Background The existence of certain interdependencies between vitamin D status and osteoarthritis (OA) has been known for over 20 years. This issue needs closer investigation, however, as the VDD ramifications are multiple and poorly defined.
Objectives Establishment of:
1. frequency of vitamin D deficiency (VDD) within the population of OA patients.
2. relationship between VDD and severity of OA, BMD, and well-being for these patients (including quality of life)
3. impact of other factors on the above parameters.
Methods 83 non-osteoporotic subjects (aged 50–65 years) were enrolled in the study. 85.5% of these were women.
All subjects underwent ultrasound densitometry. Numerous questionnaires were also being completed (VAS, Lequesne index, EuroQoL). Blood sampling with subsequent 25(OH)D assessment was done. DXA was utilized to verify BMD.
Results VDD was found in 79.5% of the subjects. Vitamin D insufficiency was diagnosed in 16.9%.
Severity of pain in non-deficient patients was 22.4±8.1 by VAS, whereas vitamin D-deficient subjects were found to have significantly more prominent pain syndrome (57.8±11.8), p<0.05. Quality of life in non-deficient patients as confirmed by EuroQoL-5D was better (3.17±0.91) than in patients with insufficiency (5.05±0.39) and deficiency (5.69±0.54), p<0.05.
In addition, 25(OH)D was proven to be linked to PTH level in this patient population.
A probable (p<0.05) inverse relationship between BMD in Ward's area and 25(OH)D level was discovered.
Conclusions It was proven that VDD frequency and severity among the OA population is significantly higher than that within the reference population. Specifically, severe VDD was registered almost three times as often (39.8%) within the study subjects. On the contrary, no correlation was found between 25(OH)D and X-ray evidence of OA.
BMD values in Ward zone may help in identification of vitamin D deficient subjects with OA.
Vitamin D level was found out to be closely linked with subjective signs in these patients, thus having an impact on the quality of their life. Further, among this population of the patients VAS turned out to be more predictable and accurate tool compared to Lequesne index. Based upon the study results, routine screening for and correction of VDD may prove to be beneficial for the OA patients. Supplementary therapy with vitamin D preparations was suggested to be an integral part of the treatment of the patients with osteoarthritis, notably since the implementation of this approach is relatively quick and simple.
Disclosure of Interest None declared