A study on correlation between deficiency of vitamin D and knee osteoathritis among patients attending a tertiary care hospital in Andhra Pradesh

Komala Rao, V. Ramesh


Background: The prevalence of vitamin D deficiency is the burning topic worldwide. Vitamin D deficiency is a under diagnosed medical condition since a significant proportion of the population in many countries and regions around the world have low serum 25-hydroxy (OH) vitamin D levels. The aim of this study was to investigate the association between serum vitamin D deficiency and knee osteoarthritis (OA).

Methods: The study population consists of 200 patients divided into two groups, group 1 and group 2. Group 1 with 100 subjects with no clinical features of knee osteoarthritis served as controls and group 2 consists of 100 patients of patients diagnosed with knee osteoarthritis. Serum 25-OH vitamin D was measured in all the participants by the enzyme-linked fluorescence assay (ELFA) method and concentrations <20 ng/ml was considered as deficient.

Results: In group 1, 47% were male and 53% were female whereas in group 2, 41% were male and 59% were female. In group 1, only 8% are vitamin D deficiency whereas in group 2, 61% have vitamin D deficiency. There was a significant association between serum vitamin D and staging of knee OA.

Conclusions: The present study findings showed a significant association between serum 25-OH vitamin D deficiency and in patients with knee OA.


Osteoarthritis, Knee joint pain, 25-OH vitamin D, Andhra Pradesh

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Heidari B, Heidari P, Hajian-Tilaki K. Association between serum vitamin D deficiency and knee osteoarthritis. Int Orthop. 2011;35(11):1627-31.

Enteshari-Moghaddam A, Azami A, Isazadehfar KH, Mohebbi H, Habibzadeh A, Jahanpanah P. Efficacy of duloxetine and gabapentin in pain reduction in patients with knee osteoarthritis. Clin Rheumatol. 2019;38:2873-80.

McAlindon T, LaValley M, Schneider E, Nuite M, Lee JY, Price LL, et al. Effect of vitamin D supplementation on progression of knee pain and cartilage volume loss in patients with symptomatic osteoarthritis: a randomized controlled trial. JAMA. 2013;309(2):155-62.

Bergink AP, Uitterlinden AG, Van Leeuwen JP, Buurman CJ, Hofman A, Verhaar JA, 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):2307.

Glover TL, Goodin BR, King CD, Sibille KT, Herbert MS, Sotolongo AS, et al. A Cross-Sectional Examination of Vitamin D, Obesity, and Measures of Pain and Function in Middle-aged and Older Adults With Knee Osteoarthritis. Clin J Pain. 2015;31(12):1060.

Mabey T, Honsawek S. Role of vitamin D in osteoarthritis: molecular, cellular, and clinical perspectives. Int J Endocrinol. 2015;31(2):118-24.

Zoë Miller. 14 foods that contain a surprising amount of vitamin D. 2018. Available at: Dec 2018. Accessed on: 15 March 2020.

Zhang FF, Driban JB, Lo GH, Price LL, Booth S, Eaton CB, et al. Vitamin D Deficiency Is Associated with Progression of Knee Osteoarthritis. J Nutr. 2014;144(12):2002-8.

Chaganti RK, Parimi N, Cawthon P, Dam TL, Nevitt MC, Lane NE. Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men: the osteoporotic fractures in men study. Arthritis Rheum. 2010;62:511-4.

Enteshari-Moghaddam A, Isazadehfar KH, Habibzadeh A, Hemmati M. Efficacy of Methotrexate on Pain Severity Reduction and Improvement of Quality of Life in Patients with Moderate to Severe Knee Osteoarthritis. Anesth Pain Med. 2019;9(3):e89990.

Mäkinen TJ, Alm JJ, Laine H, Svedström E, Aro HT. The incidence of osteopenia and osteoporosis in women with hip osteoarthritis scheduled for cementless total joint replacement. Bone. 2007;40:1041-7.

Antony B, Zheng S, Burgess J, Ding C. Long-term effects of vitamin d supplementation and maintaining vitamin d sufficiency on knee osteoarthritis over 5 years. Osteoarthritis Cartilage. 2018;26(1):S302-3.

Dhaon P, Das SK, Srivastava R, Asthana A, Agarwal G. Osteoporosis in postmenopausal females with primary knee osteoarthritis in a vitamin D deficient population. J Assoc Physicians India. 2017;65(11):26-9.

Levinger P, Begg R, Sanders KM, Nagano H, Downie C, Petersen A, et al. The effect of vitamin D status on pain, lower limb strength and knee function during balance recovery in people with knee osteoarthritis: an exploratory study. Arch Osteoporos. 2017;12(1):83.

Muraki S, Dennison E, Jameson K, Boucher BJ, Akune T, Yoshimura N, et al. Association of vitamin D status with knee pain and radiographic knee osteoarthritis. Osteoarthritis Cartilage. 2011;19(11):1301-6.

Nawabi DH, Chin KF, Keen RW, Haddad FS. Vitamin D deficiency in patients with osteoarthritis undergoing total hip replacement: a cause for concern. J Bone Joint Surg Br. 2010;92(4):496-9.

Baskan BM, Yurdakul FG, Aydin E, Sivas F, Bodur H. Effect of Vitamin D levels on radiographic knee osteoarthritis and functional status. Turk J Phys Med Rehabil. 2018;64(1):1-8.

Momoeda M, Kaneko H, Liu L, Hada S, Arita H, Aoki T, et al. Vitamin D status is associated with mineralization of osteophyte in patients with knee osteoarthritis. Osteoarthritis Cartilage. 2018;26:583-4.

Garfinkel RJ, Dilisio MF, Agrawal DK. Vitamin D and its effects on articular cartilage and osteoarthritis. Orthop J Sports Med. 2017;5(6):232-41.

Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96:53-8.

Altman R, Asch E, Bloch D, Boil G, Borestein D, Brandt K, Cheristy W, Cooke TD, Greenwald R, Hochberg M et al. Development of criteria for classification and reporting of osteoarthritis of the knee. Arthtitis Rheum. 1986;29:1039-49.

Muraki S, Dennison E, Jameson K, Boucher BJ, Akune T, Yoshimura N, et al. Association of vitamin D status with knee pain and radiographic knee osteoarthritis. Osteoarthritis Cartilage. 2011;19(11):1301-6.

Goula T, Kouskoukis A, Drosos G, AS, Ververidis A, Valkanis C, Zisimopoulos A, Kazakos K. Vitamin D status in patients with knee or hip osteoarthritis in a Mediterranean country. J Orthopaed Traumatol. 2015;16:35-9.

Heidari B, Heidari P, Tilaki KH. Association between serum vitamin D deficiency and knee osteoarthritis. International Orthopaed (SICOT). 2011;35:1627-31.

Cao Y, Winzenberg T, Nguo K, Lin J, Jones G, Ding C. Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. Rheumatol (Oxford). 2013;52:1323-34.

Breijawi N, Eckardt A, Pitton MB, Hoelzl AJ, Giesa M, von Stechow D, Haid F, Drees P. Bone mineral density and vitamin D status in female and male patients with osteoarthritis of the knee or hip. Eur Surg Res. 2009;42(1):1-10.