Case Control Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2150-2161
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2150
Determination of vitamin D and analysis of risk factors for osteoporosis in patients with chronic pain
Bao-Lin Duan, Yuan-Rong Mao, Li-Qi Xue, Qing-Yuan Yu, Mei-Yi Liu
Bao-Lin Duan, Yuan-Rong Mao, Li-Qi Xue, Qing-Yuan Yu, Mei-Yi Liu, Department of Pain, Qinghai Provincial People’s Hospital, Xining 810000, Qinghai Province, China
Author contributions: Duan BL performed the majority of experiments and wrote the manuscript; Liu MY designed the study and corrected the manuscript; Mao YR was involved in analytical tools; Xue LQ and Yu QY participated in the collection of data.
Supported by the 2016 Guidance Project of Qinghai Provincial Health and Family Planning Commission, No. 2016-wjzdx-14.
Institutional review board statement: The study was approved by the ethics committee of Qinghai Provincial People’s Hospital.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at 1461519537@qq.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: Mei-Yi Liu, MD, Doctor, Department of Pain, Qinghai Provincial People’s Hospital, 2 Gonghe Road Chengdong District, Xining 810000, Qinghai Province, China. 1461519537@qq.com
Received: January 2, 2020
Peer-review started: January 2, 2020
First decision: February 26, 2020
Revised: April 17, 2020
Accepted: May 1, 2020
Article in press: May 1, 2020
Published online: June 6, 2020
Processing time: 157 Days and 10.8 Hours
Abstract
BACKGROUND

Vitamin D deficiency is common in patients with chronic pain and healthy people, but the difference between the two has not been reported; thus, whether there is a relationship between vitamin D deficiency and chronic pain remains to be confirmed. Osteoporosis is a common disease in chronic pain disorders. Understanding the relationship between vitamin D and osteoporosis will provide a basis for the rational supplementation of vitamin D to prevent osteoporosis, and to understand the risk factors of bone mass change to provide a new treatment plan for early prevention of osteoporosis.

AIM

To determine 25 hydroxy vitamin D (25OHD) level in patients with chronic pain to clarify its clinical significance. The relationship between vitamin D and bone mineral density (BMD) and the risk factors for bone mass change were also evaluated.

METHODS

In this study, 184 patients with chronic pain were included in the study group, and 104 healthy individuals who underwent routine health checkups during the same period were included in the control group. 25OHD level was detected in both groups by enzyme-linked immunosorbent assay. According to the BMD test results, the patients in the study group were further classified into three subgroups: Normal BMD group, reduced BMD group, and osteoporosis group. Age, sex, ethnicity, living altitude, body mass index, 25OHD level, parathyroid hormone (PTH), calcium (Ca) and phosphorus levels were analyzed statistically in both groups.

RESULTS

The vitamin D level in the study group was lower than that in the control group at 53.8% vs 57.7%, with no significant difference between the two groups. The proportion of patients with severe vitamin D deficiency in the study group was higher than that in the control group. The mean age was greater in the osteoporosis subgroup, and the youngest in the normal BMD subgroup. Vitamin D level in the osteoporosis subgroup was lower than that in the other two subgroups, and was not specific for the diagnosis of bone mass reduction and osteoporosis. The above results were analyzed statistically and showed significant differences (P < 0.05). There was a positive correlation between age and BMD in patients with chronic pain (R = 0.567, P < 0.001). Age, PTH and Ca were risk factors for bone mass reduction, while age, ethnicity and altitude were risk factors for osteoporosis.

CONCLUSION

Vitamin D deficiency is a common phenomenon in patients with chronic pain, and severe vitamin D deficiency is not uncommon. Vitamin D level is not a risk factor for bone mass reduction and osteoporosis. Bone mass reduction is correlated with age, PTH and Ca, while osteoporosis is correlated with age, ethnicity and altitude.

Keywords: Chronic pain; Vitamin D deficiency; Bone mass reduction; Osteoporosis; Bone mineral density

Core tip: Vitamin D deficiency is common in chronic pain patients and healthy people, and its level is not different between the two, but severe deficiency is more common in patients with chronic pain. Vitamin D is not a risk factor for bone loss and osteoporosis. Age, parathyroid hormone, and calcium are risk factors for bone loss. Age, ethnicity, and altitude are risk factors for osteoporosis.