RESEARCH - Association between nonspecific skeletal pain and vitamin D deficiency

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Int J Rheum Dis. 2010 Oct;13(4):340-6. doi:

10.1111/j.1756-185X.2010.01561.x. Epub 2010 Aug 16.

Association between nonspecific skeletal pain and vitamin D deficiency.

Heidari B, Shirvani JS, Firouzjahi A, Heidari P, Hajian-Tilaki KO.

Deparment of Medicine, Division of Rheumatology, Rouhani Hospital,

Babol University of Medical Sciences, Babol, Iran.

Abstract

BACKGROUND: deficiency of vitamin D has been reported in patients with

many types of musculoskeletal pain. The present study was designed to

determine the association between serum 25-hydroxyvitamin D [25-(OH)D]

deficiency and nonspecific skeletal pain.

METHODS: a total of 276 patients with nonspecific skeletal pain at

different regions of the skeletal system diagnosed as leg pain,

widespread pain, arthralgia, rib pain, back pain and fibromyalgia were

compared with 202 matched controls with regard to mean serum 25-(OH)D

level and 25-(OH)D deficiency. Serum 25-(OH)D was measured by

enzyme-linked immunosorbent assay method and levels < 20 ng/mL were

considered as deficient. Nonparametric one-way analysis of variance,

Kruskal Wallis and Wilcoxon tests were used for group comparisons.

Multiple logistic regression analysis with calculation of adjusted

odds ratio (OR) and 95% confidence interval (95% CI) were performed to

determine associations.

RESULTS: in patients with nonspecific skeletal pain the mean 25-(OH)D

was significantly lower (P = 0.0001) and the proportion of 25-(OH)D

deficiency was significantly higher (63.4%vs. 36.1%, P = 0.0001)

compared with controls. There was a significantly positive association

between 25-(OH)D deficiency and skeletal pain (OR = 2.94, 95% CI =

1.01-4.3, P = 0.0001). The strength of association varied across the

groups with strongest association observed with leg pain (OR = 7.4;

95% CI = 3.9-13.9, P = 0.0001) followed by arthralgia (OR = 3.9, 95%

CI = 2.1-7.1, P = 0.0001) and widespread pain (OR = 2.8, 95% CI =

1.1-6.6, P = 0.020) but no association with back pain and

fibromyalgia. There was a greater positive associations in women

compared with men (OR = 2.1, 95% CI = 1.1-4.3, P = 0.001).

CONCLUSION: the results of this study indicate a positive association

of vitamin D deficiency with a variety of nonspecific bone pain,

particularly in women. More studies with larger samples are required

to confirm these findings. Increasing serum vitamin D to sufficient

levels and longitudinal follow-up of patients may provide further

evidence in relation to vitamin D deficiency and skeletal pain.

PMID: 21199469

http://www.ncbi.nlm.nih.gov/pubmed/21199469

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