Vitamin D Status, Bone Mineral Density, and the Development of Radiographic Osteoarthritis of the Knee The Rotterdam Study

Arjan Bergink, André Uitterlinden, Hans van Leeuwen, CJ (Cok) Buurman, Bert Hofman, Jan Verhaar, Huib Pols

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Abstract

Objective: To study the association between baseline vitamin D status, bone mineral density (BMD),, and the development of radiographic osteoarthritis (ROA) of the knee in a large population-based cohort of men and women. Methods: A sample of 1248 subjects (728 women and 520 men) was drawn from the Rotterdam Study, a prospective population-based cohort study of the elderly. At baseline, vitamin D dietary intake was determined, and BMD and 25-hydroxy vitamin D (25(OH)D) serum levels were measured. After a mean follow-up time of 6.5 years incidence and progression of knee ROA of was assessed. Results: The mean vitamin D intake in our study population was 64 IU/d and the mean 25(OH)D level 66 nmol/L. Vitamin D levels were associated with baseline BMD, particularly in subjects with baseline knee ROA. Progressive ROA occurred in 5.1% of the participants in the highest tertile of vitamin D intake against 12.6% in the lowest tertile, resulting in an adjusted odds ratio of 7.7 (95% CI: 1.3-43.5). Both intake and levels of 25(OH)D were not significantly related to incident ROA. However, we found a significant interaction between vitamin D intake and BMD in the association with incident knee ROA (P = 0.03): in subjects with low lumbar spine BMD at baseline we observe an increasing incidence of knee ROA with decreasing vitamin D intake and serum levels. Conclusions: Low dietary vitamin D intake increases the risk of progression of knee ROA. Particularly in subjects with low baseline BMD, vitamin D status seems to influence the incidence and progression of knee ROA. Thus, improving the vitamin D status in the elderly could protect against the development and worsening of knee OA, especially in those with low BMD.
Original languageUndefined/Unknown
Pages (from-to)230-237
Number of pages8
JournalJcr. Journal of Clinical Rheumatology
Volume15
Issue number5
DOIs
Publication statusPublished - 2009

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