Affiliations: [a] Tunceli State Hospital, Tunceli, Turkey | [b] Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Firat University, Elazig, Turkey
Correspondence:
[*]
Corresponding author: Gurkan Akgol, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Firat University, Elazig, Turkey. Tel.: +90 04242333555/2032; GSM: +90 05333357784; E-mail:drgurkanakgol@gmail.com
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.
Keywords: Knee osteoarthritis, vitamin D deficiency, quality of life
