Vitamin D deficiency is associated with progression of knee osteoarthritis

Fang Fang Zhang, Jeffrey B. Driban, Grace H. Lo, Lori Lyn Price, Sarah Booth, Charles B. Eaton, Bing Lu, Michael Nevitt, Becky Jackson, Cheryl Garganta, Marc C. Hochberg, Kent Kwoh, Timothy E. McAlindon

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


Background: Knee osteoarthritis causes functional limitation and disability in the elderly. Vitamin D has biological functions on multiple knee joint structures and can play important roles in the progression of knee osteoarthritis. The metabolism of vitamin D is regulated by parathyroid hormone (PTH). Objective: The objective was to investigate whether serum concentrations of 25-hydroxyvitamin D [25(OH)D] and PTH, individually and jointly, predict the progression of knee osteoarthritis. Methods: Serum 25(OH)D and PTH were measured at the 30- or 36-mo visit in 418 participants enrolled in the Osteoarthritis Initiative (OAI) who had ≥1 knee with both symptomatic and radiographic osteoarthritis. Progression of knee osteoarthritis was defined as any increase in the radiographic joint space narrowing (JSN) score between the 24- and 48-mo OAI visits. Results: The mean concentrations of serum 25(OH)D and PTH were 26.2 μg/L and 54.5 pg/mL, respectively. Approximately 16% of the population had serum 25(OH)D < 15 μg/L. Between the baseline and follow-up visits, 14% progressed in JSN score. Participants with low vitamin D [25(OH)D < 15 μg/L] had >2-fold elevated risk of knee osteoarthritis progression compared with those with greater vitamin D concentrations (≥15 μg/L; OR: 2.3; 95% CI: 1.1, 4.5). High serum PTH (≥73 pg/mL) was not associated with a significant increase in JSN score. However, participants with both low vitamin D and high PTH had >3-fold increased risk of progression (OR: 3.2; 95%CI: 1.2, 8.4). Conclusion: Our results suggest that individuals deficient in vitamin D have an increased risk of knee osteoarthritis progression.

Original languageEnglish (US)
Pages (from-to)2002-2008
Number of pages7
JournalJournal of Nutrition
Issue number12
StatePublished - 2014


  • Joint space narrowing
  • Knee osteoarthritis
  • Parathyroid hormone
  • Progression
  • Vitamin D

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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