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Low Vitamin D Raises Pain and Functional Impairment in Osteoarthritis: Presented at ACR

By Bruce Sylvester

BOSTON, MA -- November 12, 2007 -- Low levels of vitamin D are associated with more knee pain and walking difficulty in persons with knee osteoarthritis (OA), investigators reported here in a press conference on November 9 at the 71st annual meeting of the American College of Rheumatology (ACR).

"Among those patients with lower levels of vitamin D in their blood we saw more back pain and functional impairment," said Tim McAlindon, MD, MPH, Associate Professor of Medicine, Tufts New England Medical Center, Boston, Massachusetts. "So this adds further data on vitamin D, suggesting its benefits for musculoskeletal functions," he added.

As background, the authors noted that recent studies suggest vitamin D levels affect musculoskeletal health and neuromuscular function. In this study, Dr. McAlindon and colleagues investigated whether serum 25-hydroxyvitamin D (25(OH)D) level was associated with pain and physical function in patients with symptomatic knee OA.

They performed an analysis of baseline data for subjects in a clinical trial of knee OA progression. Eligibility criteria included chronic knee symptoms, radiographic tibiofemoral OA (Kellgren and Lawrence [K/L] grade >=2) and serum 25(OH)D <80 ng/ml.

The investigators evaluated data on physical function from the timed chair stand test and 20-meter walking test. They evaluated knee pain using the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index pain subscale. They defined vitamin D deficiency as serum 25(OH)D <30 ng/ml. The analysis included 100 subjects, 65 women (mean age 62 years) and 35 men (66 years). The mean body mass index for all subjects was 30.4 kg/m².

The investigators found that 47% of all subjects had 25(OH)D <30 ng/ml at baseline.

Fifty percent of the subjects had radiographic tibiofemoral OA K/L grade >=3. The mean WOMAC pain score was 6.7, the mean 20-meter walking time was 17.4 seconds, and the mean chair stand test time was 21.4 seconds.

The investigators found that vitamin D deficiency was associated with greater knee pain (adjusted odds ratio [OR] for WOMAC pain score >6, 3.22; 95% confidence interval [CI], 1.08-9.58). They also found that vitamin D deficiency was associated with a slower walking speed (adjusted OR 3.24; 95% CI, 1.12-9.42). They found no association between vitamin D deficiency and chair stand time (adjusted OR 0.92; 95% CI, 0.29-2.92).

Dr. McAlindon noted that these are preliminary results of an ongoing study of vitamin D designed to determine whether supplementation is an effective disease-modifying treatment for knee osteoarthritis.


[Presentation title: Low Vitamin D Levels Are Associated With Greater Pain and Slow Walking Speed in Patients With Knee Osteoarthritis (KOA). Abstract 199]

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