Effect of Vitamin D Supplementation on Depressive Symptoms in Patients With Knee Osteoarthritis.

Abstract

OBJECTIVES:

To determine the effect of vitamin D supplementation and maintaining sufficient serum vitamin D on depressive symptoms in patients with knee osteoarthritis (OA) and vitamin D deficiency.

DESIGN:

A prespecified secondary analysis of a multicentre, randomized, double-blind, placebo-controlled trial. Participants were randomly assigned to receive oral vitamin D3 (50,000 IU, n = 209) or placebo (n = 204) monthly for 24 months. In addition, participants who completed the trial were classified into 2 groups according to their serum 25(OH)D levels at month 3 and 24 as follows: not consistently sufficient (serum 25(OH)D ≤ 50 nmol/L at month 3 and/or 24), and consistently sufficient (serum 25(OH)D > 50 nmol/L at both month 3 and 24). Multilevel mixed-effect models were used to compare differences of change in PHQ-9 scores between groups.

SETTING AND PARTICIPANTS:

This clinical trial was conducted in participants with symptomatic knee OA and vitamin D deficiency from June 2010 to December 2013 in Tasmania and Victoria, Australia.

MEASURES:

The primary outcome was the depressive symptoms change over 24 months, which was measured using the Patient Health Questionnaire (PHQ-9, 0-27).

RESULTS:

Of 599 participants who were screened for eligibility, 413 participants were enrolled (mean age: 63.2 years; 50.3% female) and 340 participants (intervention n = 181, placebo n = 159, 82.3% retention rate) completed the study. The baseline prevalence of depression (PHQ-9 score ≥5) was 25.4%. Depressive symptoms improved more in the vitamin D supplementation group compared to the placebo group [β: -0.66, 95% confidence interval (CI): -1.22 to -0.11, P for difference = .02] and in the participants who maintained vitamin D sufficiency compared to those who did not (β: -0.73, 95% CI: -1.41 to -0.05, P for difference = .04) over 24 months.

CONCLUSIONS/IMPLICATIONS:

These findings suggest that vitamin D supplementation and maintaining adequate vitamin D levels over 24 months may be beneficial for depressive symptoms in patients with knee OA.

• Authors: Shuang Zheng, Liudan Tu, Flavia Cicuttini, Weiyu Han, Zhaohua Zhu, Benny Antony, Anita Wluka, Tania Winzenberg, Tao Meng, Dawn Aitken, Leigh Blizzard, Graeme Jones, Changhai Ding
• Journal: Journal of the American Medical Directors Association (J Am Med Dir Assoc) Vol. 20 Issue 12 Pg. 1634-1640.e1 (12 2019) ISSN: 1538-9375 [Electronic] United States
• PMID: 30401608 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Chemical References

• Vitamins
• Vitamin D

Topics

• Aged
• Australia (epidemiology)
• Depression (epidemiology, physiopathology)
• Dietary Supplements
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Osteoarthritis, Knee (psychology)
• Prevalence
• Self Report
• Vitamin D (administration & dosage)
• Vitamin D Deficiency
• Vitamins (administration & dosage)