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Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review.

Abstract

OBJECTIVE

To systematically review the evidence for association between serum 25-hydroxyvitamin D (25-(OH)D) and OA and the effect of vitamin D therapy on OA.

METHODS

An English Medline, EMBASE and Cochrane Library search for vitamin D and OA from January 1980 to June 2012 was performed. Randomized controlled trials (RCTs), cohort, case-control and cross-sectional studies in adults were included. The methodological quality of the selected studies was assessed and a best-evidence synthesis was used to summarize the results due to the heterogeneity of the studies.

RESULTS

Of the 86 evaluated articles, 2 RCTs and 13 observational studies were included in the final analyses. The number of participants ranged from 64 to 1644 (0-100% women). The RCTs were only reported in abstract form and showed inconsistent results, most likely due to variations in their study design. There was insufficient or limited evidence for associations between 25-(OH)D and hand or hip OA. For knee radiographic OA as assessed by the Kellgren and Lawrence (KL) score, there was moderate evidence showing that low levels of 25-(OH)D were associated with increased progression of radiographic OA. Strong evidence for an association between 25-(OH)D and cartilage loss was apparent when joint space narrowing and changes in cartilage volume were considered collectively as cartilage loss.

CONCLUSION

25-(OH)D appears to be implicated in structural changes of knee OA rather than symptoms, and further well-designed RCTs are required to determine whether vitamin D supplementation can slow disease progression. There is insufficient evidence for other sites.

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  • Authors+Show Affiliations

    ,

    Menzies Research Institute Tasmania, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia.

    , , , ,

    Source

    Rheumatology (Oxford, England) 52:7 2013 Jul pg 1323-34

    MeSH

    Adult
    Aged
    Female
    Humans
    Male
    Middle Aged
    Osteoarthritis
    Regression Analysis
    Vitamin D

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    23542678

    Citation

    Cao, Yuelong, et al. "Association Between Serum Levels of 25-hydroxyvitamin D and Osteoarthritis: a Systematic Review." Rheumatology (Oxford, England), vol. 52, no. 7, 2013, pp. 1323-34.
    Cao Y, Winzenberg T, Nguo K, et al. Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. Rheumatology (Oxford). 2013;52(7):1323-34.
    Cao, Y., Winzenberg, T., Nguo, K., Lin, J., Jones, G., & Ding, C. (2013). Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. Rheumatology (Oxford, England), 52(7), pp. 1323-34. doi:10.1093/rheumatology/ket132.
    Cao Y, et al. Association Between Serum Levels of 25-hydroxyvitamin D and Osteoarthritis: a Systematic Review. Rheumatology (Oxford). 2013;52(7):1323-34. PubMed PMID: 23542678.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. AU - Cao,Yuelong, AU - Winzenberg,Tania, AU - Nguo,Kay, AU - Lin,Jianhao, AU - Jones,Graeme, AU - Ding,Changhai, Y1 - 2013/03/29/ PY - 2013/4/2/entrez PY - 2013/4/2/pubmed PY - 2013/9/4/medline KW - 25-hydroxyvitamin D KW - osteoarthritis KW - systematic review SP - 1323 EP - 34 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 52 IS - 7 N2 - OBJECTIVE: To systematically review the evidence for association between serum 25-hydroxyvitamin D (25-(OH)D) and OA and the effect of vitamin D therapy on OA. METHODS: An English Medline, EMBASE and Cochrane Library search for vitamin D and OA from January 1980 to June 2012 was performed. Randomized controlled trials (RCTs), cohort, case-control and cross-sectional studies in adults were included. The methodological quality of the selected studies was assessed and a best-evidence synthesis was used to summarize the results due to the heterogeneity of the studies. RESULTS: Of the 86 evaluated articles, 2 RCTs and 13 observational studies were included in the final analyses. The number of participants ranged from 64 to 1644 (0-100% women). The RCTs were only reported in abstract form and showed inconsistent results, most likely due to variations in their study design. There was insufficient or limited evidence for associations between 25-(OH)D and hand or hip OA. For knee radiographic OA as assessed by the Kellgren and Lawrence (KL) score, there was moderate evidence showing that low levels of 25-(OH)D were associated with increased progression of radiographic OA. Strong evidence for an association between 25-(OH)D and cartilage loss was apparent when joint space narrowing and changes in cartilage volume were considered collectively as cartilage loss. CONCLUSION: 25-(OH)D appears to be implicated in structural changes of knee OA rather than symptoms, and further well-designed RCTs are required to determine whether vitamin D supplementation can slow disease progression. There is insufficient evidence for other sites. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/23542678/full_citation L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/ket132 DB - PRIME DP - Unbound Medicine ER -