Ming-Yen Hsiao1, Chen-Yu Hung2, Ke-Vin Chang1, Der-Sheng Han1, Tyng-Guey Wang3. 1. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine; 2. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Chu-Tung Branch; 3. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Abstract
BACKGROUND: Chronic widespread pain (CWP) is a global musculoskeletal disorder leading to disability and a reduced quality of life. Low levels of serum vitamin D has long been proposed to be associated with CWP, but previous research remains inconclusive. OBJECTIVES: To determine whether hypovitaminosis D was independently associated with CWP. STUDY DESIGN: Meta-analysis of observational study. METHODS: Electronic databases were searched for studies published up to November 2014 comparing the prevalence of hypovitaminosis D and serum vitamin D levels between participants with and without CWP. The crude and adjusted odds ratios (ORs) of hypovitaminosis D with CWP were calculated. Subgroup analysis according to gender, threshold of hypovitaminosis, and definition of patients was performed, as well as meta-regression to test the linear relationship between crude ORs and the latitude of study locations. RESULTS: Twelve studies were included, comprising 1,854 patients with CWP. The patient group showed a significantly higher risk of hypovitaminosis D than the control group (crude OR, 1.63; 95% CI, 1.20-2.23). The association was slightly attenuated after adjusting confounders, with a pooled adjusted OR of 1.41 (95% CI, 1.00-2.00). There was an increase in ORs of hypovitaminosis D using a lower diagnostic value of serum vitamin D (8 and 10 ng/mL). The subgroup analysis according to gender and definition of CWP did not reveal significant between-group differences. The meta-regression showed no linear relationship between latitude and the crude ORs. CONCLUSIONS: There was a positive crude association between hypovitaminosis D and CWP, and the association was likely to remain after adjusting confounding factors. Use of a cut-off value of hypovitaminosis D (8-10 ng/mL) could better define the population with and without CWP. Further prospective follow-up studies are warranted to clarify the causal relationship between hypovitaminosis D and CWP.
BACKGROUND:Chronic widespread pain (CWP) is a global musculoskeletal disorder leading to disability and a reduced quality of life. Low levels of serum vitamin D has long been proposed to be associated with CWP, but previous research remains inconclusive. OBJECTIVES: To determine whether hypovitaminosis D was independently associated with CWP. STUDY DESIGN: Meta-analysis of observational study. METHODS: Electronic databases were searched for studies published up to November 2014 comparing the prevalence of hypovitaminosis D and serum vitamin D levels between participants with and without CWP. The crude and adjusted odds ratios (ORs) of hypovitaminosis D with CWP were calculated. Subgroup analysis according to gender, threshold of hypovitaminosis, and definition of patients was performed, as well as meta-regression to test the linear relationship between crude ORs and the latitude of study locations. RESULTS: Twelve studies were included, comprising 1,854 patients with CWP. The patient group showed a significantly higher risk of hypovitaminosis D than the control group (crude OR, 1.63; 95% CI, 1.20-2.23). The association was slightly attenuated after adjusting confounders, with a pooled adjusted OR of 1.41 (95% CI, 1.00-2.00). There was an increase in ORs of hypovitaminosis D using a lower diagnostic value of serum vitamin D (8 and 10 ng/mL). The subgroup analysis according to gender and definition of CWP did not reveal significant between-group differences. The meta-regression showed no linear relationship between latitude and the crude ORs. CONCLUSIONS: There was a positive crude association between hypovitaminosis D and CWP, and the association was likely to remain after adjusting confounding factors. Use of a cut-off value of hypovitaminosis D (8-10 ng/mL) could better define the population with and without CWP. Further prospective follow-up studies are warranted to clarify the causal relationship between hypovitaminosis D and CWP.
Authors: W Eich; K-J Bär; M Bernateck; M Burgmer; C Dexl; F Petzke; C Sommer; A Winkelmann; W Häuser Journal: Schmerz Date: 2017-06 Impact factor: 1.107
Authors: N Üçeyler; M Burgmer; E Friedel; W Greiner; F Petzke; M Sarholz; M Schiltenwolf; A Winkelmann; C Sommer; W Häuser Journal: Schmerz Date: 2017-06 Impact factor: 1.107
Authors: Monica L Joustra; Isidor Minovic; Karin A M Janssens; Stephan J L Bakker; Judith G M Rosmalen Journal: PLoS One Date: 2017-04-28 Impact factor: 3.240