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Effect of vitamin D supplementation on depressive symptoms in patients with knee osteoarthritis

Zheng, S ORCID: 0000-0003-3552-1247, Tu, L, Cicuttini, F, Han, W ORCID: 0000-0003-1590-7433, Zhu, Z ORCID: 0000-0003-3913-2564, Antony, B ORCID: 0000-0001-8704-6084, Wluka, A, Winzenberg, T ORCID: 0000-0002-4112-3491, Meng, T ORCID: 0000-0001-6901-3801, Aitken, D ORCID: 0000-0001-5685-7634, Blizzard, L ORCID: 0000-0002-9541-6943, Jones, G ORCID: 0000-0002-9814-0006 and Ding, C ORCID: 0000-0002-9479-730X 2018 , 'Effect of vitamin D supplementation on depressive symptoms in patients with knee osteoarthritis' , Journal of The American Medical Directors Association , pp. 1-7 , doi: 10.1016/j.jamda.2018.09.006.

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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.

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