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Knee osteoarthritis more painful if low vitamin D, especially among obese – Jan 2015

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 Jan 7. [Epub ahead of print]
Glover TL1, Goodin BR, King CD, Sibille KT, Herbert MS, Sotolongo AS, Cruz-Almeida Y, Bartley EJ, Bulls HW, Horgas AL, Redden DT, Riley JL 3rd, Staud R, Fessler BJ, Bradley LA, Fillingim RB.
1*University of Florida, College of Nursing, Adult and Elderly Nursing, Gainesville FL †University of Alabama at Birmingham, Departments of Psychology and Anesthesiology, Birmingham, AL ‡University of Florida, College of Dentistry, Department of Community Dentistry and Behavioral Science, Gainesville, FL ∥University of Alabama at Birmingham, Department of Psychology, Birmingham, AL ¶University of Alabama at Birmingham, Department of Medicine, Division of Clinical Immunology and Rheumatology, Birmingham, AL §University of Florida, Institute on Aging, Department of Aging and Geriatric Research, Gainesville, FL #University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL **University of Florida, Department of Medicine, Gainesville, FL ††University of Alabama at Birmingham School of Medicine, Department of Clinical Immunology and Rheumatology, Birmingham, AL

The prevalence of knee osteoarthritis is increasing with the aging population and is exacerbated by the growing numbers of obese older adults. Low levels of vitamin D, measured by serum 25-hydroxyvitamin D (25(OH)D), in older adults and obese individuals are correlated with several negative health conditions, including chronic pain. This cross-sectional study sought to examine the interactive influence of 25(OH)D levels and obesity on knee osteoarthritis pain and functional performance measures.

The sample consisted of 256 (63% female) racially-diverse (55% Black/African Americans) middle-aged and older adults (mean age 56.8 y). Blood was collected for analysis of 25(OH)D by high performance liquid chromatography. Participants provided self-report regarding knee osteoarthritis pain and underwent a lower extremity functional performance test.

Results demonstrated that obesity was associated with lower levels of 25(OH)D. Participants with adequate 25(OH)D levels reported significantly less knee osteoarthritis pain compared to participants with deficient or insufficient levels, regardless of obesity status. Furthermore, there was a significant interaction between obesity and 25(OH)D levels for lower extremity functional performance, such that obese individuals with adequate 25(OH)D levels demonstrated better performance than those obese participants with deficient or insufficient 25(OH)D levels.

The mechanisms by which adequate 25(OH)D levels are associated with pain severity and improved function have not been completely elucidated. It may be that the pleiotropic role of biologically active 25(OH)D influences pain and pain processing via peripheral and central mechanisms. Alternatively, higher levels of pain may lead to reduced outdoor activity, which may contribute to both obesity and decreased vitamin D. Thus, investigating vitamin D status in obese and non-obese individuals with knee osteoarthritis warrants further study.

PMID: 25569220

Study was reported in ScienceDaily

. . obese individuals who suffer from osteoarthritis and have adequate vitamin D levels could walk, balance and rise from sitting to standing better than obese participants with insufficient vitamin D levels.”

See also VitaminDWiki

Overview Obesity and Vitamin D contains the following summary

Obese need more Vitamin D

  • Normal weight     Obese     (50 ng = 125 nanomole)

Click here for 2014 study