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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.

Item Type:	Article
Authors/Creators:	Zheng, S and Tu, L and Cicuttini, F and Han, W and Zhu, Z and Antony, B and Wluka, A and Winzenberg, T and Meng, T and Aitken, D and Blizzard, L and Jones, G and Ding, C
Keywords:	Vitamin D supplementation, depressive symptoms, osteoarthritis, vitamin D deficiency
Journal or Publication Title:	Journal of The American Medical Directors Association
Publisher:	Elsevier Inc.
ISSN:	1525-8610
DOI / ID Number:	10.1016/j.jamda.2018.09.006
Copyright Information:	2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
Related URLs:	Google Scholar: Antony, B Google Scholar: Winzenberg, T UTAS Profile: Winzenberg, T Google Scholar: Aitken, D UTAS Profile: Aitken, D UTAS Profile: Blizzard, L Google Scholar: Jones, G UTAS Profile: Jones, G Google Scholar: Ding, C UTAS Profile: Ding, C
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