Vitamin D and osteoarthritis


  • V.V. Povoroznyuk State Institution “D.F. Chebotarev Institute of Gerontology of the NAMS of Ukraine”, Kyiv, Ukraine
  • N.V. Dedukh State Institution “D.F. Chebotarev Institute of Gerontology of the NAMS of Ukraine”, Kyiv, Ukraine
  • N.M. Yakovenchuk Municipal Institution “Sumy Regional Clinical Hospital”, Sumy, Ukraine



osteoarthritis, vitamin D deficiency and insufficiency, experimental and clinical studies


The attention of researchers and clinicians is drawn to vitamin D. It is a steroid hormone with a pluripotent mechanism of action, the targets of which, along with other organs and tissues, are articular cartilage and bone tissue. The aim of the review is to analyze and summarize the data about vitamin D effect on joint cartilage, to evaluate its role in the development of osteoarthritis and the possibility of correcting structural and functional disorders of the joints. The review provides general information about vitamin D, analyzes the risk factors for vitamin D deficiency in the body, as well as provides information on the development of various pathologies against this background. The data of studies on the effect of vitamin D on normal articular cartilage and experimentally induced arthritis are summarized. The analysis of data on the polymorphism of vitamin D receptor genes and their correlation with the development of osteoarthritis is carried out. Data on the relationship between clinical and X-ray indices in patients with osteoarthritis and vitamin D deficiency are presented. The literature data are evaluated on the results of treatment of patients with osteoarthritis when vitamin D is included into the treatment regimens under the conditions of deficiency or insufficiency. Based on the lite­rature data analysis, the current scientific research trends in the field of studying the mechanisms of vitamin D effect on normal articular cartilage homeostasis and with osteoarthritis are indicated.


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Korzh NA, Dedukh NV, Zupanets IA. Osteoartroz: konservativnaya terapiya. Monografiya [Osteoporosis: conservative therapy. Monograph]. Harkov: Zolotyie stranitsyi; 2007. 424 p. (In Ukrainian).

Korzh NA, Yakovenchuk NN, Deduh NV. Osteoporosis and osteoarthritis: pathogenetically interrelated diseases? (literature review). Orthopaedics, traumatology and prosthetics. 2013;(4):102-110. doi: 10.15674/0030-598720134102-110. (In Ukrainian).

Hansen АК, Figenschau Y, Zubiaurre-Martinez I. Co-expression of 1α-hydroxylase and vitamin D receptor in human articular chondrocytes. BMC Musculoskelet Disord. 2017 Nov 6;18(1):432. doi: 10.1186/s12891-017-1791-y.

Pike JW, Meyer MB. The vitamin D receptor: new paradigms for theregulation of gene expression by 1,25-Dihydroxyvitamin D3. Rheum Dis Clin North Am. 2012 Feb;38(1):13-27. doi: 10.1016/j.rdc.2012.03.004.

Płudowski P, Karczmarewicz E, Bayer M, et al. Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe - recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol. 2013;64(4):319-27. PMID: 24002961.

Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30. doi: 10.1210/jc.2011-0385.

Francis R, Aspray T, Fraser W, et al. Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management. Bath: The National Osteoporosis Society; 2013. 28 p.

Pasquali M, Tartaglione L, Rotondi S, et al. S. Calcitriol/calcifediol ratio: An indicator of vitamin D hydroxylation efficiency? BBA Clin. 2015 Mar 14;3:251-6. doi: 10.1016/j.bbacli.2015.03.004.

Povoroznyuk V, Pludowski P Defitsyt i nedostatnistʹ vitaminu D: epidemiolohiya, diahnostyka, profilaktyka ta likuvannya [Vitamin D deficiency and deficiency: epidemiology, diagnosis, prevention and treatment]. Kyiv: Publisher Zaslavsky OYu; 2014. 262 p. (In Ukrainian).

Pereira-Santos M, Costa PR, Assis AM. Obesity and vitamin D deficiency: a systematic review and meta-analysis. Obes Rev. 2015 Apr;16(4):341-9. doi: 10.1111/obr.12239.

Mabey T,  Honsawek S. Role of Vitamin D in Osteoarthritis: Molecular, Cellular, and Clinical Perspectives. International Journal of Endocrinology. 2015;2015:Article ID 383918. doi: 10.1155/2015/383918.

Holick M. The vitamin D deficiency pandemic: A forgotten hormone important for health. Pubic Health Rev. 2010;32:267-283.  doi: 10.1007/BF03391602.

Povoroznyuk VV, Balatska NI, Muts VY, et al. Vitamin D deficiency and insufficiency among Ukrainian population. Standardy medyczne. Pediatria. 2012;5(9):584-589. (In Ukrainian).

Loeser RF. Articular cartilage nuclear receptors: an emerging target for treatment of osteoarthritis. Osteoarthritis Cartilage. 2009 Jul;17(7):829-31. doi: 10.1016/j.joca.2009.03.025.

Pasquel-Garrido C, Angeline ME, Ma R, et al. Low levels of vitamin D effect the articular cartilage in a rat model. HSS J. 2016 Jul;12(2):150-7. doi: 10.1007/s11420-016-9492-x.

Li S, Niu G, Wu Y, et al. Vitamin D prevents articular cartilage erosion by regulating collagen II turnover through TGF-β1 in ovariectomized rats. Osteoarthritis Cartilage. 2016 Feb;24(2):345-53. doi: 10.1016/j.joca.2015.08.013.

Oestergaard S, Chouinard L, Doyle N, et al. The utility of measuring C-terminal telopeptides of collagen type II (CTX-II) in serum and synovial fluid samples for estimation of articular cartilage status in experimental models of destructive joint diseases. Osteoarthritis Cartilage. 2006 Jul;14(7):670-9. doi: 10.1016/j.joca.2006.01.004.

Boyan BD, Hyzy SL, Pan Q, et al. 24R,25-dihydroxyvitamin D3 рrotects against аrticular Cartilage Damage following Anterior Cruciate Ligament Transection in Male Rats. PLoS One. 2016 Aug 30;11(8):e0161782. doi: 10.1371/journal.pone.0161782.

Pan Q, O'Connor MI, Coutts RD, et al. Characterization of osteoarthritic human knees indicates potential sex differences. Biol Sex Differ. 2016 Jun 2;7:27. doi: 10.1186/s13293-016-0080-z.

Tok О, Yılmaz TE, Güzel E, et al. Effect of Systemic D Vitamin Supplementation on The Treatment of Full Thickness Articular Cartilage Defects. In: The 16th European Microscopy Congress, Lyon, France. Available from: Accessed: August 23, 2017

Masuyama R, Stockmans I, Torrekens S, et al. Vitamin D receptor in chondrocytes promotes osteoclastogenesis and regulates FGF23 production in osteoblasts. J Clin Invest. 2006 Dec;116(12):3150-9. doi: 10.1172/JCI29463.

Chen D, Li Y, Dai X, Zhou X, et al. 1,25-Dihydroxyvitamin D3 activates MMP13 gene expression in chondrocytes through p38 MARK pathway. Int J Biol Sci. 2013 Jul 5;9(6):649-55. doi: 10.7150/ijbs.6726.

Garfinkel RJ, Dilisio MF, Agrawal DK. Vitamin D and Its Effects on Articular Cartilage and Osteoarthritis. Orthop J Sports Med. 2017 Jun 20;5(6):2325967117711376. doi: 10.1177/2325967117711376.

Rodriguez WJ, Gromelski J. Vitamin D status and spine surgery outcomes. ISRN Orthop. 2013;2013:471695. doi: 10.1155/2013/471695.

Wang Y, Zhu J, DeLuca HF. Identification of the vitamin D receptor in osteoblasts and chondrocytes but not osteoclasts in mouse bone. J Bone Miner Res. 2014 Mar;29(3):685-92. doi: 10.1002/jbmr.2081.

Tetlow LC, Woolley DE. Expression of vitamin D receptors and matrix metalloproteinases in osteoarthritic cartilage and human articular chondrocytes in vitro. Osteoarthritis Cartilage. 2001 Jul;9(5):423-31. DOI: 10.1053/joca.2000.0408.

Orfanidou T, Malizos KN, Varitimidis S, Tsezou A. 1,25-Dihydroxyvitamin D(3) and extracellular inorganic phosphate activatemitogen-activated protein kinase pathway through fibroblast growth factor 23 contributing to hypertrophy and mineralization in osteoarthritic chondrocytes. Exp Biol Med (Maywood). 2012 Mar;237(3):241-53. doi: 10.1258/ebm.2011.011301.

Muraki S, Dennison E, Jameson K, et al. Association of vitamin D status with knee pain and radiographic knee osteoarthritis. Osteoarthritis Cartilage. 2011 Nov;19(11):1301-6. doi: 10.1016/j.joca.2011.07.017.

Zhu ZH, Jin XZ, Zhang W, et al. Associations between vitamin D receptor gene polymorphisms and osteoarthritis: an updated meta-analysis. Rheumatology (Oxford). 2014 Jun;53(6):998-1008. doi:10.1093/rheumatology/ket418.

Lee YH, Woo JH, Choi SJ, et al. Vitamin D receptor TaqI, BsmI and ApaI polymorphisms and osteoarthritis susceptibility: a meta-analysis. Joint Bone Spine. 2009 Mar;76(2):156-61. doi: 10.1016/j.jbspin.2008.06.011.

Liu H, He S, Li L, et al. Vitamin D receptor gene polymorphisms and risk of osteoarthritis: A meta-analysis. Exp Biol Med (Maywood). 2014 May;239(5):559-67. doi: 10.1177/1535370213514920.

Bayram B, Sayin BE, Türkoğlu Z, et al. An Investigation Into the Relationship Between Taq1 and Apa1 Polymorphisms of the Vitamin D Receptor Gene and the Development of Osteoarthritis. Arch Rheumatol. 2011;26(4):303-307 doi: 10.5606/tjr.2011.048.

Sanghi D, Srivastava RN, Agarwal S. Vitamin D receptor gene polymorphisms modulate the clinico-radiological response to vitamin d supplementation in knee osteoarthritis. Mol Cytogenet. 2014;7(Suppl 1):P13. doi: 10.1186/1755-8166-7-S1-P13.

Goula T, Kouskoukis A, Drosos G, et al. Vitamin D status in patients with knee or hip osteoarthritis in a Mediterranean country. J Orthop Traumatol. 2015;16(1):35-39. doi: 10.1007/s10195-014-0322-y.

Chaganti RK, Parimi N, Cawthon P, Dam TL, Nevitt MC, Lane NE. Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men: the osteoporotic fractures in men study. Arthritis Rheum. 2010 Feb;62(2):511-4. doi: 10.1002/art.27241.

Felson DT, Niu J, Clancy M, et al. Low levels of vitamin D and worsening of knee osteoarthritis: results of two longitudinal studies. Arthritis Rheum. 2007;56(1):129-136. doi: 10.1002/art.22292.

Heidari B, Heidari P, Hajian-Tilaki K. Association between serum vitamin D deficiency and knee osteoarthritis. Int Orthop. 2011;35(11):1627-1631. doi: 10.1007/s00264-010-1186-2.

Jansen JA, Haddad FS. High prevalence of vitamin D deficiency in elderly patients with advanced osteoarthritis scheduled for total knee replacement associated with poorer preoperative functional state. Ann R Coll Surg Engl. 2013 Nov;95(8):569-72. doi: 10.1308/003588413X13781990150374.

Glover T, Goodin B, King C, et al. A cross-sectional examination of vitamin D, obesity, and measures of pain and function in middle-aged and older adults with knee osteoarthritis. Clin J Pain. 2015;31(12):1060-1067. doi:  10.1097/AJP.0000000000000210.

Konstari S, Kaila-Kangas L, Jaaskelainen T, et al. Serum 25-hydroxyvitamin D and the risk of knee and hip osteoarthritis leading to hospitalization: a cohort study of 5274 Finns. Rheumatology. 2014;53(10):1778-1782. doi: 10.1093/rheumatology/keu178.

Konstari S, Paananen M, Helifvaara M, et al. Association of 25-hydroxyvitamin D with the incidence of knee and hip osteoarthritis: a 22-year follow-up study. Scand J Rheumatol. 2012;41(2):124-131. doi: 10.3109/03009742.2011.617314.

Bergink AP, Uitterlinden AG, Van Leeuwen JP, et al. Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: The Rotterdam Study. J Clin Rheumatol. 2009 Aug;15(5):230-7. doi: 10.1097/RHU.0b013e3181b08f20.

Breijawi N, Eckardt A, Pitton MB, et al. Bone mineral density and vitamin d status in female and male patients with osteoarthritis of the knee or hip. Eur Surg Res. 2009;42(1):1-10. doi: 10.1159/000166164.

Ding C, Cicuttini F, Parameswaran V, Burgess J, Quinn S, Jones G. Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the asmanian older adult cohort study. Arthritis Rheum. 2009;60(5):1381-1389. doi: 10.1002/art.24486.

Al-Jarallah K F, Shehab D, Al-Awadhi A, Nahar I, Haider MZ, Moussa MA. Are 25(OH)D levels related to the severity of knee osteoarthritis and function? Med Princ Pract. 2012;21(1):74-8. doi: 10.1159/000330025.

Laslett LL, Quinn S, Burgess JR, et al. Moderate vitamin D deficiency is associated with changes in knee and hip pain in older adults: a 5-year longitudinal study. Ann Rheum Dis. 2014;73(4):697-703. doi: 10.1136/annrheumdis-2012-202831.

Baraki R, Weiler H, Payette H, Gray-Donald K. Vitamin D Status in Healthy Free-Living Elderly Men and Women Living in Québec, Canada. J Am Coll Nutr. 2010 Feb;29(1):25-30. doi: 10.1080/07315724.2010.10719813.

Veronese N, Maggi S, Noale M, et al. Serum 25-hydroxyvitamin D and osteoarthritis in older people: the Progetto Veneto Anziani study. Rejuvenation Res. 2015 Dec;18(6):543-53. doi: 10.1089/rej.2015.1671.

Povoroznyuk VV, Balatska NI, Kuziv OE. Influence of vitamin D deficiency on clinical course of osteoarthritis of large joints. Problemy osteologii'. 2015;18(2):44. (In Ukrainian).

Cao Y, Winzenberg T, Nguo K, et al. Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. Rheumatology (Oxford). 2013 Jul;52(7):1323-34. doi: 10.1093/rheumatology/ket132.

Zhang FF, Driban JB, Lo GH, et al. Vitamin D deficiency is associated with progression of knee osteoarthritis. J Nutr. 2014 Dec;144(12):2002-8. doi: 10.3945/jn.114.193227.

Bassiouni H, Aly H, Zaky K, et al. Probing the relation between vitamin D deficiency and progression of medial femoro-tibial osteoarthitis of the knee. Curr Rheumatol Rev. 2017;13(1):65-71. doi: 10.2174/1573397112666160404124532.

Malas FU, Kara M, Aktekin L, Ersoaz M, Oazcuakar L. Does vitamin D affect femoral cartilage thickness? An ultrasonographic study. Clin Rheumatol. 2014 Sep;33(9):1331-4. doi: 10.1007/s10067-013-2432-y.

McAlindon T, LaValley M, Schneider E, et al. Effect of vitamin D supplementation on progression of knee pain and cartilage volume loss in patients with symptomatic оsteoarthritis: a randomized controlled trial. JAMA. 2013 Jan 9;309(2):155-62. doi: 10.1001/jama.2012.164487.

Başkan BM, Yurdakul FG, Aydın E, Sivas F, Bodur H. Effect of Vitamin D levels on radiographic knee osteoarthritis and functional status. Turk J Phys Med Rehab. 2018;64(1):1-7 doi: 10.5606/tftrd.2018.986.

Heidari B, Javadian Y, Babaei M, Yousef-Ghahari B. Restorative effect of vitamin D deficiency on knee pain and quadriceps muscle strength in knee osteoarthritis. Acta Med Iran. 2015;53(8):466-470. PMID:26545990.

Diao N, Yang B, Yu F. Effect of vitamin D supplementation on knee osteoarthritis: A systematic review and meta-analysis of randomized clinical trials. Clin. Biochem. 2017;50(18):1312-1316. doi: 10.1016/j.clinbiochem.2017.09.001.

Jin X, Jones G, Cicuttini F, et al. Effect of vitamin D supplementation on tibial cartilage volume and knee pain among patients with symptomatic knee osteoarthritis: a randomized clinical trial. JAMA. 2016;315(10):1005-13. doi: 10.1001/jama.2016.1961.

Arden NK, Cro S, Sheard S, et al. The effect of vitamin D supplementation on knee osteoarthritis, the VIDEO study: a randomised controlled trial. Osteoarthritis Cartilage. 2016;24(11):1858-1866. doi: 10.1016/j.joca.2016.05.020.

Dzerovych NI. Skeletal muscular tissue and vitamin d levels in women of various ages. Problemy osteologii'. 2015;18( 3):28-32. (In Ukrainian).

Povoroznyuk VV, Dzerovich NI. The role of vitamin D and therapeutic exercises in correction of sarcopenia. Bol’, Sustavy, Pozvonochnik. 2017;7(3):109-115. doi: 10.22141/2224-1507.7.3.2017.116865. (In Ukrainian).

Sakalli H, SakArslan D, Yucel AE. The effect of oral and parenteral vitamin D supplementation in the elderly:a prospective, double-blinded, randomized, placebo-controlled study. Rheumatol Int. 2012;32(8):2279-2283. doi: 10.1007/s00296-011-1943-6.

Povoroznyuk VV, Balatska N, Grygorieva NV. Correction of Vitamin D Deficiency with High Doses of Cholecalciferol. Bolʹ, sustavy, pozvonočnik. 2016;(23):32-41. doi: 10.22141/2224-1507.3.23.2016.85004. (In Ukrainian).

Levinger P, Begg R, Sanders KM, et al. The effect of vitamin D status on pain, lower limb strength and knee function during balance recovery in people with knee osteoarthritis: an exploratory study. Arch Osteoporos. 2017;12(1):83. doi: 10.1007/s11657-017-0378-4 .

Barker T, Henriksen VT, Rogers VE, et al. Vitamin D deficiency associates with 𝛾-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis. Redox Biol. 2014;2:466-474. doi: 10.1016/j.redox.2014.01.024 .



How to Cite

Povoroznyuk, V., Dedukh, N., & Yakovenchuk, N. (2021). Vitamin D and osteoarthritis. PAIN, JOINTS, SPINE, 8(1), 7–16.




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