Babaei Mansour, Esmaeili Jadidi Mehdi, Heidari Behzad, Gholinia Hemmat
Mobility Impairment Research Center, Babol University Of Medical Sciences, Babol, Iran.
Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
Int J Rheum Dis. 2018 Apr;21(4):788-795. doi: 10.1111/1756-185X.13253. Epub 2018 Jan 5.
Vitamin D deficiency is associated with osteomalacia and a variety of musculoskeletal pain. This study aimed to determine the association of vitamin D deficiency with tibial bone pain and tenderness.
Patients with leg pain, defined as local pain and tenderness over tibial bones for ≥ 6 weeks were consecutively selected. Secondary causes of pain were excluded by appropriate clinical, radiological and laboratory examinations. Serum 25-hydroxyvitamin D (25-OHD) was assessed by enzyme-linked immunosorbent assay method and levels < 20 ng/mL were considered as deficiency. Age- and sex-matched subjects without leg pain served as controls. Multiple logistic regression analysis was used to determine associations.
One hundred and eighteen patients and 114 controls aged 46.8 ± 14.8 and 44.6 ± 14.1 years, respectively (P = 0.93) were analyzed. Mean 25-OHD level was significantly lower (P = 0.001) and the prevalence of 25-OHD deficiency was significantly higher in the patients as compared with the controls (75.4% vs. 23.6%), odds ratio (OR) = 9.54 (95% CI, 5.22-17.45, P = 0.001). There was a negative dose-response relationship between serum 25-OHD and tibial bone pain by OR = 17.33 (95% CI, 6.48-46.3) in subjects with 25-OHD < 10 ng/mL, and OR = 14.7 (95% CI, 6.35-34.6) in serum 25-OHD levels at 10-19.9 ng/mL, and OR = 2.58 (95% CI, 1.08-6.1) in those with 25-OHD at 20-29.9 ng/mL as compared with 25-OHD ≥ 30 ng/mL. After controlling for demographic and biochemical factors, the association reached a stronger level of 19.8 (6.9-56.3) in subjects with serum 25-OHD < 10 ng/mL and 14.4 (5.8-34.6) in those with serum 25-OHD at levels of 10-19.9 ng/mL and 1.85 (0.73-4.6) in 20-29 ng/mL.
These findings indicate a possible contributive role for serum 25-OHD deficiency in the development of pain and tenderness over the tibial bone.
维生素D缺乏与骨软化症及多种肌肉骨骼疼痛相关。本研究旨在确定维生素D缺乏与胫骨疼痛及压痛之间的关联。
连续选取有腿部疼痛的患者，定义为胫骨局部疼痛及压痛持续≥6周。通过适当的临床、放射学和实验室检查排除疼痛的继发原因。采用酶联免疫吸附测定法评估血清25-羟维生素D（25-OHD），25-OHD水平<20 ng/mL被视为缺乏。年龄和性别匹配的无腿部疼痛的受试者作为对照。采用多因素logistic回归分析确定关联。
分析了118例患者和114例对照，患者年龄为46.8±14.8岁，对照年龄为44.6±14.1岁（P = 0.93）。患者的平均25-OHD水平显著更低（P = 0.001），25-OHD缺乏的患病率显著高于对照（75.4%对23.6%），比值比（OR）= 9.54（95%可信区间，5.22 - 17.45，P = 0.001）。血清25-OHD与胫骨疼痛之间存在负剂量反应关系，25-OHD<10 ng/mL的受试者中OR = 17.33（95%可信区间，6.48 - 46.3），血清25-OHD水平在10 - 19.9 ng/mL时OR = 14.7（95%可信区间，6.35 - 34.6），25-OHD在20 - 29.9 ng/mL的受试者与25-OHD≥30 ng/mL者相比OR = 2.58（95%可信区间，1.08 - 6.1）。在控制人口统计学和生化因素后，血清25-OHD<10 ng/mL的受试者中关联强度达到19.8（6.9 - 56.3），血清25-OHD水平在10 - 19.9 ng/mL的受试者中为14.4（5.8 - 34.6），20 - 29 ng/mL时为1.85（0.73 - 4.6）。
这些发现表明血清25-OHD缺乏在胫骨疼痛及压痛的发生中可能起作用。
