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Pain Physician
Article . 2018 . Peer-reviewed
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Pain Physician
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High Prevalence of Hypovitaminosis D in Patients with Low Back Pain: Evidence from Meta-Analysis

Authors: Dipika Bansal;

High Prevalence of Hypovitaminosis D in Patients with Low Back Pain: Evidence from Meta-Analysis

Abstract

Background: Emerging evidence suggests an association between vitamin D deficiency and low back pain (LBP). Objective: To pool evidence on the prevalence of hypovitaminosis D in patients with LBP. Study Design: Meta-analysis. Methods: A comprehensive literature search was done in PubMed, Cochrane Database, and Google scholar for observational studies including cohort, cross sectional (CS), and case control (CC) evaluating the prevalence of hypovitaminosis D in LBP patients. The primary outcome assessed was a prevalence of hypovitaminosis D in patients with LBP, presented as weighted pooled prevalence ratio (WPPR) with 95% confidence interval (CI) using the random effects model. Heterogeneity and inconsistency of the measurements were identified through Cochran’s Q statistic and I2 statistic. We also performed sensitivity analysis, publication bias (using funnel plot and Begg’s test), and subgroup analysis. Results: Fourteen studies (6 were CC, 6 CS, and 2 cohort) involving 2602 patients were included in the final analysis. The WPPR (95% CI) of hypovitaminosis D in patients with LBP was found to be 0.72 (0.60–0.83). Marked heterogeneity was observed, median quality score of all studies was 7.5 interquartile range (IQR) (6.2 - 8.7) on a scale of 0 to 11. Sensitivity analysis showed robustness of the results. The WPPR of hypovitaminosis D was lower in CS at 0.60 (0.35–0.85) as compared to CC studies at 0.81 (0.72–0.90) (P < 0.01). The WPPR was lower in men at 0.74 (0.63–0.86) as compared to women at 0.84 (0.78–0.89) (P < 0.01). No publication bias was observed. Limitations: Heterogeneity in the cut off level of vitamin D to classify the included patients as vitamin D deficient. Conclusions: The high prevalence of hypovitaminosis D was observed in patients with LBP. This provides a chance to screen the deficiency and correct it by supplementation, which can be therapeutic adjunct in the management of LBP patients. Key words: Low back pain, hypovitaminosis D, meta-analysis, pooled prevalence, systematic review

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    Top 10%
    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
7
Top 10%
Average
Top 10%
gold