Department of Otorhinolaryngology, The Catholic University of Korea, College of Medicine, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Auris Nasus Larynx. 2023 Oct;50(5):700-707. doi: 10.1016/j.anl.2022.12.017. Epub 2023 Jan 24.
Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness in the general population. BPPV is known to be closely related to the serum vitamin D level. This study aimed to examine the relationship between serum vitamin D levels and BPPV recurrence.
A retrospective chart review was conducted on 50 patients diagnosed with posterior and lateral canal BPPV. The diagnosis of BPPV was based on the finding of vertigo and nystagmus induced by certain head positions (The Dix-Hallpike maneuver and head roll tests). The patients were classified into BPPV recurrence (Group A) and non-recurrence groups (Group B). Otolith function was assessed by cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP), and their association with vitamin D levels was evaluated.
There were 19 subjects in Group A and 31 in Group B. There were no significant differences in age, sex, cVEMP, and oVEMP between the two groups. The average vitamin D level was 12.9 ± 8.0 ng/mL for Group A and 19.2 ± 8.2 ng/mL for Group B, and the difference between the groups was significant (p = 0.011). In the receiver operating characteristic curve analysis for BPPV recurrence with the best sensitivity and specificity, the optimal cut-off value of total serum vitamin D was determined as 12.74 ng/mL. Furthermore, reclassifying the patients based on the cut-off value showed a significantly higher recurrence rate in the group with a lower serum vitamin D level (70.5% vs. 22.5%, p = 0.007).
This complex finding highlights the importance of measuring serum vitamin D levels to monitor and evaluate patients at risk of BPPV recurrence.
良性阵发性位置性眩晕(BPPV)是普通人群中最常见的头晕原因。已知 BPPV 与血清维生素 D 水平密切相关。本研究旨在探讨血清维生素 D 水平与 BPPV 复发之间的关系。
对 50 例被诊断为后、外侧管 BPPV 的患者进行回顾性图表审查。BPPV 的诊断基于特定头部位置引起的眩晕和眼震(Dix-Hallpike 手法和头滚试验)。将患者分为 BPPV 复发组(A 组)和非复发组(B 组)。通过颈性前庭诱发肌源性电位(cVEMP)和眼性前庭诱发肌源性电位(oVEMP)评估耳石功能,并评估其与维生素 D 水平的关系。
A 组有 19 例,B 组有 31 例。两组间年龄、性别、cVEMP 和 oVEMP 无显著性差异。A 组平均维生素 D 水平为 12.9±8.0ng/ml,B 组为 19.2±8.2ng/ml,两组间差异有统计学意义(p=0.011)。在 BPPV 复发的最佳敏感性和特异性的受试者工作特征曲线分析中,确定总血清维生素 D 的最佳截断值为 12.74ng/ml。此外,根据截断值重新分类患者,发现血清维生素 D 水平较低的组复发率显著更高(70.5%比 22.5%,p=0.007)。
这一复杂的发现强调了测量血清维生素 D 水平以监测和评估 BPPV 复发风险患者的重要性。