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% ( 1,683) were diagnosed with knee osteoarthritis. Among these patients, the levels of adjusted 25-(OH) vitamin D3 were significantly lower ( 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; 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.
BrandtKDRadinELDieppePAvan de PutteL. Yet more evidence that osteoarthritis is not a cartilage disease. Ann Rheum Dis.2006; 65(10): 1261-4.
2.
Martel-PelletierJBarrAJCicuttiniFMConaghanPGCooperCGoldringMB, et al. Osteoarthritis. Nat Rev Dis Primers.2016; 2: 16072.
3.
MartinJMeltzerHElliotD. OPCS surveys of disability in Great Britain. Report 1. The prevalence of disability among adults. HMSO, London: 1988.
4.
AltmanRAschEBlochDBoleGBorensteinDBrandtK, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum.1986; 29(8): 1039-49.
5.
ZhangWDohertyMPeatGBierma-ZeinstraMAArdenNKBresnihanB, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis.2010; 69(3): 483-9.
6.
LawrenceRCHelmickCGArnettFCDeyoRAFelsonDTGianniniEH, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum.1998; 41(5): 778-99.
7.
FelsonDTLawrenceRCDieppePAHirschRHelmickCGJordanJM, et al. Osteoarthritis: New insights. Part 1: The disease and its risk factors. Ann Intern Med.2000; 133(8): 635-46.
8.
SrikanthVKFryerJLZhaiGWinzenbergTMHosmerDJonesG. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis Cartilage.2005; 13(9): 769-81.
9.
KaçarCGilgilEUrhanSArikanVDündarUOksüzMC, et al. The prevalence of symptomatic knee and distal interphalangeal joint osteoarthritis in the urban population of Antalya, Turkey. Rheumatol Int.2005; 25(3): 201-4.
10.
GuptaSHawkerGALaporteACroxfordRCoytePC. The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford).2005; 44(12): 1531-7.
11.
LozaELopez-GomezJMAbasoloLMaeseJCarmonaLBatlle-GualdaE; Artrocad Study Group. Economic burden of knee and hip osteoarthritis in Spain. Arthritis Rheum.2009; 61(2): 158-65.
12.
PabingerCBergholdABoehlerNLabekG. Revision rates after knee replacement. Cumulative results from worldwide clinical studies versus joint registers. Osteoarthritis Cartilage.2013; 21(2): 263-8.
13.
TravenSAChiaramontiAMBarfieldWRKirklandPADemosHASchutteHD, et al. Fewer complications following revision hip and knee arthroplasty in patients with normal vitamin D levels. J Arthroplasty.2017; 32(9S): S193-S196.
14.
LipsP. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev.2001; 22: 477-501.
15.
BikleDD. Vitamin D and bone. Curr Osteoporos Rep.2012; 10(2): 151-9.
16.
BerginkAPUitterlindenAGVan LeeuwenJPBuurmanCJHofmanAVerhaarJA, et al. Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: The Rotterdam Study. J Clin Rheumatol.2009; 15(5): 230-7.
17.
DingC. Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: The Tasmanian older adult cohort study. Arthritis Rheum.2009; 60(5): 1381-9.
18.
MohamedAAHanafiRSBadawySE, et al. Association of suboptimal 25-hydroxyvitamin D levels with knee osteoarthritis incidence in post-menopausal Egyptian women. Rheumatol Int.2013; 33(11): 2903-7.
19.
KellgrenJHLawrenceJS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis.1957; 16(4): 494-502.
20.
HolickMF. Vitamin D deficiency. N Engl J Med.2007; 357(3): 266-81.
21.
HeidariBHeidariPHajian-TilakiK. Association between serum vitamin D deficiency and knee osteoarthritis. Int Orthop.2011; 35(11): 1627-31.
22.
ChagantiRKParimiNCawthonPDamTLNevittMCLaneNE. Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men: The osteoporotic fractures in men study. Arthritis Rheum.2010; 62(2): 511-4.
23.
VeroneseNMaggiSNoaleMDe RuiMBolzettaFZambonS, et al. Serum 25-hydroxyvitamin D and osteoarthritis in older people: The progetto veneto anziani study. Rejuvenation Res.2015; 18(6): 543-53.
24.
KonstariSPaananenMHeliövaaraMKnektPMarniemiJImpivaaraO, et al. Association of 25-hydroxyvitamin D with the incidence of knee and hip osteoarthritis: A 22-year follow-up study. Scand J Rheumatol.2012; 41(2): 124-31.
25.
FelsonDTNiuJClancyMAliabadiPSackBGuermaziA, et al. Low levels of vitamin D and worsening of knee osteoarthritis: Results of two longitudinal studies. Arthritis Rheum.2007; 56(1): 129-36.
26.
MacFarlaneLACookNRKimELeeIMIversenMDGordonD, et al. The effects of vitamin D and marine omega-3 fatty acid supplementation on chronic knee pain in older US adults: Results from a randomized trial. Arthritis Rheumatol.2020; 72(11): 1836-44.
27.
WangRWangZMXiangSCJinZKZhangJJZengJC, et al. 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.
DeanDDBoyanBDSchwartZMunizOECarrenoMRMaedaS, et al. Effect of 1alpha, 25-dihydroxyvitamin D3 and 24R, 25-dihydroxyvitamin D3 on metalloproteinase activity and cell maturation in growth plate cartilage in vivo. Endocrine.2001; 14: 311-23.
30.
MaedaSDeanDDGayISchwartzZBoyanBD. Activation of latent transforming growth factor beta1 by stromelysin 1 in extracts of growth plate chondrocyte-derived matrix vesicles. J Bone Miner Res.2001; 16: 1281-90.
31.
GarfinkelRJDilisioMFAgrawalDK. Vitamin D and its effects on articular cartilage and osteoarthritis. Orthop J Sports Med.2017; 5(6): 232-41.
32.
PhillipsSKRookKMSiddleNCBruceSAWoledgeRC. Muscle weakness in women occurs at an earlier age than in men, but strength is preserved by hormone replacement therapy. Clin Sci (Lond).1993; 84: 95-8.
33.
MaltaisMLDesrochesJDionneIJ. Changes in muscle mass and strength after menopause. J Musculoskelet Neuronal Interact.2009; 9(4): 186-97.
34.
LouCXiangGWengQChenZChenDWangQ, et al. Menopause is associated with articular cartilage degeneration: A clinical study of knee joint in 860 women. Menopause.2016; 23(11): 1239-46.
35.
Roman-BlasJACastañedaSLargoRHerrero-BeaumontG. Osteoarthritis associated with estrogen deficiency. Arthritis Res Ther.2009; 11(5): 241.
