비타민 D와 무릎 골관절염 – 임상연구 총설

Vitamin D and Knee Osteoarthritis – A Review of Clinical Trials

The current dietary reference intakes (DRI) for vitamin D (VD) targets 25-hydroxyvitamin D levels for optimal bone health. Older persons are advised to increase VD intake to prevent bone loss and fracture risk. This age group is also at risk of osteoarthritis (OA), but whether the DRI for VD is appropriate for knee OA patients is unknown. In this review, we examine several observational studies and randomized-controlled trials (RCT) to identify the effect of VD on knee OA outcome measures, such as pain, joint-space narrowing, cartilage volume loss, cartilage thickness changes, cartilage defects, bone marrow lesions and effusionsynovitis volume change. VD was not beneficial in terms of knee OA incidence whereas the evidence of sufficient VD levels for pain, joint-space narrowing, cartilage volume loss and effusion-synovitis volume changes are mixed, pointing to no effect or a positive effect. For change in cartilage thickness, cartilage defects and bone marrow lesions, VD had no positive effect. Consequently, the current DRI for vitamin D may not protect the joint from knee OA initiation, but at least does not seem to be detrimental to knee OA progression. Further studies focusing on older adults with lower VD levels must be performed. In addition, RCTs are required to identify dose-response relationships of VD on knee OA in various races and age groups.