Vitamin D Deficiency Is Associated with Progression of Knee Osteoarthritis
J. Nutr. December 1, 2014 jn.114.193227
Fang Fang Zhang 3,8, fang_fang.zhang at tufts.edu, Jeffrey B Driban 6, Grace H Lo 9, Lori Lyn Price 4,5, Sarah Booth 3,8, Charles B Eaton10, Bing Lu11, Michael Nevitt12, Becky Jackson13, Cheryl Garganta7, Marc C Hochberg14, Kent Kwoh15, and Timothy E McAlindon6
3 Department of Nutrition Science, Friedman School of Nutrition Science and Policy and
4 Tufts Clinical and Translational Sciences Institute, Tufts University, Boston, MA
5 Institute for Clinical Research and Health Policy Studies
6 Division of Rheumatology, and
7 Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA
8 Jean Mayer USDA Human Nutrition Research Center at Tufts University, Boston, MA
9 Section of Immunology, Allergy, and Rheumatology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX
10 Department of Family Medicine and Epidemiology, Alpert Medical School of Brown University, Center for Primary Care and Preventive, Pawtucket, RI
11 Division of Rheumatology, Brigham and Women’s Hospital and Harvard School of Medicine, Boston, MA
12 Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA
13 Division of Endocrinology, Diabetes, and Metabolism, Ohio State University Waxner Medical Center, Columbus, OH
14 Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD; and
15 Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA
Background: Knee osteoarthritis (OA) causes functional limitation and disability in the elderly. Vitamin D has biological functions on multiple knee joint structures and can play important roles in the progression of knee OA. The metabolism of vitamin D is regulated by PTH.
Objective: The objective is to investigate whether serum concentrations of 25(OH)D and PTH, individually and jointly, predict the progression of knee OA.
Methods: Serum 25(OH)D and PTH were measured at the 30- or 36-mo visit in 418 participants enrolled in the Osteoarthritis Initiative (OAI) who had ≥1 knee with symptomatic and radiographic knee OA. Progression of knee OA was defined as any increase in the radiographic joint space narrowing (JSN) score between the 24- and 48-mo OAI visits.
Results: The mean concentrations of serum 25(OH)D and PTH were 26.2 μg/L and 54.5 pg/mL, respectively. Approximately 16% of the population had serum 25(OH)D < 15 μg/L. Between the baseline and follow-up visits, 14% progressed in JSN score. Participants with low vitamin D [25(OH)D < 15 μg/L] had >2-fold elevated risk of knee OA progression compared with those with greater vitamin D concentrations (≥15 μg/L; OR: 2.3; 95% CI: 1.1, 4.5). High serum PTH (≥73 pg/mL) was not associated with a significant increase in JSN score. However, participants with both low vitamin D and high PTH had >3-fold increased risk of progression (OR: 3.2; 95%CI: 1.2, 8.4).
Conclusion: Our results suggest that individuals deficient in vitamin D have an increased risk of knee OA progression.
- Supported by NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases grant 1R01AR054938 and Houston Veterans Affairs Health Services Research and Development Center of Excellence grant HFP90-020.
- Author disclosures: FF Zhang, JB Driban, GH Lo, LL Price, S Booth, CB Eaton, B Lu, M Nevitt, B Jackson, C Garganta, MC Hochberg, K Kwoh, and TE McAlindon, no conflicts of interests.
- Manuscript received: March 3, 2014. Initial review completed: April 8, 2014. Revision accepted: September 3, 2014.
See also VitaminDWiki
- Knee pain in seniors predicted by low vitamin D 5 years before – Feb 2014
- Good evidence for knee osteoarthritis and vitamin D, unsure of other OA – Review March 2013
- Probability of knee osteoarthritis up 50 percent if 20 ng less vitamin D – Nov 2011
- Overview Osteoarthritis and Vitamin D
- Search VitaminDWiki for knee osteoarthritis 170 items as of Oct 2014
- Vitamin D and rheumatic diseases. – Review July 2014 which shows 2X increase in OA for if low vitamin D