Basic Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Oct 18, 2020; 11(10): 418-425
Published online Oct 18, 2020. doi: 10.5312/wjo.v11.i10.418
Association of vitamin D and knee osteoarthritis in younger individuals
Sujit Kumar Tripathy, Amrit Gantaguru, Saurav Narayan Nanda, Sandeep Velagada, Anand Srinivasan, Manaswini Mangaraj
Sujit Kumar Tripathy, Amrit Gantaguru, Saurav Narayan Nanda, Sandeep Velagada, Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
Anand Srinivasan, Department of Pharmacology, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
Manaswini Mangaraj, Department of Biochemistry, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
Author contributions: Tripathy SK, Srinivasan A, and Mangaraj M designed the research; Tripathy SK, Gantaguru A, Nanda SN, and Velagda S performed the research; Mangaraj M performed the laboratory tests; Tripathy SK, Gantaguru A, Nanda S, and Velagda S collected the data; Srinivasan A and Tripathy SK analyzed the data; Tripathy SK and Mangaraj M wrote the paper.
Institutional review board statement: The study was conducted in All India Institute of Medical Sciences, Bhubaneswar, India. This study was funded by AIIMS Bhubaneswar as an intramural project grant. The institutional ethics committee approved the study (T/IM-F/Ortho/15/16).
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Data sharing statement: The data of this study cannot be shared with third party.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sujit Kumar Tripathy, DNB, MBBS, MD, Associate Professor, Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapada, Bhubaneswar 751019, Odisha, India. sujitortho@yahoo.co.in
Received: March 30, 2020
Peer-review started: March 30, 2020
First decision: June 7, 2020
Revised: June 26, 2020
Accepted: August 24, 2020
Article in press: August 24, 2020
Published online: October 18, 2020
Abstract
BACKGROUND

The incidence of primary osteoarthritis knee is gradually increasing among young individuals. The increasing prevalence of obesity, sedentary lifestyle, sporting activity, and vitamin D deficiency (VDD) has been hypothesized for this shifting disease trend. This study was designed to look for the association of serum vitamin D among these young arthritic patients.

AIM

To look for the association of serum vitamin D in younger knee osteoarthritis (KOA) patients.

METHODS

In a 2-year observational study, 146 non-obese KOA patients of 35-60 years were evaluated clinically (Knee injury and Osteoarthritis Outcome Score, KOOS) and radiologically (Kellegren-Lawrence stage, KL). The serum 25(OH)D level of these patients and 146 normal healthy individuals of same age group were estimated.

RESULTS

Both the groups were comparable in terms of age and sex. The average serum 25(OH)D level in healthy individuals and KOA patients was 45.83 ng/mL and 34.58 ng/mL, respectively (P < 0.001). Inadequate serum 25(OH)D level (< 30 ng/mL) was found in 46.57% of KOA patients and 24% of normal healthy participants indicating a significant positive association (odds ratio 2.77, 95%CI: 1.67-4.54, P < 0.001). The 25(OH)D level in KL grade I, II, III and IV was 43.40, 30.59, 31.56 and 33.93 ng/mL respectively (no difference, P = 0.47). Similarly, the KOOS score in sufficient, insufficient and deficient groups were 65.31, 60.36 and 65.31, respectively (no difference, P = 0.051).

CONCLUSION

The serum 25(OH)D level is significantly low in younger KOA patients. However, the clinical and radiological severities have no association with serum vitamin D level.

Keywords: Degenerative disease, Early-onset arthritis, Cholecalciferol, Sunlight, Knee joint, Arthroplasty, Knee replacement

Core Tip: The association of vitamin D deficiency in young knee osteoarthritis (KOA) patients were studied. Serum 25(OH)D level of young KOA patients and healthy individuals were estimated along with clinical and radiological severity assessment of KOA patients. Serum vitamin D level in healthy individuals and KOA patients were found to be 45.83 and 34.58 ng/mL, respectively; 46.57% of KOA patients had inadequate vitamin D compared to 24% healthy participants (odds ratio 2.77, P < 0.001). The clinical and radiological severities had no association with vitamin D. Although disease severity cannot be predicted from vitamin D level, it is significantly low in younger KOA patients.