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


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, Effect of vitamin D supplementation on depressive symptoms in patients with knee osteoarthritis, Journal of The American Medical Directors Association pp. 1-7. ISSN 1525-8610 (2018) [Refereed Article]

Copyright Statement

2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

DOI: doi:10.1016/j.jamda.2018.09.006


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 Details

Item Type:Refereed Article
Keywords:Vitamin D supplementation, depressive symptoms, osteoarthritis, vitamin D deficiency
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Zheng, S (Miss Shuang Zheng)
UTAS Author:Han, W (Dr Weiyu Han)
UTAS Author:Zhu, Z (Mr Zhaohua Zhu)
UTAS Author:Antony, B (Dr Benny Eathakkattu Antony)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Meng, T (Mr Tao Meng)
UTAS Author:Aitken, D (Associate Professor Dawn Aitken)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Ding, C (Professor Chang-Hai Ding)
ID Code:129693
Year Published:2018
Web of Science® Times Cited:4
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-12-13
Last Modified:2019-01-18

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