Association between vitamin D deficiency, inflammatory markers, and knee osteoarthritis: a retrospective study
J Orthop Surg Res 2025 Aug 23;20(1):794. doi: 10.1186/s13018-025-05805-0
Khaled Swailem # 1, Mohammed Sadhan # 2, Gehad Abdullah Al-Mashramah # 3, Mohammed Ali Saghir # 4
Background: Knee osteoarthritis (OA) is a prevalent condition influenced by various biochemical, anatomical, and lifestyle factors. Vitamin D deficiency has been implicated in OA, but its role in disease severity and associated symptoms remains unclear. We aimed to investigate the prevalence of vitamin D deficiency in knee OA patients and its relationship with inflammatory markers and clinical symptoms.
Methods: This retrospective study analyzed 986 patients with knee OA over a 3.5-year period. Vitamin D levels, ESR, and platelet counts were assessed, along with demographic and clinical data. Statistical analyses were conducted to explore associations.
Result: This study involved 986 patients with knee OA, majority of them (85% ) were female with mean age 52.95 ± 12.44 years. More than half of patients 59.7% had unilateral knee OA and 40.3% had bilateral knee OA. The mean value of Vitamin D3 was 25.35 ± 14.125. Vitamin D deficiency was observed in 70.9% of patients, with moderate deficiency being most prevalent (36.94%). No significant association was found between vitamin D levels and inflammatory markers.
However, a strong association was observed between vitamin D deficiency and symptoms like polyarthralgia (p < .05).,
Bilateral OA was associated with higher vitamin D deficiency levels compared to unilateral OA (P < .001).
Conclusion: OA more prevalence among female .As well as, vitamin D deficiency is highly prevalent in knee OA patients and its severity associated with Bilateral OA and polyarthralgia but not with inflammatory markers. Future research should focus on the long-term impact of vitamin D supplementation and the molecular mechanisms underlying these disparities.
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Is polyarthralgia associated with low Vitamin D Perplexity AI - Aug 2025
Yes, there is strong evidence that polyarthralgia is associated with low vitamin D levels. Research demonstrates a clear relationship between vitamin D deficiency and pain in multiple joints.
Key Research Findings (2.7 X more likely)
Strong Association with Joint Pain: A landmark case-control study found that vitamin D deficiency was associated with a 3.01 times increased risk of arthralgia, and even after adjusting for age and sex, the risk remained significant at 2.71 times higher. The study showed that as vitamin D levels decreased, the odds of arthralgia increased dramatically - from 3.48 times higher risk when levels were below 10 ng/ml to 3.39 times higher at 10-19.9 ng/ml.applications.emro.who+1
Recent Confirmation: A 2025 study specifically found a strong association between vitamin D deficiency and polyarthralgia with statistical significance (p < .05). This confirms that pain affecting multiple joints is particularly linked to inadequate vitamin D status.pubmed.ncbi.nlm.nih
Dose-Response Relationship: Research demonstrates that the severity of joint pain correlates with the degree of vitamin D deficiency. The lowest vitamin D levels are associated with the highest pain scores, suggesting a biological mechanism rather than coincidence.pubmed.ncbi.nlm.nih+1
Mechanism and Clinical Evidence
Biological Plausibility: Vitamin D deficiency is frequently identified as the sole cause of polyarthralgia, myalgia, bone pain and chronic widespread pain in patients referred to specialists. This occurs because vitamin D plays crucial roles in muscle function, bone health, and immune regulation.medicalnewstoday+3
Clinical Manifestations: Typical symptoms of vitamin D deficiency include joint pain, muscle weakness, bone pain, fatigue, and reduced range of motion - all components that can contribute to polyarthralgia.yeditepehastaneleri+2
Treatment Implications
Therapeutic Response: Studies show that correcting vitamin D deficiency can improve joint pain symptoms. Clinical trials have demonstrated that vitamin D supplementation in deficient patients can lead to significant improvements in pain scores and functional outcomes.pmc.ncbi.nlm.nih+2
Clinical Recommendation: Given that vitamin D deficiency may be an environmental factor for the development or progression of rheumatic diseases, researchers strongly recommend identification and correction of vitamin D deficiency in patients with arthralgia. This is particularly important since some patients with unexplained joint pain may progress to definite rheumatic diseases months later.applications.emro.who
In summary, the evidence clearly supports an association between low vitamin D levels and polyarthralgia, with deficiency increasing the risk of multiple joint pain by 2-3 times. For anyone experiencing persistent joint pain in multiple locations, checking and correcting vitamin D status should be considered as part of the evaluation and treatment plan.pubmed.ncbi.nlm.nih+4
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