Knee joint space narrowing (Osteoarthritis) 1.5X worse with low vitamin D – meta-analysis

25-Hydroxyvitamin D and osteoarthritis: A Meta-Analysis Including New Data

Seminars in Arthritis and Rheumatism. doi:10.1016/j.semarthrit.2015.09.010

ARJAN P. BERGINK, MDa, c, M.CAROLA ZILLIKENS, MD, PhDa, JOHANNES P.T.M. VAN LEEUWEN, PhDa, ALBERT HOFMAN, MD, PhDb, ANDRÉ G. UITTERLINDEN, PhDa, b, JOYCE B.J. VAN MEURS, PhDa, ,

Objectives: To study the relationship between 25-hydroxy (OH) vitamin D serum levels and osteoarthritis (OA) of the knee, hip and hand in a meta-analysis, with up-dated and expanded results of our previous study.

Methods: Pubmed was searched from February 1975 to December 2014 for articles assessing the relationship between vitamin D levels and OA. In our meta-analysis, 6 cross-sectional and 6 longitudinal studies were included. The number of subjects in these studies ranged from 99 to 1,248 subjects. The latter 1,248 subjects (58% women) were drawn from the Rotterdam Study, a prospective population-based cohort study of the elderly. At baseline, 25(OH) vitamin D serum levels were measured and prevalent OA of knees, hips and hands was scored by the Kellgren-Lawrence grading system. After a mean follow-up time was 8.4 years, incidence and progression of OA were assessed.

Results: No clear association between vitamin serum levels and prevalent, incident or progressive knee, hip or hand OA was observed. The quality of most studies was low, and the results conflicting. Meta-analysis of three cross-sectional studies on vitamin D levels and knee joint space narrowing (JSN) showed an increased risk of prevalent JSN with decreasing vitamin D levels (OR 1.52, 95% CI 1.15 to 2.01). The association observed in the meta-analysis of three studies on low vitamin D levels and incident and progressive knee OA was not significant (OR 1.37, 95% CI 0.97 to 1.92), however when considering solely progressive knee OA, the risk was significantly increased (OR 2.40 , 95% CI 1.22 to 4.72).

Conclusions: Epidemiological studies do not provide evidence of an independent association between 25(OH) vitamin D serum levels with hip or hand OA. When analyzing subgroups of knee OA, significant associations of low vitamin D levels with prevalent knee JSN and with progressive knee OA were observed. Overall, the results of this study do not support the advice to supplement vitamin D to prevent the onset or worsening of osteoarthritis, except perhaps for progressive knee OA.

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