Heidari Behzad, Javadian Yahya, Babaei Mansour, Yousef-Ghahari Behnaz
Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran AND Department of Internal Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran.
Acta Med Iran. 2015 Aug;53(8):466-70.
Both vitamin D deficiency and quadriceps muscle weakness are associated with knee osteoarthritis (KOA) and pain. The aim of this study was to determine the restorative effect of vitamin D deficiency on pain and quadriceps muscle strength in knee osteoarthritis. Patients with KOA aged ≥30 years, the presence of knee pain for at least one month or longer and serum 25-hydroxyvitamin (25-OHD) deficiencies were recruited in the study. Participants with KOA compatible with Kellgren-Lawrence grade 4, joint instability, and effusion, history of surgery or inflammatory arthropathies were excluded. Serum 25-OHD was assessed by ELISA method and concentrations<20 ng/ml was considered deficiency. Quadriceps muscle strength was measured by dynamometry method and intensity of knee pain by Western Ontario and McMaster University Osteoarthritis index scored by Likert scale and visual analog scale. All participants received 50.000 IU oral cholecalciferol weekly for at least two months. The influence of raising serum 25-OHD on quadriceps muscle strength and pain was assessed by calculation of mean changes from baseline at the end of the treatment period using paired t-test. A total of 67 patients with mean age of 50±6.6 years of age were treated for 2 months. Serum 25-OHD reached to sufficient levels in all except one patient. At the end of the study period, serum 25-OHD and quadriceps muscle strength increased significantly as compared with baseline (P=0.007 and P=0.002, respectively), whereas knee pain decreased significantly based on Western Ontario and McMaster University Osteoarthritis index (P=0.001)as well as visual analogue scale scores (P=0.001). These findings indicated that correction of vitamin D deficiency in patients with KOA exerts a significant favorable effect on quadriceps muscle strength and knee pain.
维生素D缺乏和股四头肌无力均与膝关节骨关节炎（KOA）及疼痛相关。本研究旨在确定维生素D缺乏对膝关节骨关节炎患者疼痛和股四头肌力量的恢复作用。研究纳入年龄≥30岁、膝关节疼痛至少持续1个月或更长时间且血清25-羟维生素D（25-OHD）缺乏的KOA患者。排除Kellgren-Lawrence分级为4级、关节不稳定和积液、有手术史或炎性关节病的KOA参与者。采用酶联免疫吸附测定（ELISA）法评估血清25-OHD，浓度<20 ng/ml被视为缺乏。采用测力计法测量股四头肌力量，通过西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以Likert量表和视觉模拟量表对膝关节疼痛强度进行评分。所有参与者每周口服50000 IU胆钙化醇，至少持续两个月。使用配对t检验计算治疗期末相对于基线的平均变化，以评估血清25-OHD升高对股四头肌力量和疼痛的影响。共有67例平均年龄为50±6.6岁的患者接受了2个月的治疗。除1例患者外，所有患者的血清25-OHD均达到充足水平。在研究期末，与基线相比，血清25-OHD和股四头肌力量显著增加（分别为P = 0.007和P = 0.002），而基于WOMAC指数（P = 0.001）以及视觉模拟量表评分（P = 0.001），膝关节疼痛显著减轻。这些发现表明，纠正KOA患者的维生素D缺乏对股四头肌力量和膝关节疼痛有显著的有利影响。
