Vitamin D deficiency is associated with tibial bone pain and tenderness. A possible contributive role.

Abstract: Background: Vitamin D deficiency is associated with osteomalacia and a variety of musculoskeletal pain. This study aimed to determine the association of vitamin D deficiency with tibial bone pain and tenderness. Methods: Patients with leg pain, defined as local pain and tenderness over tibial bones for ≥ 6 weeks were consecutively selected. Secondary causes of pain were excluded by appropriate clinical, radiological and laboratory examinations. Serum 25‐hydroxyvitamin D (25‐OHD) was assessed by enzyme‐linked immunosorbent assay method and levels < 20 ng/mL were considered as deficiency. Age‐ and sex‐matched subjects without leg pain served as controls. Multiple logistic regression analysis was used to determine associations. Results: One hundred and eighteen patients and 114 controls aged 46.8 ± 14.8 and 44.6 ± 14.1 years, respectively (<italic>P </italic>=<italic> </italic>0.93) were analyzed. Mean 25‐OHD level was significantly lower (<italic>P </italic>=<italic> </italic>0.001) and the prevalence of 25‐OHD deficiency was significantly higher in the patients as compared with the controls (75.4% <italic>vs</italic>. 23.6%), odds ratio (OR) = 9.54 (95% CI, 5.22–17.45, <italic>P </italic>=<italic> </italic>0.001). There was a negative dose‐response relationship between serum 25‐OHD and tibial bone pain by OR = 17.33 (95% CI, 6.48–46.3) in subjects with 25‐OHD < 10 ng/mL, and OR = 14.7 (95% CI, 6.35–34.6) in serum 25‐OHD levels at 10–19.9 ng/mL, and OR = 2.58 (95% CI, 1.08–6.1) in those with 25‐OHD at 20–29.9 ng/mL as compared with 25‐OHD ≥ 30 ng/mL. After controlling for demographic and biochemical factors, the association reached a stronger level of 19.8 (6.9–56.3) in subjects with serum 25‐OHD < 10 ng/mL and 14.4 (5.8–34.6) in those with serum 25‐OHD at levels of 10–19.9 ng/mL and 1.85 (0.73–4.6) in 20–29 ng/mL. Conclusion: These findings indicate a possible contributive role for serum 25‐OHD deficiency in the development of pain and tenderness over the tibial bone. [ABSTRACT FROM AUTHOR]