Talaat Hossam Sanyelbhaa, Abuhadied Ghada, Talaat Ahmed Sanyelbhaa, Abdelaal Mohamed Samer S
Audiology Unit, ENT Department, Menoufiya University, Shibin al-Kawm, Egypt,
Eur Arch Otorhinolaryngol. 2015 Sep;272(9):2249-53. doi: 10.1007/s00405-014-3175-3. Epub 2014 Jun 29.
Several studies indicated the association between benign paroxysmal positional vertigo (BPPV) with osteoporosis and vitamin D deficiency implying that abnormal calcium metabolism may underlie BPPV. The aim of the present study is to confirm the correlation between BPPV and both decrease in bone mineral density (BMD) and vitamin D deficiency. The study group included 80 patients with idiopathic BPPV (52 females, 28 males), with age range 31-71 years (47.6 ± 9.1). The patients were divided into two groups; recurrent BPPV group including 36 subjects and non-recurrent group including 44 subjects. The control group included 100 healthy volunteers with age and gender distribution similar to the study group. All the subjects in the study were examined using Dual-energy X-ray absorptiometry to assess BMD, and serum 25-hydroxyvitamin D for vitamin D assessment. The accepted normal levels were T-score > -1, and 25-hydroxyvitamin D > 30 ng/ml. Twenty-six (26 %) subjects showed abnormal T-score in the control group; 26 (59 %) in the non-recurrent BPPV and 22 (61 %) in the recurrent BPPV group. Chi square test showed significant difference between the control group and both BPPV groups. The control group had significantly higher 25-hydroxyvitamin D levels than the BPPV subgroups (p < 0.05). Moreover, the 25-hydroxyvitamin D was significantly lower in the recurrent BPPV than it was in the non-recurrent subgroup (p < 0.05). The results of the current study associate between reduced BMD and development/recurrence of BPPV. Moreover, low levels of vitamin D were related to development of BPPV while very low levels were associated with recurrence of BPPV. The co-occurrence of two morbidities is not by itself supportive of a relationship, but the cumulating studies correlating between BPPV and both vitamin D deficiency and low BMD indicate the investigation and treatment of those disorders in cases with recurrent BPPV.
多项研究表明良性阵发性位置性眩晕（BPPV）与骨质疏松症及维生素D缺乏之间存在关联，这意味着钙代谢异常可能是BPPV的潜在病因。本研究的目的是证实BPPV与骨密度（BMD）降低及维生素D缺乏之间的相关性。研究组包括80例特发性BPPV患者（52例女性，28例男性），年龄范围为31 - 71岁（47.6±9.1）。患者被分为两组；复发性BPPV组包括36名受试者，非复发性组包括44名受试者。对照组包括100名年龄和性别分布与研究组相似的健康志愿者。研究中的所有受试者均使用双能X线吸收法评估骨密度，并检测血清25 - 羟维生素D以评估维生素D水平。公认的正常水平为T值＞ -1，25 - 羟维生素D＞30 ng/ml。对照组中有26名（26%）受试者T值异常；非复发性BPPV组中有26名（59%），复发性BPPV组中有22名（61%）。卡方检验显示对照组与两个BPPV组之间存在显著差异。对照组25 - 羟维生素D水平显著高于BPPV亚组（p＜0.05）。此外，复发性BPPV组的25 - 羟维生素D水平显著低于非复发性亚组（p＜0.05）。本研究结果表明骨密度降低与BPPV的发生/复发之间存在关联。此外，低水平的维生素D与BPPV的发生有关，而极低水平与BPPV的复发有关。两种疾病的同时出现本身并不足以支持它们之间存在关联，但越来越多的研究将BPPV与维生素D缺乏及低骨密度联系起来，这表明对于复发性BPPV患者，应调查并治疗这些疾病。
