise the effects of nutrition on cartilage metabolism and OA progression. METHODS A systematic literature search was performed including those related to macro- and micro-nutrients' actions on cartilage and OA outcome. We selected peer-reviewed articles reporting the results of human clinical trials. RESULTS Glucosamine and chondroitin sulfate have shown to delay OA knee progression in several clinical trials. The effectiveness of some products considered nutraceuticals has been widely reviewed in the literature. This article presents a general description of the effectiveness and mechanism of action of nutrients, vitamins, antioxidants and other natural components considered as part of the normal diet. Many in vitro studies indicate the efficacy of specific nutrients in cartilage metabolism and its involvement in OA. However, rigorous clinical studies needed to evaluate the efficacy of these compounds in humans are still missing. The influence of nutrients and diet on the metabolism of cartilage and OA could represent a long-term coadjuvant alternative in the management of patients with OA. Effects of diet modifications on lipid and cholesterol profiles, adequate vitamin levels and weight reduction in obese patients could influence the course of the disease. CONCLUSION This review demonstrates that nutrition can improve the symptoms of OA. Glucosamine and chondroitin sulfate have shown robustly to delay the progression of knee OA in several well-designed studies, however more controlled clinical trials are needed to conclude that nutritional changes slow down the progression of the disease.
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Affiliation(s)
- Osvaldo Daniel Messina
- Rheumatology IRO Medical Center and Hospital C Argerich, Member of the Board of Governance, International Osteoporosis Foundation (IOF), Buenos Aires, Argentina
| | - Maritza Vidal Wilman
- Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru.
| | - Luis F Vidal Neira
- Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru
- Member of International Osteoporosis Foundation, Latin America (IOF-LATAM), Lima, Peru
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Vitamin D history part III: the "modern times"-new questions for orthopaedic practice: deficiency, cell therapy, osteomalacia, fractures, supplementation, infections. INTERNATIONAL ORTHOPAEDICS 2019; 43:1755-1771. [PMID: 31037319 DOI: 10.1007/s00264-019-04334-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 04/08/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The nutritional basis for rickets was described between 1880 and 1915, at the same period of discovery of other "vital substances" or vitamins. In contrast, rickets could also be prevented or cured by sunshine. But as the capacity to produce vitamin D depends on exposure to ultraviolet B rays (UVB) from sunlight or artificial sources, vitamin D became one of the most frequently used "drugs" in the twentieth century to compensate for insufficient exposure to UVB of humans. Furthermore, as the understanding of vitamin D metabolism grew during the twentieth century, other concerns than rickets occurred for the orthopaedic surgeon: In recent history, deficiency is explored as being an associated factor of different bone pathologies as fracture or prosthetic infection. The aim of this review is to analyze these new data on vitamin D. MATERIALS AND METHODS During the twentieth century, there were many concerns for the orthopaedic surgeon: sources and synthesis of vitamin D, regulation of the calcium deposition process for both children and adults, when vitamin D deficiency is observed, and what the best method of vitamin D supplementation is. As target genes regulated by vitamin D are not limited to those involved in mineral homeostasis, orthopedists recently discovered that vitamin D might prevent periprosthetic infection. RESULTS The primary source (80%) of vitamin D is dermal synthesis related to the sun. Dietary sources (20%) of vitamin D are fat fishe, beef, liver, and eggs. Vitamin D is produced industrially to be used in fortified foods and supplements. Maintenance of skeletal calcium balance is mediated through vitamin D receptors. Progenitor cells, chondrocytes, osteoblasts, and osteoclasts contain these receptors which explains the role of vitamin D in cell therapy, in the prevention of rickets and osteomalacia. Despite fortified foods, the prevalence of deficiency remains endemic in north latitudes. However, the definition of vitamin D insufficiency or deficiency remains controversial. Vitamin D has been evaluated in patients undergoing fractures and elective orthopaedic procedures Although supplementation may not be able to prevent or cure all the orthopaedic pathologies, oral supplementation is able to improve the vitamin D levels of deficient patients. These vitamin D level improvements might be associated with better functional and clinical outcomes after some surgical procedures and improvement of immunity to decrease the risk of infection in arthroplasties. CONCLUSION Vitamin D deficiency is frequent and concerns millions of people in the world. It is therefore normal to find hypovitaminosis in various orthopaedic populations including trauma and arthroplasties. However, we do not know exactly if this phenomenon only reflects the general prevalence of vitamin D deficiency or has an influence on the outcome of some pathologies on specific populations at risk. After the success of treatment of rickets, it is disappointing that we are still wondering in the twenty-first century whether supplementation of a substance synthetized millions of years ago by plankton and necessary for growth of all the animals may improve (or not) clinical and functional outcomes of a simple fracture in humans.
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Madani A, Shamsian SA, Layegh P, Abrisham SM, Ravaghi A, Tayarani Najjaran N. Are certain factors involved in calcium metabolism associated with temporomandibular disorders? Cranio 2019; 39:202-208. [PMID: 30931843 DOI: 10.1080/08869634.2019.1596054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: The aim of the present study was to investigate whether there is an association between serum concentrations of calcium, phosphate, alkaline phosphatase, parathyroid hormone (PTH), and vitamin D and temporomandibular disorders (TMDs).Methods: In this case-control study, 51 patients with TMDs (28 patients with TMJ clicking, 5 patients with muscular disorders, and 18 osteoarthritis patients) and 29 healthy subjects within the age range of 20-50 years as the control group, were referred to the laboratory for calcium, phosphate, alkaline phosphatase, PTH, and vitamin D (25 OHD) analysis tests. The TMJ status of all participants was examined according to RDC-TMD criteria by a prosthodontist who is an expert in TMDs. The results were analyzed with Fisher's precise test.Results: No statistically significant difference was observed between TMD patients and healthy subjects.Conclusion: Serum concentrations of calcium, phosphate, alkaline phosphatase, PTH, and vitamin D are not associated with TMDs.
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Affiliation(s)
- Azamsadat Madani
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Aliakbar Shamsian
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Layegh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed Mohammad Abrisham
- Department of Prosthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Niloufar Tayarani Najjaran
- Department of Prosthodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Vaishya R, Vijay V, Lama P, Agarwal A. Does vitamin D deficiency influence the incidence and progression of knee osteoarthritis? - A literature review. J Clin Orthop Trauma 2019; 10:9-15. [PMID: 30705525 PMCID: PMC6349580 DOI: 10.1016/j.jcot.2018.05.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/12/2018] [Accepted: 05/19/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Vitamin D has been believed to have a bearing in the pathogenesis of knee osteoarthritis (OA). This study was done to search the literature and review the correlation between vitamin D levels in knee OA in the adult population and the outcome of vitamin D supplementation in knee OA. METHODS An exhaustive search of Pub Med and Cochrane library database was done with keywords vitamin D, knee and osteoarthritis for a period from Jan 2005 to December 2015. All Randomized Control Trials (RCT), Cohort, Case-control, cross-sectional studies were included in the present systematic review. RESULTS The search resulted in a total of 86 studies; out of which 11 studies were included in the current review. There were two Randomized Control Trial (RCT), one case-control, four cross-sectional and four cohort studies. These studies comprised of a total of 5137 participants (ranging from 46 to 1248) Our results suggested there was a moderate evidence of positive association in vitamin D deficiency (VDD) and progression of radiographic OA (ROA), as assessed by Kellgren and Lawrence (KL) grading. However, VDD was not associated with the incidence of ROA and MRI-detected change in focal cartilage defect. However, this study has a limited evidence for a positive correlation in VDD and the cartilage volume loss. There was also limited evidence showing no role of vitamin D therapy in reducing cartilage volume loss and knee pain in Knee OA. CONCLUSION The VDD is common and has been associated with knee OA, in an adult population. However, there is still inconsistent evidence regarding the prevention of incidence and progression of ROA after vitamin D therapy. There is a need for multicentric and well-conducted randomized studies with larger samples to conclude the positive effect of Vitamin D therapy.
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Affiliation(s)
| | - Vipul Vijay
- Corresponding author at: Room no 1210, Department of Orthopaedics, Joint Replacement & Arthroscopy, Indraprastha Apollo Hospital, New Delhi, 110076, India.
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Thomas JE, Bhat AK, Rao M, Guddattu V, Sekhar M S. Use of Vitamin D Supplements in Osteoarthritis: An Observational Study in a Tertiary Health Care Facility. J Am Coll Nutr 2018; 38:227-234. [PMID: 30485164 DOI: 10.1080/07315724.2018.1494641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The purpose of the study was to assess impact of vitamin D supplements on the disease progression and overall health of osteoarthritis (OA) patients. METHODOLOGY A cohort study was carried out for 8 months (August 2017-March 2018) in the Orthopedics Department of Kasturba Hospital, Manipal, India, a tertiary care hospital. One hundred and forty-two patients who were diagnosed with OA (grades 1-3) with low serum 25(OH)D levels (severely deficient, deficient, or insufficient) were selected for the study. These patients were categorized into two cohorts: a control cohort (CC) and a study cohort (SC). CC members were patients (n = 71) who had not received vitamin D supplements, and SC members were patients (n = 71) who had received vitamin D supplements. Severity grading of OA, pain score, and health assessment were performed using the Kellgren-Laurence grading score, visual analogue scale (VAS), and WOMAC, respectively, at baseline and after 3 months of follow-up. RESULTS Subjects in the both CC and SC reported no statistically significant difference (similar in both group) in severity grade (p = 0.303), pain score (p = 0.099), parathyroid hormone (PTH) (p = 0.083), and health status (p = 0.76) at baseline. After 3 months of follow-up (post vitamin D supplementation), OA patients have shown statistically significant difference in severity grades, serum 25(OH)D status, PTH level (p < 0.001), and overall health status (p = 0.001) in the SC with respect to baseline. Likewise, percentage distribution of positive changes was significantly higher in severity grade, pain score, serum 25(OH)D level, overall health status (p < 0.001), and PTH (p = 0.040) of SC as compared to CC at follow-up. CONCLUSION Vitamin D supplements have significantly improved serum 25(OH)D levels, PTH, severity grade, and pain score of OA patients. Most importantly, vitamin D supplements have shown improvement in the overall health of OA patients, emphasizing the place of vitamin D supplements in the management of OA. Clinical Trial Registry-India (CTRI) registration no: CTRI/2017/12/011031.
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Affiliation(s)
- Jino Elsa Thomas
- a Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences , Manipal Academy of Higher Education , Manipal , Karnataka , India
| | - Anil K Bhat
- b Department of Orthopaedics, Kasturba Medical College , Manipal Academy of Higher Education , Manipal , Karnataka , India
| | - Mahadev Rao
- a Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences , Manipal Academy of Higher Education , Manipal , Karnataka , India
| | - Vasudeva Guddattu
- c Department of Statistics, Prasanna School of Public Health , Manipal Academy of Higher Education , Manipal , Karnataka , India
| | - Sonal Sekhar M
- a Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences , Manipal Academy of Higher Education , Manipal , Karnataka , India
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Ahmadiahangar A, Javadian Y, Babaei M, Heidari B, Hosseini S, Aminzadeh M. The role of quadriceps muscle strength in the development of falls in the elderly people, a cross-sectional study. Chiropr Man Therap 2018; 26:31. [PMID: 30128111 PMCID: PMC6091154 DOI: 10.1186/s12998-018-0195-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 05/24/2018] [Indexed: 12/25/2022] Open
Abstract
Background Falls are a major health issue in the elderly people and an important cause of bone fracture. The aim of this study was to determine the association between quadriceps muscle strength (QMS) and falls in the elderly subjects. Methods All eligible participants of the Amirkola Cohort Study entered the study. Data regarding demographic characteristics, clinical and laboratory examinations were provided between 2011 to 2014. Occurrence of falls during previous year was determined by interview and review of the medical records. The study patients were divided into low, moderate and high muscle strength groups according to QMS values ≥ 30, 15-30, and < 15 kg respectively). Association between muscle strength and falls was determined by using multiple logistic regression analysis with calculation of odds ratio (OR). Results A total 1028 participants (females, 44.3%) were analyzed and 178(17.3%) subjects experienced a fall. Individuals with falls had higher age (p = 0.001) and lower QMS value (p = 0.001). After adjustment for all clinical and demographic variables, occurrence of falls was negatively associated with QMS and positively associated with age > 70 years old. Compared to group with QMS ≥ 30 kg, the prevalence of falls in low and moderate QMS groups increased by OR = 3(95% CI, 1.78-5.05) and 2.18 (95% CI, 1.22-3.42) respectively. Conclusion These findings indicate that older subjects with lower QMS are at greater risk of falls. These findings provide a rational for muscle strengthening exercise in older people.
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Affiliation(s)
- Alijan Ahmadiahangar
- 1Mobility Impairement Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran, Ganjafrouz Ave., Babol, 4717641367 Iran
| | - Yahya Javadian
- 1Mobility Impairement Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran, Ganjafrouz Ave., Babol, 4717641367 Iran.,2Department of Physiotherapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, I.R Iran, Ganjafrouz Ave., Babol, 4717641367 Iran
| | - Mansour Babaei
- 1Mobility Impairement Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran, Ganjafrouz Ave., Babol, 4717641367 Iran
| | - Behzad Heidari
- 3Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, I.R. Iran, Ganjafrouz Ave., Babol, 4717641367 Iran
| | - Seyedreza Hosseini
- 4Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran, Ganjafrouz Ave., Babol, 4717641367 Iran
| | - Mohammad Aminzadeh
- 5School of Medicine, Babol University of Medical Sciences, Ganjafrouz Ave., Babol, 4717641367 Iran
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Cakar M, Ayanoglu S, Cabuk H, Seyran M, Dedeoglu SS, Gurbuz H. Association between vitamin D concentrations and knee pain in patients with osteoarthritis. PeerJ 2018; 6:e4670. [PMID: 29707434 PMCID: PMC5922228 DOI: 10.7717/peerj.4670] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 04/06/2018] [Indexed: 12/27/2022] Open
Abstract
Objectives Osteoarthritis (OA) and vitamin D deficiency are common health conditions in older people. Whether vitamin D concentration is associated with knee OA is controversial. In this study, we aimed to determine the association between serum concentrations of vitamin D and osteoarthritic knee pain. Subjects and Methods Vitamin D concentrations were measured with the 25 hydroxyvitamin D test in patients presenting with clinical symptoms of primary knee osteoarthritis. Osteoarthritis was graded on the Kellgren-Lawrence grading scale from anteroposterior and lateral radiographs. Height, weight, and body mass index (BMI) were recorded. Patients completed a 10-cm visual analogue scale (VAS) for indicating pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Vitamin D concentration was defined as severely deficient (<10 ng/mL), insufficient (10 to 19 ng/mL), or normal (20 to 50 ng/mL). Results Of 149 patients (133 women), the mean age was 63.6 years. Mean vitamin D concentration was 11.53 ng/mL, and 90% patients were vitamin D deficient. Mean WOMAC score was 57.2, and VAS pain score was 7.5. Kellgren-Lawrence grade was 2 for 10 patients, grade 3 for 61, and grade 4 for 88. Mean BMI was 33.4. Mean values of VAS, WOMAC, and BMI did not differ by vitamin D status. Conclusion Serum vitamin D concentration is not associated with knee pain in patients with osteoarthritis.
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Affiliation(s)
- Murat Cakar
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Semih Ayanoglu
- Department of Orthopaedics and Traumatology, Medipol Universty Hospital, Istanbul, Turkey
| | - Haluk Cabuk
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Metin Seyran
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Suleyman Semih Dedeoglu
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Hakan Gurbuz
- Department of Orthopaedics and Traumatology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
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Alkan G, Akgol G. Do vitamin D levels affect the clinical prognoses of patients with knee osteoarthritis? J Back Musculoskelet Rehabil 2018; 30:897-901. [PMID: 28372319 DOI: 10.3233/bmr-160589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Although vitamin D deficiency has been associated with osteoporosis, as well as fractures, in elderly men and women, the role of vitamin D deficiency in the pathogenesis of osteoarthritis (OA) remains controversial. In this study, we aimed to investigate the effects of vitamin D deficiency on the functional status and disease prognosis of patients with knee osteoarthritis. PATIENTS AND METHODS Our study comprised 100 patients that met the American College of Rheumatology criteria for a diagnosis of knee osteoarthritis. Each patient underwent knee radiography, the results of which were graded according to Kellgren and Lawrence radiographic grading scale; those that met the diagnostic criteria were included in the study. The visual analog scale (VAS), Nottingham Health Profile (NHP), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne Knee Osteoarthritis Index were used to assess patients' pain, function and quality of life. Complete blood counts, sedimentation rates and serum C-reactive protein, rheumatoid factor, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, sodium, potassium, calcium, phosphorus, parathyroid and thyroid hormone levels were routinely recorded for each patient. Vitamin D levels were analyzed in winter (between November and February) using high performance liquid chromatography. RESULTS Patients were divided into two groups, Group 1 and Group 2, according to the presence or absence of vitamin D deficiency. The groups did not differ significantly in terms of age, disease duration, sex distribution, presence of osteoporosis or radiographic stage of knee osteoarthritis (p = 0.793, 0.092, 0.250, 0.835 and 0.257, respectively). However, the NHP pain, physical activity, fatigue, social isolation, and emotional reactions subsets, WOMAC pain and physical function subsets and total score, Lequesne knee osteoarthritis index, and patient/physician VAS scores were significantly higher in Group 1 than in Group 2 (p < 0.05). CONCLUSIONS Our study therefore suggests that vitamin D deficiency exacerbates pain, dysfunction and a poorer quality of life in patients with knee osteoarthritis. Further longer-term studies are needed to investigate the effects of vitamin D deficiency on OA-related symptoms.
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Affiliation(s)
| | - Gurkan Akgol
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Firat University, Elazig, Turkey
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Babaei M, Esmaeili Jadidi M, Heidari B, Gholinia H. Vitamin D deficiency is associated with tibial bone pain and tenderness. A possible contributive role. Int J Rheum Dis 2018; 21:788-795. [PMID: 29314669 DOI: 10.1111/1756-185x.13253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Vitamin D deficiency is associated with osteomalacia and a variety of musculoskeletal pain. This study aimed to determine the association of vitamin D deficiency with tibial bone pain and tenderness. METHODS Patients with leg pain, defined as local pain and tenderness over tibial bones for ≥ 6 weeks were consecutively selected. Secondary causes of pain were excluded by appropriate clinical, radiological and laboratory examinations. Serum 25-hydroxyvitamin D (25-OHD) was assessed by enzyme-linked immunosorbent assay method and levels < 20 ng/mL were considered as deficiency. Age- and sex-matched subjects without leg pain served as controls. Multiple logistic regression analysis was used to determine associations. RESULTS One hundred and eighteen patients and 114 controls aged 46.8 ± 14.8 and 44.6 ± 14.1 years, respectively (P = 0.93) were analyzed. Mean 25-OHD level was significantly lower (P = 0.001) and the prevalence of 25-OHD deficiency was significantly higher in the patients as compared with the controls (75.4% vs. 23.6%), odds ratio (OR) = 9.54 (95% CI, 5.22-17.45, P = 0.001). There was a negative dose-response relationship between serum 25-OHD and tibial bone pain by OR = 17.33 (95% CI, 6.48-46.3) in subjects with 25-OHD < 10 ng/mL, and OR = 14.7 (95% CI, 6.35-34.6) in serum 25-OHD levels at 10-19.9 ng/mL, and OR = 2.58 (95% CI, 1.08-6.1) in those with 25-OHD at 20-29.9 ng/mL as compared with 25-OHD ≥ 30 ng/mL. After controlling for demographic and biochemical factors, the association reached a stronger level of 19.8 (6.9-56.3) in subjects with serum 25-OHD < 10 ng/mL and 14.4 (5.8-34.6) in those with serum 25-OHD at levels of 10-19.9 ng/mL and 1.85 (0.73-4.6) in 20-29 ng/mL. CONCLUSION These findings indicate a possible contributive role for serum 25-OHD deficiency in the development of pain and tenderness over the tibial bone.
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Affiliation(s)
- Mansour Babaei
- Mobility Impairment Research Center, Babol University Of Medical Sciences, Babol, Iran.,Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.,Division Rheumatology, Department of Medicine, Rouhani Hospital, Babol, Iran
| | | | - Behzad Heidari
- Mobility Impairment Research Center, Babol University Of Medical Sciences, Babol, Iran.,Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.,Student Research Committee, Master of Biostatistics and Epidemiology, Babol University of Medical Science, Babol, Iran.,Health Research Center, Master of Biostatistics and Epidemiology, Babol University of Medical Science, Babol, Iran
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Shin KY, Park KK, Moon SH, Yang IH, Choi HJ, Lee WS. Vitamin D deficiency adversely affects early post-operative functional outcomes after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2017; 25:3424-3430. [PMID: 27316697 DOI: 10.1007/s00167-016-4209-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 06/08/2016] [Indexed: 01/21/2023]
Abstract
PURPOSE Vitamin D has received considerable attention in recent years owing to the increasing evidence of its importance in muscle function and physical performance. The present study attempted to determine whether patients with low serum vitamin D levels had impairment in early functional outcomes following total knee arthroplasty (TKA). METHODS This was a prospective cohort study that included 92 patients. Patients were divided into two groups according to their vitamin D levels as assessed at the preoperative visit: (1) vitamin D-deficient group, serum 25-hydroxyvitamin D3 (25(OH)D) levels <12 ng/mL; (2) vitamin D non-deficient group, serum 25(OH)D levels ≥12 ng/mL. American Knee Society Score (KSS) and four other performance tests including the alternative step test (AST), six-metre walk test (SMT), sit-to-stand test (STS), and timed up and go test (TUGT) were used for assessment of post-operative function. All assessments were performed one day before and three months after TKA. RESULTS Of the 92 patients included in the study, 87 patients performed all required assessments. The mean post-operative functional KSS was significantly lesser in the vitamin D-deficient group than in the vitamin D non-deficient group (67.2 vs. 73.4, p = 0.031). The mean values of time taken for post-operative AST (16.6 vs. 14.6 s, p = 0.033) and SMT (8.8 vs. 7.7 s, p = 0.012) were significantly longer in the vitamin D-deficient group than in the vitamin D non-deficient group. Post-operative STS and TUGT demonstrated higher values for mean time taken in the vitamin D-deficient group than in the vitamin D non-deficient group, but these were not statistically significant (13.6 vs. 12.4 s, not significant (n.s.); 12.7 vs. 11.7 s, n.s., respectively). CONCLUSION Early post-operative functional outcomes following TKA appear to be adversely affected by vitamin D deficiency. LEVEL OF EVIDENCE Prospective cohort study, Level II.
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Affiliation(s)
- Keun-Young Shin
- Department of Orthopaedic Surgery, College of Medicine, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-Gu, Seoul, 135-720, Republic of Korea
| | - Kwan Kyu Park
- Department of Orthopaedic Surgery, College of Medicine, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-Gu, Seoul, 135-720, Republic of Korea
| | - Seong-Hwan Moon
- Department of Orthopaedic Surgery, College of Medicine, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-Gu, Seoul, 135-720, Republic of Korea
| | - Ick Hwan Yang
- Department of Orthopaedic Surgery, College of Medicine, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-Gu, Seoul, 135-720, Republic of Korea
| | - Ho-June Choi
- Department of Orthopaedic Surgery, College of Medicine, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-Gu, Seoul, 135-720, Republic of Korea
| | - Woo-Suk Lee
- Department of Orthopaedic Surgery, College of Medicine, Gangnam Severance Hospital, Yonsei University, 211 Eonju-ro, Gangnam-Gu, Seoul, 135-720, Republic of Korea.
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The effect of vitamin D status on pain, lower limb strength and knee function during balance recovery in people with knee osteoarthritis: an exploratory study. Arch Osteoporos 2017; 12:83. [PMID: 28942549 DOI: 10.1007/s11657-017-0378-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 09/17/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED The association between vitamin D and muscle function associated with balance recovery and falls in people with knee osteoarthritis is unclear. Those with vitamin D insufficiency demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function. PURPOSE Low vitamin D status in people with knee osteoarthritis (OA) is often reported to be associated with increased pain and locomotor dysfunction. However, despite the growing evidence of the effect of vitamin D on the pathogenesis of knee OA, its role remains conflicting. Importantly, muscle function is important for knee joint health; however, the association between vitamin D levels and muscle function associated with balance recovery and falls is unclear. This study investigated the effect of circulating 25-hydroxyvitamin D (25 (OH) D) on pain, quadriceps strength, lower limb muscle mass and knee power function during balance recovery in people with knee OA. METHODS Twenty-four participants with clinical symptoms of knee OA (68.6 ± 6.2 years) participated in the study. Serum levels of 25 (OH) D were assessed and participants were classified as follows: vitamin D insufficiency ≤ 50 nmol/L and vitamin D sufficiency > 50 nmol/L. The groups were compared on knee function during balance recovery tasks, lower limb strength and muscle mass as well as perceived pain and function. RESULTS Seven patients (29.1%) were classified as vitamin D-insufficient. Vitamin D insufficiency was associated with reduced knee muscle function during the balance recovery task, increased pain (Western Ontario and McMasters University Osteoarthritis Index (WOMAC) subscore), dysfunction (WOMAC subscore) and total WOMAC score (p < 0.05). CONCLUSION People with knee OA with vitamin D insufficiency demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function.
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Gao XR, Chen YS, Deng W. The effect of vitamin D supplementation on knee osteoarthritis: A meta-analysis of randomized controlled trials. Int J Surg 2017; 46:14-20. [PMID: 28797917 DOI: 10.1016/j.ijsu.2017.08.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/02/2017] [Accepted: 08/03/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE We conducted a meta-analysis of RCTs to evaluate the effects of vitamin D supplementation in the prevention of symptom and structural progression of knee OA. METHODS PubMed, Embase, and Web of Science databases were searched to identify relevant studies. Outcomes included Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, function, stiffness, tibial cartilage volume, and serum vitamin D3 levels, and adverse events. Results were expressed as weight mean difference (WMD) with 95% confidence interval (CI), and risk ratio (RR) with 95%CI. RESULTS Four RCTs involving 1136 patients were included in this study. Pooled estimates suggested that vitamin D supplementation was associated with a significant reduction in WOMAC pain, and WOMAC function, but not in WOMAC stiffness. Vitamin D supplementation increased the serum vitamin D3 level, but had no effect on tibial cartilage volume. Subgroup analysis showed that, a daily supplement of more than 2000 IU vitamin D significantly decreased the WOMAC pain and WOMAC function. There was no significant difference in incidence of adverse events between the vitamin D and placebo groups. CONCLUSION Vitamin D supplementation was effective in improving the WOMAC pain and function in patients with knee OA. However, it had no beneficial effect on the prevention of tibial cartilage loss. Therefore, there is currently a lack of evidence to support the use of vitamin D supplementation in preventing the progression of knee OA.
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Affiliation(s)
- Xu-Ren Gao
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China.
| | - Ye-Shuai Chen
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
| | - Wei Deng
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China
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Garfinkel RJ, Dilisio MF, Agrawal DK. Vitamin D and Its Effects on Articular Cartilage and Osteoarthritis. Orthop J Sports Med 2017; 5:2325967117711376. [PMID: 28680892 PMCID: PMC5480771 DOI: 10.1177/2325967117711376] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Osteoarthritis (OA) currently affects 10% of the American population. There has been a recent push to determine exactly what causes OA and how it can be treated most effectively. Serum vitamin D levels have been associated with OA and may have an effect on articular cartilage remodeling. Purpose: To critically review the published research on the effect of vitamin D on articular cartilage and the development of OA as well as on the mechanism behind cartilage regeneration and degeneration. Study Design: Review. Methods: A systematic search of PubMed and the Web of Science was performed for relevant studies published in the English language through April 30, 2016, using the terms vitamin D, articular cartilage, and osteoarthritis. Results: On a molecular level, 1α,25(OH)2D3, the activated form of vitamin D, plays a role in articular cartilage degeneration. Vitamin D binds to vitamin D receptors, triggering a signaling cascade that leads to chondrocyte hypertrophy. In clinical trials, vitamin D deficiency poses a risk factor for OA, and those with decreased cartilage thickness are more likely to be vitamin D–insufficient. Conclusion: The role of vitamin D supplementation in the treatment or prevention of OA remains uncertain. More research is needed to reconcile these conflicting findings.
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Affiliation(s)
- Rachel J Garfinkel
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, Nebraska, USA
| | | | - Devendra K Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, Nebraska, USA
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Rosenberg JH, Rai V, Dilisio MF, Agrawal DK. Damage-associated molecular patterns in the pathogenesis of osteoarthritis: potentially novel therapeutic targets. Mol Cell Biochem 2017; 434:171-179. [PMID: 28474284 DOI: 10.1007/s11010-017-3047-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/25/2017] [Indexed: 10/19/2022]
Abstract
Osteoarthritis (OA) is a chronic disease that degrades the joints and is often associated with increasing age and obesity. The two most common sites of OA in adults are the knee and hip joints. Increased mechanical stress on the joint from obesity can cause the articular cartilage to degrade and release damage-associated molecular patterns (DAMPs). These DAMPs are involved in various molecular pathways that interact with nuclear factor-kappa B and result in the transcription of inflammatory cytokines and activation of matrix metalloproteinases that progressively destroy cartilage. This review focuses on the interactions and contribution to the pathogenesis and progression of OA through the DAMPs: high-mobility group box 1 (HMGB-1), the receptor for advanced glycation end-products (RAGE), the alarmin proteins S100A8 and S100A9, and heparan sulfate. HMGB-1 is released from damaged or necrotic cells and interacts with toll-like receptors (TLRs) and RAGE to induce inflammatory signals, as well as behave as an inflammatory cytokine to activate innate immune cells. RAGE interacts with HMGB-1, advanced glycation end-products, and innate immune cells to increase local inflammation. The alarmin proteins are released following cell damage and interact through TLRs to increase local inflammation and cartilage degradation. Heparan sulfate has been shown to facilitate the binding of HMGB-1 to RAGE and could play a role in the progression of OA. Targeting these DAMPs may be the potential therapeutic strategies for the treatment of OA.
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Affiliation(s)
- John H Rosenberg
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Vikrant Rai
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Matthew F Dilisio
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA.,Department of Orthopedic Surgery, Creighton University School of Medicine, Omaha, NE, 68178, USA
| | - Devendra K Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA.
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Effect of vitamin D levels on radiographic knee osteoarthritis and functional status. Turk J Phys Med Rehabil 2017; 64:1-7. [PMID: 31453483 DOI: 10.5606/tftrd.2018.986] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/26/2016] [Indexed: 12/17/2022] Open
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.
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Vaishya R, Vijay V, Hussaini SM, Agarwal AK. Association of vitamin D and knee osteoarthritis – A review. APOLLO MEDICINE 2017. [DOI: 10.1016/j.apme.2017.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Quadriceps Muscle Strength Correlates With Serum Vitamin D and Knee Pain in Knee Osteoarthritis. Clin J Pain 2017; 33:67-70. [DOI: 10.1097/ajp.0000000000000358] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Heidari B, Muhammadi A, Javadian Y, Bijani A, Hosseini R, Babaei M. Associated Factors of Bone Mineral Density and Osteoporosis in Elderly Males. Int J Endocrinol Metab 2017; 15:e39662. [PMID: 28835759 PMCID: PMC5554609 DOI: 10.5812/ijem.39662] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/19/2016] [Accepted: 11/19/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Low bone mineral density and osteoporosis is prevalent in elderly subjects. This study aimed to determine the associated factors of bone mineral density and osteoporosis in elderly males. METHODS All participants of the Amirkola health and ageing project cohort aged 60 years and older entered the study. Bone mineral density at femoral neck and lumbar spine was assessed by the dual energy X-ray absorptiometry (DXA) method. Osteoporosis was diagnosed by the international society for clinical densitometry criteria and the association of bone mineral density and osteoporosis with several clinical, demographic and biochemical parameters. Multiple logistic regression analysis was used to determine independent associations. RESULTS A total of 553 patients were studied and 90 patients (16.2%) had osteoporosis at either femoral neck or lumbar spine. Diabetes, obesity, metabolic syndrome, overweight, and quadriceps muscle strength > 30 kg, metabolic syndrome, abdominal obesity and education level were associated with higher bone mineral density and lower prevalence of osteoporosis, whereas age, anemia, inhaled corticosteroids and fracture history were associated with lower bone mineral density and higher prevalence of osteoporosis (P = 0.001). After adjustment for all covariates, osteoporosis was negatively associated only with diabetes, obesity, overweight, and QMS > 30 kg and positively associated with anemia and fracture history. The association of osteoporosis with other parameters did not reach a statistical level. CONCLUSIONS The findings of the study indicate that in elderly males, diabetes, obesity and higher muscle strength was associated with lower prevalence of osteoporosis and anemia, and prior fracture with higher risk of osteoporosis. This issue needs further longitudinal studies.
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Affiliation(s)
- Behzad Heidari
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Abdollah Muhammadi
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Yahya Javadian
- Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Department of Social Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Reza Hosseini
- Department of Social Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mansour Babaei
- Department of Internal Medicine, Clinical Research Development Unit, Rouhani Hospital, Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran
- Corresponding author: Mansour Babaei, Department of Internal Medicine, Clinical Research Development Unit, Rouhani Hospital, Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran. Tel: +098-1132238301-5; +98-9113134249, Fax: +98-1132238284, E-mail:
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Valderrama-Hinds LM, Al Snih S, Rodriguez MA, Wong R. Association of arthritis and vitamin D insufficiency with physical disability in Mexican older adults: findings from the Mexican Health and Aging Study. Rheumatol Int 2016; 37:607-616. [PMID: 27904949 DOI: 10.1007/s00296-016-3622-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/23/2016] [Indexed: 12/19/2022]
Abstract
Arthritis and vitamin D insufficiency are prevalent in older adults and are risk factors for disability. The objective of this study was to examine the effect of co-occurring arthritis and vitamin D deficiency on upper-lower extremity functional limitations and disability in older adults. We examined 1533 participants aged ≥50 years from a subsample of the Mexican Health and Aging Study. Measures included sociodemographics, body mass index, comorbid conditions, falls, physical activity, physical function tests, functional limitations, activities of daily living (ADL), and vitamin D. Participants were categorized into four groups according to arthritis and vitamin D status: no vitamin D insufficiency and no arthritis (58.80%), vitamin D insufficiency only (27.49%), arthritis only (8.47%), and arthritis and vitamin D insufficiency (5.24%). Fourteen percent reported arthritis, and 31.2% had vitamin D insufficiency. The arthritis and vitamin D insufficiency group was associated with upper-lower extremity functional limitations [odds ratio (OR) 1.82, 95% confidence interval (CI) 1.06-3.15, and OR 1.90, 95% CI 1.00-3.62, respectively] and ADL disability (OR 3.00, 95% CI 1.63-5.51) when compared with the no vitamin D insufficiency and no arthritis group (reference group). The arthritis only group was three times more likely to report upper-lower extremity functional limitations and ADL disability. The vitamin D insufficiency only group was not significantly associated with functional limitations nor ADL disability. Arthritis and vitamin D insufficiency increased the risk of ADL disability in this population. However, the effect of arthritis and vitamin D insufficiency on upper-lower extremity functional limitations was not higher than the effect of arthritis only, but higher than the effect on vitamin D insufficiency alone.
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Affiliation(s)
- Luis M Valderrama-Hinds
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA. .,Division of Rheumatology, Department of Internal Medicine, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela. .,Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.
| | - Soham Al Snih
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA. .,Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555-0177, USA. .,Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
| | - Martin A Rodriguez
- Division of Rheumatology, Department of Internal Medicine, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.,Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA.,Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA
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Arden NK, Cro S, Sheard S, Doré CJ, Bara A, Tebbs SA, Hunter DJ, James S, Cooper C, O’Neill TW, Macgregor A, Birrell F, Keen R. The effect of vitamin D supplementation on knee osteoarthritis, the VIDEO study: a randomised controlled trial. Osteoarthritis Cartilage 2016; 24:1858-1866. [PMID: 27264058 PMCID: PMC5045720 DOI: 10.1016/j.joca.2016.05.020] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 05/19/2016] [Accepted: 05/23/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Epidemiological data suggest low serum 25-hydroxyvitamin D3 (25-OH-D3) levels are associated with radiological progression of knee osteoarthritis (OA). This study aimed to assess whether vitamin D supplementation can slow the rate of progression. METHOD A 3-year, double-blind, randomised, placebo-controlled trial of 474 patients aged over 50 with radiographically evident knee OA comparing 800 IU cholecalciferol daily with placebo. Primary outcome was difference in rate of medial joint space narrowing (JSN). Secondary outcomes included lateral JSN, Kellgren & Lawrence grade, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, function, stiffness and the Get up and Go test. RESULTS Vitamin D supplementation increased 25-OH-D3 from an average of 20.7 (standard deviation (SD) 8.9) μg/L to 30.4 (SD 7.7) μg/L, compared to 20.7 (SD 8.1) μg/L and 20.3 (SD 8.1) μg/L in the placebo group. There was no significant difference in the rate of JSN over 3 years in the medial compartment of the index knee between the treatment group (average -0.01 mm/year) and placebo group (-0.08 mm/year), average difference 0.08 mm/year (95% confidence interval (CI) [-0.14-0.29], P = 0.49). No significant interaction was found between baseline vitamin D levels and treatment effect. There were no significant differences for any of the secondary outcome measures. CONCLUSION Vitamin D supplementation did not slow the rate of JSN or lead to reduced pain, stiffness or functional loss over a 3-year period. On the basis of these findings we consider that vitamin D supplementation has no role in the management of knee OA.
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Affiliation(s)
- Nigel K Arden
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK,Arthritis Research UK Centre of Excellence for Sport, Injury, and Osteoarthritis
| | - Suzie Cro
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Aviation House, 125 Kingsway, London, WC2B 6NH
| | - Sally Sheard
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
| | - Caroline J Doré
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Aviation House, 125 Kingsway, London, WC2B 6NH
| | - Anna Bara
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Aviation House, 125 Kingsway, London, WC2B 6NH
| | - Susan A Tebbs
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Aviation House, 125 Kingsway, London, WC2B 6NH
| | - David J Hunter
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK,Chromatic Innovation Limited, Leamington Spa, UK
| | | | - Cyrus Cooper
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Terence W O’Neill
- Arthritis Research UK Centre for Epidemiology, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK,NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | | | - Richard Keen
- Royal National Orthopaedic Hospital, Stanmore, Middlesex,Institute of Orthopaedics and Musculoskeletal Science, University College London, London
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Rai V, Dietz NE, Dilisio MF, Radwan MM, Agrawal DK. Vitamin D attenuates inflammation, fatty infiltration, and cartilage loss in the knee of hyperlipidemic microswine. Arthritis Res Ther 2016; 18:203. [PMID: 27624724 PMCID: PMC5022245 DOI: 10.1186/s13075-016-1099-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/22/2016] [Indexed: 12/19/2022] Open
Abstract
Background Osteoarthritis (OA) of the knee joint is a degenerative process resulting in cartilage loss. Recent evidence suggests that OA is not merely a disease of cartilage but a disease of the entire knee joint and that inflammation may play an important role. OA has been associated with vitamin D deficiency. Vitamin D as an immunomodulator and anti-inflammatory agent may attenuate inflammation in the knee. The aim of this study was to assess the anti-inflammatory effect of vitamin D on inflammation in the knee. Methods This study was conducted with 13 microswine on a high cholesterol diet categorized into three groups of vitamin D-deficient, vitamin D-sufficient, and vitamin D supplementation. After 1 year, microswine were killed, and their knee joint tissues were harvested. Histological and immunofluorescence studies were carried out on the tissue specimens to evaluate the effect of vitamin D status. Results Histological and immunofluorescence studies of the knee joint tissues showed (1) increased inflammation in the knee joint tissues, (2) fatty infiltration in quadriceps muscle, patellar tendon, and collateral ligaments, and (3) chondrocyte clustering in the vitamin D-deficient and vitamin D-sufficient groups compared with the vitamin D supplementation group. Architectural distortion of the quadriceps muscle, patellar tendon, and collateral ligaments was also seen in the areas of inflammatory foci and fatty infiltration in the vitamin D-deficient group. Conclusions Decreased inflammation and fatty infiltration in the vitamin D supplementation group suggest the potential role of vitamin D in attenuating inflammation and fatty infiltration as well as in protecting the architecture of the tissue in the knee joint. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1099-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vikrant Rai
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Nicholas E Dietz
- Department of Pathology, Creighton University School of Medicine, 601 North 30th Street, Omaha, NE, 68131, USA
| | - Matthew F Dilisio
- Department of Orthopedic Surgery, Creighton University School of Medicine, Omaha, NE, 68178, USA.,CHI Health Alegent Creighton Clinic, 601 North 30th Street, Suite 2300, Omaha, NE, 68131, USA
| | - Mohamed M Radwan
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA
| | - Devendra K Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA.
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50
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Poulet B, Staines KA. New developments in osteoarthritis and cartilage biology. Curr Opin Pharmacol 2016; 28:8-13. [DOI: 10.1016/j.coph.2016.02.009] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/11/2016] [Accepted: 02/12/2016] [Indexed: 01/05/2023]
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