Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2150
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
Vitamin D deficiency is common in chronic pain patients and healthy people, but the difference between the two has not been reported. The relationship between vitamin D, chronic pain and bone mineral density (BMD) is controversial. The aim of the present study was to observe changes in vitamin D levels in patients with chronic pain, clarify the relationship between vitamin D and BMD, and explore risk factors for bone mass reduction and osteoporosis.
To understand the relationship between vitamin D and chronic pain, clarify the relationship between vitamin D and bone density, analyze the risk factors of bone mass reduction and osteoporosis, and provide a basis for early treatment of osteoporosis.
Vitamin D deficiency is very common in patients with chronic pain and healthy people, but severe vitamin D deficiency is more likely to occur in patients with chronic pain. Vitamin D is not a risk factor for bone mass changes. Age, parathyroid hormone (PTH) and calcium (Ca) were risk factors for bone mass reduction, while age, ethnicity and altitude were risk factors for osteoporosis.
25 hydroxy vitamin D and PTH were determined by a Cobas 8000 electrochemical luminescence immunoassay kit. Ca and P levels were detected using a fully automated biochemical analyzer and the relevant kit (Hitachi). BMD of l-1-4, femoral neck, Ward's triangle, and femoral trochanter was measured by dual-energy X-ray absorptiometry. General patient information was collected including age, height, weight, body mass index, altitude of residence, previous medical history and medication use. All statistical analyses were performed using SPSS 17.0. Quantitative data are expressed as x ± s. Comparisons between two groups were performed using the independent sample t test; comparisons between three groups were performed by one way ANOVA; and comparisons between multiple groups were performed by LSD. Counting data are expressed as c2. Two sets of ordered counting data were analyzed by the Mantel-Haenszel test for linear trend. Risk factors were analyzed by binary logistic regression. Values of P < 0.05 were considered statistically significant.
Both chronic pain patients and healthy people were mainly deficient in vitamin D, but the proportion of severe vitamin D deficiency in chronic pain patients was significantly higher than that in the healthy group. Patients with chronic pain were more likely to suffer from vitamin D deficiency or severe deficiency, the causes of which require further study. The levels of vitamin D in the osteoporosis group were lower than those in the groups with normal bone mass and reduced bone mass, but vitamin D levels were not a risk factor for changes in bone mass. Age, PTH and Ca were risk factors for bone mass loss. Age, sex, ethnicity, and altitude were risk factors for osteoporosis.
Vitamin D deficiency is common among patients with chronic pain, and severe vitamin D deficiency is more likely to occur. Although vitamin D levels are lowest during osteoporosis, they are not a risk factor for changes in bone mass. According to the different risk factors of bone mass change, independent treatment methods can be adopted clinically.
Chronic pain patients are more likely to have severe vitamin D deficiency, and the reason for this is not clear. Vitamin D is not a risk factor for osteoporosis. Whether vitamin D supplementation is beneficial requires further study. Whether early monitoring of PTH and Ca levels has an effect on the prevention of bone mass change, and which age group can effectively prevent osteoporosis requires further investigation.