Basic Study
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World J Orthop. Oct 18, 2020; 11(10): 418-425
Published online Oct 18, 2020. doi: 10.5312/wjo.v11.i10.418
Association of vitamin D and knee osteoarthritis in younger individuals
Sujit Kumar Tripathy, Amrit Gantaguru, Saurav Narayan Nanda, Sandeep Velagada, Anand Srinivasan, Manaswini Mangaraj
Sujit Kumar Tripathy, Amrit Gantaguru, Saurav Narayan Nanda, Sandeep Velagada, Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
Anand Srinivasan, Department of Pharmacology, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
Manaswini Mangaraj, Department of Biochemistry, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
Author contributions: Tripathy SK, Srinivasan A, and Mangaraj M designed the research; Tripathy SK, Gantaguru A, Nanda SN, and Velagda S performed the research; Mangaraj M performed the laboratory tests; Tripathy SK, Gantaguru A, Nanda S, and Velagda S collected the data; Srinivasan A and Tripathy SK analyzed the data; Tripathy SK and Mangaraj M wrote the paper.
Institutional review board statement: The study was conducted in All India Institute of Medical Sciences, Bhubaneswar, India. This study was funded by AIIMS Bhubaneswar as an intramural project grant. The institutional ethics committee approved the study (T/IM-F/Ortho/15/16).
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Data sharing statement: The data of this study cannot be shared with third party.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sujit Kumar Tripathy, DNB, MBBS, MD, Associate Professor, Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Sijua, Patrapada, Bhubaneswar 751019, Odisha, India. sujitortho@yahoo.co.in
Received: March 30, 2020
Peer-review started: March 30, 2020
First decision: June 7, 2020
Revised: June 26, 2020
Accepted: August 24, 2020
Article in press: August 24, 2020
Published online: October 18, 2020
Processing time: 202 Days and 11.6 Hours
ARTICLE HIGHLIGHTS
Research background

The rise in the incidence of primary osteoarthritis knee among young individuals is alarming. The increasing prevalence of obesity, sedentary lifestyle, sporting activity and vitamin D deficiency (VDD) has been hypothesized for this shifting disease trend. However, there are limited studies evaluating the association of vitamin D deficiency among young osteoarthritic knee patients.

Research motivation

Vitamin D deficiency (VDD) has been associated with knee osteoarthritis in elderly individuals. The association of VDD among young arthritic individuals has never been studied.

Research objectives

The objectives of this study were to look for the association of serum vitamin D and knee osteoarthritis (KOA) in younger individuals between 35 and 60 years of age.

Research methods

In a 2-year observational study, 146 non-obese KOA patients of 35-60 years were evaluated clinically and radiologically. The serum 25(OH)D level of these patients and 146 normal healthy individuals of same age group were estimated.

Research results

There was a significantly low vitamin D level in younger OA knee patients compared to normal individuals. There were 47% OA knee patients who had inadequate serum vitamin D compared to 24% normal individuals. The odds of development of KOA were 2.77 times more in younger individuals with below-normal vitamin D compared to healthy individuals with normal vitamin D, but the clinical and radiological severities of OA knee had no association with serum vitamin-D level.

Research conclusions

The serum vitamin D level is significantly low in younger KOA patients. However, the clinical and radiological severities have no association with the vitamin D level.

Research perspectives

The association of inadequate serum vitamin D with KOA in younger individuals may be explained by greater bone health and higher activity of bone remodeling compared to elderly individuals. Therefore, younger individuals are more dependent on vitamin D and expected to be more sensitive to serum 25-(OH)D deficiency. Vitamin D supplementation might prevent the onset of the OA knee in these young individuals. However, the disease progression is probably dependent on other variables as the severity of OA knee is not correlated with the severity of vitamin D deficiency. Further research at the molecular and genetic level will probably clarify the association in a better way.