title: Relationship between unexplained arthralgia and vitamin D deficiency: a case control study.
abstract: Arthralgia is a common presenting symptom of many rheumatic diseases. Vitamin D deficiency may lead to progression of skeletal symptoms to definite disease in susceptible subjects. This study was conducted to determine the relationship between vitamin D deficiency and unexplained arthralgia. Patients with arthralgia not related to a definite clinical condition were selected prospectively among subjects presented to a rheumatology clinic. Serum 25-hydroxyvitamin D (25-OHD) was measured by ELISA method and levels less than 20 ng/ml were considered as deficient levels. Serum 25-OHD levels and proportion of 25-OHD deficiency was compared in patients versus control. The association of serum 25-OHD and arthralgia was assessed by calculation of odds ratio (OR) using regression analysis. 167 patients with mean age of 38 ± 13.3 and 283 controls with mean age of 42.6±14.37 years (P=0.001) were studied. In patients mean serum 25-OHD was lower and proportion of deficiency was higher (P=0.001 for both).Serum 25-OHD deficiency was associated with 3.01 times increased risk of arthralgia (OR=3.01, 95% CI, 2.0- 4.25, P=0.001). After adjusment for age and sex, the risk of arthralgia remained significan at OR= 2.71(95%CI, 1.79-4.11,P=0.001).The odds of arthralgia decreased with increasing serum 25-OHD from OR=3.48 (95% CI,197-6,P=0.001) at serum <10 ng/ml to 3.39 (95%CI,1.93-5.98, P=0.001) at 10-19.9; and 1.31 (95%CI, 0.69-2.5, P=0.42) at 20-29.9 ng/ml. These findings indicate significant association of vitamin D deficiency and arthralgia. Regarding vitamin D deficiency as an environmental factor for development or progression of rheumatic diseases, this study justifies identification and correction of vitamin D deficiency in patients with arthralgia.
authors.affiliation: Department of Internal Medicine, Rouhani Hospital, Babol, Iran-Mobility Impairment Research Center, Babol University of Medical Sciences, Babol, Iran heidaribeh@yahoo.com.
authors.forename: Behzad
authors.initials: B
authors.lastname: Heidari
authors.affiliation: Avina Clinic, Tehran, Iran heidaribeh@yahoo.com.
authors.forename: Parham
authors.initials: P
authors.lastname: Heidari
authors.affiliation: Department of Social Medicine, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran heidaribeh@yahoo.com.
authors.forename: Karim Hajian
authors.initials: KH
authors.lastname: Tilaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D