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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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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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Namutebi F, Kayima J, Kaddumukasa M. Vitamin D and its association with symptom severity in knee osteoarthritis: a cross sectional study at a national referral hospital in Uganda. BMC Rheumatol 2021; 5:56. [PMID: 34955099 PMCID: PMC8711200 DOI: 10.1186/s41927-021-00228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is highly prevalent among patients with osteoarthritis. It is associated with joint pain, stiffness and worse physical function. Whether vitamin D deficiency is associated with osteoarthritis is controversial. We investigated serum vitamin D levels and its association with symptom severity in patients with knee osteoarthritis. METHODS Between January 2020 to March and May 2020, we conducted a cross sectional study at a national referral hospital in Uganda. Using the American College of Rheumatology clinical criteria, 107 consenting adults were diagnosed with knee osteoarthritis. A questionnaire captured patient demographics and clinical characteristics. Joint pain, stiffness and physical function severity were assessed and graded based on the Western Ontario and McMaster Universities Arthritis Index (WOMAC). We determined serum vitamin D levels by electrochemilumniscence immunoassay. The data were analysed and adjusted for age, sex, education, occupation, family history, body mass index (BMI) and calcium supplementation. RESULTS Of the 107 patients, 92 (86%) patients were females, mean (SD) age was 58.1 (12.6) years. Nearly 65% of the patients had suboptimal serum vitamin D levels < 30 ng/ml. The median (Q1, Q3) WOMAC joint scores were as follows: pain 8.0 (5, 11), stiffness 1 (0, 2), physical function 29.0 (16, 41) and total WOMAC 39.0 (21, 54). Spearman correlations between serum vitamin D levels with symptom severity were as follows: joint pain (r = 0.18, p = 0.06), stiffness (r = 0.13, p = 0.17), physical function (r = 0.09, p = 0.36) and total WOMAC (r = 0.13, p = 0.19). CONCLUSION Serum vitamin D levels are not associated with joint pain, stiffness and physical function severity. Older age and higher BMI are associated with vitamin D deficiency in patients with knee osteoarthritis attending a national referral hospital rheumatology clinic in Uganda. Suboptimal vitamin D is an independent risk factor for total mortality in the general population. Clinical guidelines and further studies to determine age and BMI ranges required for vitamin D screening are needed in patients with osteoarthritis in Uganda. Patients are advised to keep a normal BMI.
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Affiliation(s)
- Fiona Namutebi
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda.
| | - James Kayima
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda.,Uganda Heart Institute, Kampala, Uganda
| | - Mark Kaddumukasa
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O Box 7062, Kampala, Uganda
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Amini Kadijani A, Bagherifard A, Mohammadi F, Akbari A, Zandrahimi F, Mirzaei A. Association of Serum Vitamin D with Serum Cytokine Profile in Patients with Knee Osteoarthritis. Cartilage 2021; 13:1610S-1618S. [PMID: 33890506 PMCID: PMC8808942 DOI: 10.1177/19476035211010309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The role of vitamin D in the pathogenesis of osteoarthritis (OA) is not well understood. In this study, we aimed to investigate the association of serum vitamin D with the serum cytokine profile in patients with primary knee OA. DESIGN In a cross-sectional study, 116 patients with radiologic diagnosis of grade I to III knee OA were included. The study population included 79 (75.9%) females and 25 (24.1%) males with a mean age of 55.1 ± 9.6 years. The serum concentration of IL-6, IL-8, TNF-α, IL-4, IL-10, IL-13, and vitamin D were assessed using an enzyme-linked immunosorbent assay. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used for the assessment of patient's reported disability associated with knee OA. RESULTS Serum vitamin D status was deficient, insufficient, and sufficient in 18 (15.5%), 63 (54.3%), 35 (30.2%) patients, respectively. Higher levels of serum IL-6 were observed in patients with vitamin D deficiency (P = 0.022). The mean serum vitamin D level was not associated with OA grade (P = 0.88) and WOMAC scores of the patients (P = 0.67). Serum IL-6 level was significantly associated with both OA grade and WOMAC scores of the patients (P < 0.001 and P = 0.001, respectively). The vitamin D status was not significantly associated with the serum levels of other evaluated cytokines. CONCLUSION Vitamin D deficiency in knee OA seems to be associated with a higher release of IL-6. Therefore, vitamin D supplementation could reduce the disease burden by controlling the IL-6 release.
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Affiliation(s)
- Azade Amini Kadijani
- Basic and Molecular Epidemiology of
Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology
and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Abolfazl Bagherifard
- Bone and Joint Reconstruction Research
Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran,
Iran
| | - Fatemeh Mohammadi
- Emergency Medicine Management Research
Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Akbari
- Colorectal Research Center, Iran
University of Medical Sciences, Tehran, Iran
| | - Farshad Zandrahimi
- Basic and Molecular Epidemiology of
Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology
and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran,
Iran,Kerman University of Medical Sciences,
Kerman, Iran
| | - Alireza Mirzaei
- Bone and Joint Reconstruction Research
Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran,
Iran,Alireza Mirzaei, Bone and Joint
Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of
Medical Sciences, Baharestan Square, Tehran, Iran.
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Alabajos-Cea A, Herrero-Manley L, Suso-Martí L, Viosca-Herrero E, Cuenca-Martínez F, Varangot-Reille C, Blanco-Díaz M, Calatayud J, Casaña J. The Role of Vitamin D in Early Knee Osteoarthritis and Its Relationship with Their Physical and Psychological Status. Nutrients 2021; 13:nu13114035. [PMID: 34836290 PMCID: PMC8622912 DOI: 10.3390/nu13114035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/20/2021] [Accepted: 09/25/2021] [Indexed: 12/17/2022] Open
Abstract
Osteoarthritis (OA) is a common joint condition and one of the greatest causes of disability worldwide. The role of vitamin D in the origin and development of the disease is not clear, although it could have important implications for diagnosis and treatment. For this proposal, a cross-sectional study with a non-probabilistic sample was performed. In total, 48 with early osteoarthritis (EOA) and 48 matched controls were selected, and serum 25(OH)D and parathyroid hormone (PTH) levels were analyzed. In addition, physical and psychological variables were measured to establish their relationship with vitamin D levels. Patients with EOA showed lower levels (22.3 ± 7.3 ng/mL) in comparison to matched controls (29.31 ± 9.2 ng/mL). A statistically significant higher number (Chi-squared = 8.525; p = 0.004) of patients with EOA had deficiency levels (<20 ng/mL) compared to the control group. Patients with lower vitamin D levels showed higher levels of pain intensity, disability, and anxiety, as well as poorer values for sit-to-stand, walking speed, and social participation. Correlation analysis showed a relationship between serum 25(OH)D, PTH and pain intensity, and social participation. These results highlight the relevance of vitamin D in the early diagnosis and prevention of EOA.
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Affiliation(s)
- Ana Alabajos-Cea
- Servicio de Medicina Física y Rehabilitación, Hospital La Fe, 46026 Valencia, Spain; (A.A.-C.); (L.H.-M.); (E.V.-H.)
- Grupo de Investigación en Medicina Física y Rehabilitación, Instituto de Investigación Sanitaria La Fe (IISLAFE), 46026 Valencia, Spain
| | - Luz Herrero-Manley
- Servicio de Medicina Física y Rehabilitación, Hospital La Fe, 46026 Valencia, Spain; (A.A.-C.); (L.H.-M.); (E.V.-H.)
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46026 Valencia, Spain; (F.C.-M.); (C.V.-R.); (J.C.); (J.C.)
- Correspondence:
| | - Enrique Viosca-Herrero
- Servicio de Medicina Física y Rehabilitación, Hospital La Fe, 46026 Valencia, Spain; (A.A.-C.); (L.H.-M.); (E.V.-H.)
- Grupo de Investigación en Medicina Física y Rehabilitación, Instituto de Investigación Sanitaria La Fe (IISLAFE), 46026 Valencia, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46026 Valencia, Spain; (F.C.-M.); (C.V.-R.); (J.C.); (J.C.)
| | - Clovis Varangot-Reille
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46026 Valencia, Spain; (F.C.-M.); (C.V.-R.); (J.C.); (J.C.)
| | - María Blanco-Díaz
- Surgery and Medical Surgical Specialities Department, Faculty of Medicine and Health Sciences, University of Oviedo, 33006 Oviedo, Spain;
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46026 Valencia, Spain; (F.C.-M.); (C.V.-R.); (J.C.); (J.C.)
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46026 Valencia, Spain; (F.C.-M.); (C.V.-R.); (J.C.); (J.C.)
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A Mendelian randomization study on the role of serum parathyroid hormone and 25-hydroxyvitamin D in osteoarthritis. Osteoarthritis Cartilage 2021; 29:1282-1290. [PMID: 33975017 DOI: 10.1016/j.joca.2021.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Serum parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D] have been demonstrated to be associated with pathogenesis and progression of osteoarthritis (OA). This study aimed to determine the potential causal relationship between serum PTH and 25(OH)D levels and risk of OA. DESIGN We applied the two-sample Mendelian randomization (MR) approach to estimate the causal roles of serum PTH and 25(OH)D on OA. The instrumental variables for serum PTH and 25(OH)D were derived from two large genome-wide association studies (GWAS), which included 29,155 and 79,366 individuals, respectively. Summary-level data for overall, hip and knee OA were extracted from a GWAS meta-analysis, including 455,221 individuals. All participants included in this study were from the European population. RESULTS An inverse association was observed between serum PTH levels and risk of OA (random-effects: Effect = 0.71; 95% CI: 0.54 to 0.92; fixed-effects: Effect = 0.71; 95% CI: 0.61 to 0.82). Stratified by site, serum PTH levels were found to be inversely associated with knee OA (random-effects: Effect = 0.53; 95% CI: 0.41 to 0.68; fixed-effects: Effect = 0.53; 95% CI: 0.41 to 0.68). However, there was no evidence of the causal effect of serum 25(OH)D levels on OA. CONCLUSIONS The present study indicates an inverse causal relationship between serum PTH concentrations and development of OA. Moreover, a site-specific association was also observed between serum PTH levels and knee OA. The potential mechanisms by which serum PTH affects OA need to be further investigated.
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RELATIONSHIP BETWEEN VITAMIN D LEVEL ON PAIN, FUNCTIONAL STATUS AND QUALITY OF LIFE IN INDIVIDUALS WITH OSTEOARTHRITIS. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.845320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Livings R, Naylor JM, Gibson K, Dennis S, Thom J, Mills K, Schabrun SM. Implementation of a community-based, physiotherapy-led, multidisciplinary model of care for the management of knee osteoarthritis: protocol for a feasibility study. BMJ Open 2020; 10:e039152. [PMID: 32737099 PMCID: PMC7394177 DOI: 10.1136/bmjopen-2020-039152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION There is a gap between the care people with knee osteoarthritis (OA) should receive according to evidence-based guidelines and the care they do receive. This feasibility study aims to test the feasibility of developing and implementing a codesigned, physiotherapy-led, multidisciplinary, evidence-based model of care for knee OA, among community physiotherapy practices in Australia, where community practice is defined as a professional physiotherapy business that is not controlled or paid for by the government. METHODS AND ANALYSIS A mixed-methods quasi-experimental (pre/postintervention) study. In the preintervention phase, all consented physiotherapists working in nine metropolitan-based, community physiotherapy practices, and 26 patients with knee OA will be recruited. Patients will be recruited from all practices by the physiotherapists, using the outlined inclusion/exclusion criteria. An audit of physiotherapy treatment notes will occur using a proforma, to gain an understanding of current community physiotherapy treatment and documentation. Patient and physiotherapist interviews will be conducted to determine current practice for the management of knee OA. A codesign phase will follow, where a model of care will be developed by researchers, patients, clinical staff, members of the public and other stakeholders, based on current guidelines for conservative management of knee OA. In the postintervention phase, a further 26 patients will be recruited, and the assessment process repeated to determine whether there is a change in practice. The feasibility outcome measures are: (1) number of patients who are recorded as receiving care according to current evidence-based guidelines; (2) number of patients who have patient-reported outcomes incorporated into their assessment and management plan; and (3) acceptability of the developed model to patients and physiotherapists. The clinical outcomes will include assessment of patient-reported outcome measures (pain, function, etc) in the preintervention and postintervention phases (baseline and 12 weeks) to assess trends towards change in participant symptoms. ETHICS AND DISSEMINATION Ethical approval has been obtained from the University of New South Wales human ethics committee (approval number HC180864, approval period 6 February 2019 to 5 February 2024). The preintervention stage of this study is complete. The next stage is to implement the intervention and compare outcomes between the preintervention and postintervention phases. The results will be disseminated via peer-reviewed publications and presentations at conferences. TRIAL REGISTRATION NUMBER The preintervention phase of the study is retrospectively registered at ClinicalTrials.gov with registration number: ACTRN12620000188932. The intervention and postintervention phase of the study is prospectively registered at ClinicalTrials.gov with registration number: ACTRN12620000218998.
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Affiliation(s)
- Rebecca Livings
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Justine M Naylor
- South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Kathryn Gibson
- Rheumatology Department, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Sarah Dennis
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Clinical and Rehabilitation Sciences, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Jeanette Thom
- School of Medical Sciences, University of New South Wales, Kensington, New South Wales, Australia
| | - Kathryn Mills
- Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
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Dalle S, Koppo K. Is inflammatory signaling involved in disease-related muscle wasting? Evidence from osteoarthritis, chronic obstructive pulmonary disease and type II diabetes. Exp Gerontol 2020; 137:110964. [PMID: 32407865 DOI: 10.1016/j.exger.2020.110964] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/15/2020] [Accepted: 04/23/2020] [Indexed: 12/12/2022]
Abstract
Muscle loss is an important feature that occurs in multiple pathologies including osteoarthritis (OA), chronic obstructive pulmonary disease (COPD) and type II diabetes (T2D). Despite differences in pathogenesis and disease-related complications, there are reasons to believe that some fundamental underlying mechanisms are inherent to the muscle wasting process, irrespective of the pathology. Recent evidence shows that inflammation, either local or systemic, contributes to the modulation of muscle mass and/or muscle strength, via an altered molecular profile in muscle tissue. However, it remains ambiguous to which extent and via which mechanisms inflammatory signaling affects muscle mass in disease. Therefore, the objective of the present review is to discuss the role of inflammation on skeletal muscle anabolism, catabolism and functionality in three pathologies that are characterized by an eventual loss in muscle mass (and muscle strength), i.e. OA, COPD and T2D. In OA and COPD, most rodent models confirmed that systemic (COPD) or muscle (OA) inflammation directly induces muscle loss or muscle dysfunctionality. However, in a patient population, the association between inflammation and muscular maladaptations are more ambiguous. For example, in T2D patients, systemic inflammation is associated with muscle loss whereas in OA patients this link has not consistently been established. T2D rodent models revealed that increased levels of advanced glycation end-products (AGEs) and a decreased mTORC1 activation play a key role in muscle atrophy, but it remains to be elucidated whether AGEs and mTORC1 are interconnected and contribute to muscle loss in T2D patients. Generally, if any, associations between inflammation and muscle are mainly based on observational and cross-sectional data. There is definitely a need for longitudinal evidence through well-powered randomized control trials that take into account confounders such as age, disease-phenotypes, comorbidities, physical (in) activity etc. This will allow to improve our understanding of the complex interaction between inflammatory signaling and muscle mass loss and hence contribute to the development of therapeutic strategies to combat muscle wasting in these diseases.
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Affiliation(s)
- Sebastiaan Dalle
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
| | - Katrien Koppo
- Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium.
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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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Ko S, Chae S, Choi W, Kwon J, Choi JY. The effectiveness of vitamin D supplementation in functional outcome and quality of life (QoL) of lumbar spinal stenosis (LSS) requiring surgery. J Orthop Surg Res 2020; 15:117. [PMID: 32209124 PMCID: PMC7092593 DOI: 10.1186/s13018-020-01629-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/10/2020] [Indexed: 01/24/2023] Open
Abstract
Study design This is a retrospective cohort comparative study. Background Vitamin D supplementation is considered to be associated with good functional outcome. Thus, a few studies have proposed vitamin D supplementation is benefit to the functional outcome in LSS requiring surgery. The purpose of this study is to identify the prevalence of vitamin D deficiency in patients with LSS requiring surgery, and to compare the differences between the cases whether vitamin D is supplemented and vitamin D is not supplemented in terms of a QoL during postoperative 2 year. Methods All patients with LSS who underwent surgery from March 1, 2015 to August 31, 2016 were enrolled. Among them, 61 patients with vitamin D deficiency were divided into two groups (supplemented group (A) and non-supplemented group (B)). Functional outcomes using Oswestry Disability Index (ODI) and Rolland Morris Disability Index (RMDQ) and QoL using SF-36 were evaluated at 12-month and 24-month follow-up periods. Differences in functional score and SF-36 between the vitamin D supplemented and non-supplemented group were compared. Results Among the total 102 patients, 78 patients (76.5%) had vitamin D deficiency. Of the 78 patients, 61 patients were included, 27 patients were group A and 27 patients were group B. There was no difference in age and 25-OHD level between the two groups (all 0 > 0.05). Group A were better functional outcomes at 2 years after surgery (p < 0.05). On the QoL, group A were higher score than group B from 12 month later after surgery (p < 0.05). Conclusions Vitamin D deficiency was highly prevalent in LSS patients (76.5%). Assessment of serum 25-hydroxyvitamin D (25(OH)D) is recommended in LSS needing surgical intervention and active treatment vitamin D supplementation and maintenance of normal range should be considered for better postoperative functional outcome and QoL.
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Affiliation(s)
- Sangbong Ko
- Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Duryugongwon-ro 17-gil, Nam-gu, Daegu city, Korea.
| | - Seungbum Chae
- Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Duryugongwon-ro 17-gil, Nam-gu, Daegu city, Korea
| | - Wonkee Choi
- Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Duryugongwon-ro 17-gil, Nam-gu, Daegu city, Korea
| | - Jaibum Kwon
- Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Duryugongwon-ro 17-gil, Nam-gu, Daegu city, Korea
| | - Je-Yong Choi
- Department of Biochemistry and Cell Biology, Kyungpook National University, Daegu, Korea
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Deng S, He Y, Nian X, Sun E, Li L. Relationship between Vitamin D levels and pain and disease activity in patients with newly diagnosed axial spondyloarthritis. Int J Nurs Sci 2020; 7:54-59. [PMID: 32099860 PMCID: PMC7031124 DOI: 10.1016/j.ijnss.2019.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/30/2019] [Accepted: 12/11/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES To explore the relationship between Vitamin D levels and pain and disease activity in patients with newly diagnosed axial spondyloarthritis (axSpA). METHODS A convenience sample of 131 newly diagnosed axSpA patients and 60 healthy controls was recruited from July 2016 to December 2018. Serum 25-hydroxyvitamin D [25(OH)D] was measured to assess vitamin D levels. Disease activity was assessed by objective indicators [Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the Bath Ankylosing Spondylitis Metrology Index (BASMI)], patient-reported questionnaires [the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Bath Ankylosing Spondylitis Functional Index (BASFI)]. Pain intensity and interference were also assessed. RESULTS Vitamin D insufficiency [serum 25(OH) D levels<50 nmol/L]was found in 46 (35.1%) and 25 (43.3%) of the axSpA patients and the healthy controls, respectively. Female patients had higher risk (OR:4.928; 95% CI: 1.921-12.642) for vitamin D insufficiency than male patients. Vitamin D was positively correlated with CRP, ESR level, the BASFI, and the BASMI. Logistic regression showed that vitamin D levels were not associated with pain, or disease activity in the newly diagnosed axSpA patients. Gender was the only predictive variable for vitamin D levels. CONCLUSIONS Vitamin D insufficiency was prevalent in both newly diagnosed axSpA patients and healthy controls. There was no association between vitamin D and pain and disease activity in the newly diagnosed axSpA patients. Monitoring vitamin D levels is important and early intervention for vitamin D insufficiency is needed, especially in female patients.
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Affiliation(s)
- Sisi Deng
- Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yi He
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xinying Nian
- Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Erwei Sun
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Li Li
- Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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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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