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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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Sirufo MM, Ginaldi L, De Martinis M. The IL-33/ST2 axis and vitamin D as a possible emerging therapeutic target in osteoarthritis. Rheumatology (Oxford) 2021; 60:e300. [PMID: 33752232 DOI: 10.1093/rheumatology/keab292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04, Teramo, Italy
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04, Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04, Teramo, Italy
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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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Avcioglu G, Özbek Ipteç B, Akcan G, Görgün B, Fidan K, Carhan A, Yilmaz G, Kozaci LD. Effects of 1,25-Dihydroxy vitamin D 3 on TNF-α induced inflammation in human chondrocytes and SW1353 cells: a possible role for toll-like receptors. Mol Cell Biochem 2019; 464:131-142. [PMID: 31734843 DOI: 10.1007/s11010-019-03655-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 11/08/2019] [Indexed: 02/06/2023]
Abstract
The purpose of this study is to evaluate anti-inflammatory and chondro-protective effects of 1,25(OH)2D3 in human chondrocytes and SW1353 cells via investigating expressions of MMPs, TIMPs, VDR, and intracellular signalling pathway mediators such as TLR-2 and -4. The HC and SW1353 cells were treated with 1,25(OH)2D3 at 10, 100, and 1000 nM concentrations in the absence/presence of TNF-α (20 ng/mL) for 48 h. The mRNA expressions of MMP-1, -2, -3, -9, and -13, TIMP-1 and -2, VDR, TLR-2 and -4 in HC and SW1353 cells were detected by qPCR after treatments. The cytotoxicity and cell proliferation analyses were assessed by LDH and WST-1 assay, respectively. Protein levels of MMPs, TIMPs, and VDR were analysed by immunocytochemistry and ELISA methods. TNF-α markedly increased cytotoxicity for 24, 48, 72 h (p < 0.05) and vitamin D treatment was shown to diminish the cytotoxic effect of TNF-α. Cell proliferations increased by Vitamin D in a dose-dependent manner. mRNA expressions of MMP-1, -2, -3, -9, and -13, TLR-2 and -4 genes decreased with 1,25(OH)2D3 treatment (p < 0.05). VDR, TIMP-1 and -2 levels elevated after TNF-α exposure compared with the control group in HC cells (p < 0.05). Protein expression levels were determined using Western blotting, ELISA and immunocytochemistry. 1,25(OH)2D3 via binding to VDR, reversed the effects of TNF-α by inhibiting TLR-2 and 4. Decreased levels of VDR, TIMP-1 and -2 after TNF-α treatment were elevated by 1,25(OH)2D3 proportional with increasing 1,25(OH)2D3 doses. 1,25(OH)2D3 and TNF-α co-treatment decreased MMP-1, -2, -3, -9, and -13 levels were after TNF-α exposure.
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Affiliation(s)
- Gamze Avcioglu
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, 06800, Ankara, Turkey.
| | - Betül Özbek Ipteç
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, 06800, Ankara, Turkey
| | - Gülben Akcan
- Department of Histology and Embryology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Büsra Görgün
- Department of Translational Medicine, Institute of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Kübra Fidan
- Department of Translational Medicine, Institute of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ahmet Carhan
- Department of Medical Biology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey.,Department of Translational Medicine, Institute of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Gulsen Yilmaz
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, 06800, Ankara, Turkey.,Department of Translational Medicine, Institute of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Leyla Didem Kozaci
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, 06800, Ankara, Turkey.,Department of Translational Medicine, Institute of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
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