Matossian-Motley Debbie L, Drake Diane A, Samimi John S, Camargo Carlos A, Quraishi Sadeq A
Nutritional Care Services, Mission Hospital, St Joseph Health, Mission Viejo, California.
Nurse Research Scientist Consultant, Mission Hospital, St Joseph Health, Mission Viejo, California.
JPEN J Parenter Enteral Nutr. 2016 Mar;40(3):367-73. doi: 10.1177/0148607114555909. Epub 2014 Oct 14.
Nonspecific musculoskeletal pain can be difficult to manage in acute rehabilitation unit (ARU) patients. We investigated whether vitamin D status is a potential modifiable risk factor for nonspecific musculoskeletal pain in ARU patients.
This cross-sectional study focused on 414 adults from an inpatient ARU in Mission Viejo, California, between July 2011 and June 2012. On ARU admission, all patients had serum 25-hydroxyvitamin D (25(OH)D) levels measured and were assessed for nonspecific musculoskeletal pain. We performed multivariable logistic regression to test the association of serum 25(OH)D level with nonspecific musculoskeletal pain while adjusting for clinically relevant covariates.
Among these 414 patients, mean (SD) 25(OH)D level was 29 (12) ng/mL, and 30% had nonspecific musculoskeletal pain. After adjustment for age, sex, race, body mass index, Functional Independence Measure score, Deyo-Charlson Comorbidity Index, fractures, steroid use, history of osteoporosis/osteomalacia, and patient type (orthopedic, cardiac, neurological, spinal cord injury, or traumatic brain injury), serum 25(OH)D level was inversely associated with nonspecific musculoskeletal pain (odds ratio [OR] per 10 ng/mL, 0.67; 95% confidence interval [CI], 0.48-0.82). When 25(OH)D level was dichotomized, patients with levels <20 ng/mL had higher odds of nonspecific musculoskeletal pain (OR, 2.33; 95% CI, 1.23-4.17) compared with patients with levels ≥20 ng/mL.
In adult patients, serum 25(OH)D level on admission to ARU was inversely associated with nonspecific musculoskeletal pain. These data support the need for randomized, controlled trials to test the role of vitamin D supplementation to improve nonspecific musculoskeletal pain in ARU patients.
在急性康复单元（ARU）患者中，非特异性肌肉骨骼疼痛可能难以处理。我们调查了维生素D状态是否是ARU患者非特异性肌肉骨骼疼痛的一个潜在可改变的风险因素。
这项横断面研究聚焦于2011年7月至2012年6月期间加利福尼亚州米申维耶霍一家住院ARU的414名成年人。在ARU入院时，所有患者均测量了血清25-羟基维生素D（25(OH)D）水平，并评估了非特异性肌肉骨骼疼痛情况。我们进行了多变量逻辑回归分析，以检验血清25(OH)D水平与非特异性肌肉骨骼疼痛之间的关联，同时对临床相关协变量进行了调整。
在这414名患者中，血清25(OH)D水平的均值（标准差）为29（12）ng/mL，30%的患者有非特异性肌肉骨骼疼痛。在对年龄、性别、种族、体重指数、功能独立性测量评分、迪尤-查尔森合并症指数、骨折、类固醇使用、骨质疏松症/骨软化症病史以及患者类型（骨科、心脏科、神经科、脊髓损伤或创伤性脑损伤）进行调整后，血清25(OH)D水平与非特异性肌肉骨骼疼痛呈负相关（每10 ng/mL的比值比[OR]为0.67；95%置信区间[CI]为0.48 - 0.82）。当将25(OH)D水平进行二分法划分时，与25(OH)D水平≥20 ng/mL的患者相比，水平<20 ng/mL的患者出现非特异性肌肉骨骼疼痛的几率更高（OR为2.33；95% CI为1.23 - 4.17）。
在成年患者中，ARU入院时的血清25(OH)D水平与非特异性肌肉骨骼疼痛呈负相关。这些数据支持开展随机对照试验以检验补充维生素D对改善ARU患者非特异性肌肉骨骼疼痛的作用。
