Prevalence of Vitamin D level deficiency among patients with non-specific musculoskeletal pain at a tertiary care hospital in Khyber Pakhtunkhwa

  • Israr Ahmad Department of Orthopaedics, Hayatabad Medical Complex Peshawar & Mercy Teaching Hospital Peshawar.
  • Sajjad Ahmad Department of Orthopaedics, Hayatabad Medical Complex Peshawar & Mercy Teaching Hospital Peshawar.
  • Muhammad Arif Khan Department of Orthopaedics, Hayatabad Medical Complex Peshawar & Mercy Teaching Hospital Peshawar.
  • Asad Ullah Jan Department of Orthopaedics, Hayatabad Medical Complex Peshawar & Mercy Teaching Hospital Peshawar.
  • Syed Hamad Ali Shah Banori Department of Orthopaedics, Hayatabad Medical Complex Peshawar & Mercy Teaching Hospital Peshawar.
  • Mohammad Ali Shah Department of Orthopaedics, Hayatabad Medical Complex Peshawar & Mercy Teaching Hospital Peshawar.

Abstract

Objective: To objective of the study is to find out the prevalence of vitamin D deficiency in patients with non-specific musculoskeletal pain presenting to outpatients department at a tertiary care hospital of Khyber Pakhtunkhwa.


Methods: The design of our study was cross section and was conducted on 253 patients with age above 15 years presenting to Orthopedic Out Patients Department (OPD) of a tertiary care hospital from from 21st June 2018 to 20th June 2019.These patients presented with non-specific musculoskeletal pain like generalized body aches, bone pain, weakness and fatigue with no other complaints such as fever, visceral pain and any other trauma history. Their routine test like complete blood count(CBC), Renal Function Tests(RFT),Erythrocyte Sedimentation Rate (ESR) and random blood sugar (RBS) were normal. They were screened for Vitamin D level.


Results: out of 253 patients 37.94 %( n= 96) were male and 62.05% (n= 157) were female .Vitamin D deficiency was below normal in 75.49% (n= 191) patients comprising of 58.1% (n= 111) patients had deficiency and 41.8% (n= 80) had insufficiency while 24.5% ( n= 62) showed sufficient level. In comparison to other age groups Vitamin D level was deficient and insufficient in 15 to 35 age group.


Conclusion: A high prevalence of vitamin D deficiency is present in our population. The Orthopaedic surgeon must keep his suspicion high for of vitamin D deficiency in patients of non specific musculoskeletal pain.

References

1. Pacifici GM. Effects of vitamin D in neonates and young infants. International Journal of Pediatrics. 2016;4(1):1273-85
2. Heshmat R, Mohammad K, Majdzadeh S, Forouzanfar M, Bahrami A, Ranjbar Omrani G. Vitamin D deficiency in Iran: A multi-center study among different urban areas. Iran J Public Health. 2008;37(suppl):72-8
3. Azizi F, Rais ZF, Mir GA. Vitamin D deficiency in a group of Tehran population. Research in Medicine 2000;4:291-303.
4. Holick MF. Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health. Current Opinion in Endocrinology, Diabetes and Obesity. 2002;9(1):87-98.
5. Qader EA, Alkhateeb NE. Vitamin D Status in Children with Iron Deficiency and/or Anemia. International Journal of Pediatrics. 2016;4(9):3571-7
6. Nasirinezhad F, Ramezanian Nick E, Sadeghi M, Pazoki Torodi H. Antinociceptive effect of 1, 25 Dihydroxy Vitamin D3 in a Neuropathic Pain Model. Razi Journal of Medical Sciences. 2007;14(55):181-90
7. Hickey L, Gordon CM. Vitamin D deficiency: new perspectives on an old disease. Current Opinion in Endocrinology, Diabetes and Obesity. 2004;11(1):18-25.
8. Leung L, Cahill CM. TNF-alpha and neuropathic pain. J Neuroinflammation 2010; 7-27
9. Bergstrom I, Palmer M, Persson J, Blanck A . Observational study of vitamin D levels and pain in pregnant immigrant women living in Sweden. Gynecol Endocrinol. 2013;30
10. Bhan A, Rao AD, Rao DS. Osteomalacia as a result of Vitamin D deficiency. Rheum Dis Clin America. 2012; 38(1):81–ix.
11. Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78(12):1463–1470
12. Ghai B, Bansal D, Kanukula R, Gudala K, Sachdeva N, Dhatt SS et al. Vitamin D supplementation in patients with chronic low back pain: an open label, single arm clinical trial. Pain physician. 2017 Jan 1;20(1):E99-105.
13. Ritu G, Ajay Gupta. Vitamin D Deficiency in India: Prevalence, Causalities and Interventions. Nutrients. 2014;6:729-775.
14. Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev.2005; 10:94-111.
15. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357:266-281.
16. Cutolo M, Paolino S, Sulli A, Smith V, Pizzorni C, Seriolo B. Vitamin D, steroid hormones, and autoimmunity. Ann N Y Acad Sci 2014; 1317:39-46.
17. Jesus CA, Feder D, Peres MF. The role of vitamin D in pathophysiology and treatment of fibromyalgia. Curr Pain Headache Rep 2013; 17:355.
18. Rkain H, Bouaddi I, Ibrahimi A, Lakhdar T, Abouqal R, Allali F et al. Relationship between vitamin D deficiency and chronic low back pain in postmenopausal women. Curr Rheumatol Rev 2013; 9:63-67.
19. Muir SW, Montero-Odasso M. Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: A systematic review and metaanalysis. J Am Geriatr Soc 2011; 59:2291- 2300.
20. Abbasi M, Hashemipour S, Hajmanuchehri F, Kazemifar AM. Is vitamin D deficiency associated with non specific musculoskeletal pain?. Global journal of health science. 2013 Jan;5(1):107.
21. Ghai B, Bansal D, Kapil G, Kanukula. High Prevalence of Hypovitaminosis D in Indian Chronic Low Back Patients. Pain Physician. 2015; 18:853-862.
22. Kalra S, Kalra B, Khandelwal SK. Vitamin D status in patients with musculoskeletal symptoms in Haryana. India J Med Nutr Nutraceut 2012; 1:50-53.
Published
2019-09-02
How to Cite
AHMAD, Israr et al. Prevalence of Vitamin D level deficiency among patients with non-specific musculoskeletal pain at a tertiary care hospital in Khyber Pakhtunkhwa. Journal of Pakistan Orthopaedic Association, [S.l.], v. 31, n. 02, p. 57-60, sep. 2019. ISSN 2076-8966. Available at: <http://jpoa.org.pk/index.php/upload/article/view/312>. Date accessed: 13 oct. 2019.

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.