Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Vitamin D deficiency, functional status, and balance in older adults with osteoarthritis
Cláudia N Montemor, Marcos Tadeu P Fernandes, Audrey S Marquez, Regina Célia Poli-Frederico, Rubens Alexandre da Silva, Karen B P Fernandes
Cláudia N Montemor, Rubens Alexandre da Silva, Karen B P Fernandes, Laboratory of Rehabilitation Research, Doctoral Program of Rehabilitation Sciences, University Pitágoras Unopar (UNOPAR), Londrina 86041-140, Parana, Brazil
Marcos Tadeu P Fernandes, Department of Anesthesiology, Irmandade da Santa Casa de Londrina, Londrina 86010-160, Parana, Brazil
Audrey S Marquez, Health Sciences Research Center, University Pitágoras Unopar (UNOPAR), Londrina 86041-140, Parana, Brazil
Regina Célia Poli-Frederico, Doctoral Program of Rehabilitation Sciences, University Pitagoras Unopar (UNOPAR), Londrina 86041-140, Parana, Brazil
Rubens Alexandre da Silva, Karen B P Fernandes, Département des Sciences de la Santé, Centre intersectoriel en santé durable, Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC ), Saguenay, G7H 2B1, Québec, Canada
Rubens Alexandre da Silva, Centre intégré de santé et services sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Hôpital de La Baie - Services gériatriques spécialisés, Saguenay, Québec, G7H 7K9, Canada
Author contributions: Montemor CN, Fernandes MTP, da Silva RA, and Fernandes KBP collected the patients’ clinical data; Fernandes MTP and Fernandes KBP organized the collected clinical data; Montemor CN, Marquez AS, and Fernandes KBP analyzed the data; Montemor CN and Fernandes MTP wrote the paper; Marquez AS, Poli-Frederico RC, da Silva RA, and Fernandes KBP revised the paper; Poli-Frederico RC and da Silva RA made important contributions to the study performance; Fernandes KBP designed the project and the study.
Supported by National Foundation for Development of Private Higher Education Institutions (FUNADESP)/University Pitagoras UNOPAR, No. 049/15.
Institutional review board statement: This study was approved by the Ethics Committee of the University Pitagoras Unopar (No. 070/09).
Informed consent statement: All study participants provided written informed consent prior to study enrollment.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist and the manuscript was prepared and revised according to the STROBE Statement.
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: Karen B P Fernandes, PhD, Associate Professor, Laboratory of Rehabilitation Research, Doctoral Program of Rehabilitation Sciences, University Pitágoras Unopar (UNOPAR), Rua Marselha, 491 Jardim Piza, Londrina 86041-140, Parana, Brazil.
karenparron@gmail.com
Received: February 4, 2021
Peer-review started: February 4, 2021
First decision: March 31, 2021
Revised: April 15, 2021
Accepted: July 9, 2021
Article in press: July 9, 2021
Published online: November 6, 2021
Processing time: 266 Days and 22.2 Hours
BACKGROUND
Low vitamin D levels are associated with a more severe case of knee osteoarthritis (OA). However, there are few published reports concerning an association between vitamin D deficiency and functional status of individuals with OA and no reports about postural balance in this population.
AIM
To analyze the relationship between vitamin D deficiency and severity, functional status, and balance in elderly patients with OA.
METHODS
In this cross-sectional study, 105 elderly patients with hip and knee OA were included. The severity was assessed by the Kellgren-Lawrence criteria. The functional status was assessed with the Lequesne index. Postural balance was assessed using a force platform, and center-of-pressure parameters (velocity at anteroposterior and mediolateral axis) were used as the balance outcomes. Serum 25(OH) vitamin D levels were measured using a chemiluminescence method.
RESULTS
Most of the patients (mean age: 70.6 ± 6.5 years) were female (n = 78, 74.3%). In the group with vitamin D deficiency, 43 patients (56.6%) had severe OA, while 33 patients (43.4%) had mild or moderate OA (χ2 test, P = 0.04). Patients with vitamin D deficiency showed a higher Lequesne index score (Mann-Whitney test, P = 0.04), indicating a worse functional impairment when compared to individuals with normal vitamin D levels. Additionally, patients with vitamin D deficiency had worse postural balance according to the Mann-Whitney test (P = 0.03).
CONCLUSION
Vitamin D deficiency is associated with worse severity, functional status, and postural balance in patients with OA.
Core Tip: This study investigated the association between vitamin D deficiency and disease severity, functional status, and postural balance in elderly patients with osteoarthritis. The severity of osteoarthritis was assessed by the Kellgren-Lawrence criteria, and the functional status was evaluated with the Lequesne index. Additionally, postural balance was evaluated using a force platform and center-of-pressure parameters. We found that vitamin D deficiency was associated with worse severity and functional status as well as worse postural balance in elderly patients with osteoarthritis.
