Prevalence of Vitamin D Insufficiency and Deficiency in Young, Female Patients With Lower Extremity Musculoskeletal Complaints.

Abstract

BACKGROUND:

Low levels of vitamin D have well-known impacts on bone health, but vitamin D also has a more global role throughout many tissues, including skeletal muscle. The high prevalence of hypovitaminosis D and the vast physiological features of vitamin D have led researchers to examine the influence of vitamin D on physical performance and injury. Because of the critical role of vitamin D in maintaining musculoskeletal health and function, a high rate of hypovitaminosis D among female patients with a variety of musculoskeletal issues could be of high clinical relevance.

HYPOTHESIS:

There is a high prevalence of low vitamin D in female patients with both acute and overuse sports-related issues of both soft tissue and bone.

STUDY DESIGN:

Prospective cohort study.

LEVEL OF EVIDENCE:

Level 3.

METHODS:

Female patients, aged 16 to 40 years, presenting with lower extremity injury diagnosed within the past 4 weeks, no use of multivitamin or vitamin D supplement, and no history of malabsorption syndrome met the inclusion criteria. Vitamin D levels were assessed and categorized as normal (≥32 ng/mL) and low, which includes insufficient (20.01-31.9 ng/mL) and deficient (≤20 ng/mL).

RESULTS:

Of the 105 patients enrolled, 65.7% had low vitamin D. Within the low vitamin D cohort, 40.6% were deficient and 59.4% were insufficient. Injuries were grouped into overuse or acute with 74 overuse injuries and 31 acute injuries, exhibiting low vitamin D prevalence of 60.8% and 77.4%, respectively. Patients with ligamentous/cartilaginous injuries exhibited the highest percentage of low vitamin D (76.5%), followed by those with patellofemoral-related complaints (71.0%), muscle/tendon injuries (54.6%), and bone stress injuries (45.5%). In univariable analysis, older age, non-White race, less physical activity, less high-intensity interval training days, less endurance training days, and more rest days showed an association with low vitamin D, but none showed an independent association in multivariable analysis.

CONCLUSION:

The prevalence of low vitamin D in female patients with various musculoskeletal complaints was high. Clinicians should evaluate for low vitamin D in both acute and overuse injuries.

CLINICAL RELEVANCE:

In addition to screening, this study suggests that clinicians should evaluate for low vitamin D levels beyond bone stress injuries in the setting of acute and overuse injuries.

• Authors: Brittany M Ammerman, Daphne Ling, Lisa R Callahan, Jo A Hannafin, Marci A Goolsby
• Journal: Sports health (Sports Health) Vol. 13 Issue 2 Pg. 173-180 (Mar 2021) ISSN: 1941-0921 [Electronic] United States
• PMID: 33301353 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Athletic Injuries (epidemiology)
• Cartilage (injuries)
• Comorbidity
• Cumulative Trauma Disorders (epidemiology)
• Female
• Fractures, Stress (epidemiology)
• Humans
• Ligaments (injuries)
• Lower Extremity (injuries)
• Muscle, Skeletal (injuries)
• Patellofemoral Joint (injuries)
• Prevalence
• Prospective Studies
• Risk Factors
• Tendon Injuries (epidemiology)
• United States (epidemiology)
• Vitamin D Deficiency (epidemiology)
• Young Adult