The relationship between hypovitaminosis D and foot and ankle pathologies: An integrative review
DOI:
https://doi.org/10.33448/rsd-v13i8.46535Keywords:
Vitamin D deficiency; Pathologies; Foot; Ankle.Abstract
Objectives: To review the available literature on the relationship between hypovitaminosis D and foot and ankle pathologies, focusing on the musculoskeletal system and the prevalence of fractures, in order to investigate the harm caused by low levels of 25-hydroxyvitamin D to human health. Methods: This is an integrative review. Articles were selected from the PubMed platform, published until 2023, obtained by combining the descriptors “Vitamin D deficiency”, “Pathologies”, “Fractures”, “Foot” and “Ankle”, in response to the guiding question: “Hypovitaminosis D and foot and ankle pathologies, is there a relationship?". Results: 22 articles published between 2009 and 2023 were included and data related to them were extracted. The findings were categorized into manifestations in the osteoarticular, muscular and vascular systems. Osteoarticular manifestations were predominant. Lower bone consolidation rates, longer healing time and higher refracture rate were the main relationships presented. Muscular manifestations included reduced muscle strength related to the hypovitaminosis, although 1 of the studies found no relationship. The vascular findings are related to vitamin D insufficiency and peripheral arterial disease. Rickets and osteomalacia secondary to the phosphaturic mesenchymal tumor of soft tissues of the foot, a rare condition that leads to hypovitaminosis D, were also addressed. Conclusion: Hypovitaminosis D establishes a cause and consequence relationship with foot and ankle pathologies, with the osteoarticular, muscular and vascular systems being the most affecteds.
References
Agarwal, A., & Gulati, D. (2009). Early adolescent nutritional rickets. Journal of orthopaedic surgery, 17(3), 340–345. https://doi.org/10.1177/230949900901700320
Almurdhi, M. M., Reeves, N. D., Bowling, F. L., Boulton, A. J., Jeziorska, M., & Malik, R. A. (2017). Distal lower limb strength is reduced in subjects with impaired glucose tolerance and is related to elevated intramuscular fat level and vitamin D deficiency. Diabetic medicine: a journal of the British Diabetic Association, 34(3), 356–363. https://doi.org/10.1111/dme.13163
Anima. (2014). Manual Revisão Bibliográfica Sistemática Integrativa: a pesquisa baseada em evidências. Grupo Anima. Recuperado de https://biblioteca.cofen.gov.br/wp-content/uploads/2019/06/manual_revisao_bibliografica-sistematica-integrativa.pdf
Bernhard, A., & Matuk, J. (2015). Vitamin D in Foot and Ankle Fracture Healing: A Literature Review and Research Design. Foot & ankle specialist, 8(5), 397–405. https://doi.org/10.1177/1938640015585958
Bisceglia, M., Galliani, C. A., Fraternali Orcioni, G., Perrone, E., Del Giudice, A., & Scillitani, A. (2019). Phosphaturic Mesenchymal Tumor of Soft Tissue of the Foot: Report of a Case With Review of the Literature. Advances in anatomic pathology, 26(5), 320–328. https://doi.org/10.1097/PAP.0000000000000240
Clutton, J., & Perera, A. (2016). Vitamin D insufficiency and deficiency in patients with fractures of the fifth metatarsal. Foot (Edinburgh, Scotland), 27, 50–52. https://doi.org/10.1016/j.foot.2015.08.005
Eigentler, A., Nachbauer, W., Donnemiller, E., Poewe, W., Gasser, R. W., & Boesch, S. (2014). Low bone mineral density in Friedreich ataxia. Cerebellum, 13(5), 549–557. https://doi.org/10.1007/s12311-014-0568-1
Giakoumis M. (2020). The Impact of Vitamin D Levels in Foot and Ankle Surgery. Clinics in podiatric medicine and surgery, 37(2), 305–315. https://doi.org/10.1016/j.cpm.2019.12.009
Goltzman D. (2018). Functions of vitamin D in bone. Histochemistry and cell biology, 149(4), 305–312. https://doi.org/10.1007/s00418-018-1648-y
Guise, J. M., Reid, E., Fiordalisi, C. V., Borsky, A., & Chang, S. (2020). AHRQ Series on Improving Translation of Evidence: Progress and Promise in Supporting Learning Health Systems. Joint Commission journal on quality and patient safety, 46(1), 51–52. https://doi.org/10.1016/j.jcjq.2019.10.008
Hammad, R., Abdel Wahab, M. A., Farouk, N., Zakaria, M. Y., Eldosoky, M. A., Elmadbouly, A. A., Tahoun, S. A., Mahmoud, E., Khirala, S. K., Mohammed, A. R., Emam, W. A., Abo Elqasem, A. A., Kotb, F. M., & Abd Elghany, R. A. E. (2023). Non-classical monocytes frequency and serum vitamin D3 levels are linked to diabetic foot ulcer associated with peripheral artery disease. Journal of diabetes investigation, 14(10), 1192–1201. https://doi.org/10.1111/jdi.14048
Kim, D. K., Park, G., Kuo, L. T., & Park, W. H. (2020). Association of Vitamin D Status with Lower Limb Muscle Strength in Professional Basketball Players: A Cross-Sectional Study. Nutrients, 12(9), 2715. https://doi.org/10.3390/nu12092715
Kim, I., & Rajani, R. (2016). Oncogenic Osteomalacia From a Primary Phosphaturic Mesenchymal Tumor of the Toe: A Case Report. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 55(2), 294–298. https://doi.org/10.1053/j.jfas.2014.09.012
Kose, O., Kilicaslan, O. F., Ozyurek, S., & Ince, A. (2016). Calcaneal Insufficiency Fracture Secondary to Celiac Disease-Induced Osteomalacia: A Rare Cause of Heel Pain. Foot & ankle specialist, 9(2), 179–183. https://doi.org/10.1177/1938640015583310
Malhotra, K., Baggott, P. J., & Livingstone, J. (2020). Vitamin D in the Foot and Ankle: A Review of the Literature. Journal of the American Podiatric Medical Association, 110(3), Article_10. https://doi.org/10.7547/18-087
Marik, I. A., Marikova, A., Hudakova, O., Samuels, M. E., & Kozlowski, K. S. (2012). Bisphosphonate therapy for painless fracture: change of HSAN 1 clinical course with biphosphonate and Vitamin D therapy. Journal of musculoskeletal & neuronal interactions, 12(3), 165–173.
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372, n71. https://doi.org/10.1136/bmj.n71
Ribbans, W. J., Aujla, R. S., Ashour, R., Allen, P. E., & Wood, E. V. (2019). Vitamin D and foot and ankle trauma: An individual or societal problem. Foot, 39, 100–105. https://doi.org/10.1016/j.foot.2019.02.003
Saponaro, F., Saba, A., & Zucchi, R. (2020). An Update on Vitamin D Metabolism. International journal of molecular sciences, 21(18), 6573. https://doi.org/10.3390/ijms21186573
Shimasaki, Y., Nagao, M., Miyamori, T., Aoba, Y., Fukushi, N., Saita, Y., Ikeda, H., Kim, S. G., Nozawa, M., Kaneko, K., & Yoshimura, M. (2016). Evaluating the Risk of a Fifth Metatarsal Stress Fracture by Measuring the Serum 25-Hydroxyvitamin D Levels. Foot & ankle international, 37(3), 307–311. https://doi.org/10.1177/1071100715617042
Smith, J. T., Halim, K., Palms, D. A., Okike, K., Bluman, E. M., & Chiodo, C. P. (2014). Prevalence of vitamin D deficiency in patients with foot and ankle injuries. Foot & ankle international, 35(1), 8–13. https://doi.org/10.1177/1071100713509240
Sprinchorn, A. E., O'Sullivan, R., & Beischer, A. D. (2011). Transient bone marrow edema of the foot and ankle and its association with reduced systemic bone mineral density. Foot & ankle international, 32(5), S508–S512. https://doi.org/10.3113/FAI.2011.0508
Tiefenbach, M., Scheel, M., Maier, A., Gehlen, M., Schwarz-Eywill, M., Werner, M., Siebers-Renelt, U., & Hammer, M. (2018). Osteomalazie – Klinik, Diagnostik und Therapie [Osteomalacia-Clinical aspects, diagnostics and treatment]. Zeitschrift fur Rheumatologie, 77(8), 703–718. https://doi.org/10.1007/s00393-018-0510-x
Tuckey, R. C., Cheng, C. Y. S., & Slominski, A. T. (2019). The serum vitamin D metabolome: What we know and what is still to discover. The Journal of steroid biochemistry and molecular biology, 186, 4–21. https://doi.org/10.1016/j.jsbmb.2018.09.003
Uday, S., & Högler, W. (2020). Nutritional rickets & osteomalacia: A practical approach to management. The Indian journal of medical research, 152(4), 356–367. https://doi.org/10.4103/ijmr.IJMR_1961_19
Ursi, E. S. (2005). Prevenção de lesões de pele no perioperatório: revisão integrativa da literatura. Dissertação de Mestrado, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto. 10.11606/D.22.2005.tde-18072005-095456
Warner, S. J., Garner, M. R., Nguyen, J. T., & Lorich, D. G. (2016). Perioperative vitamin D levels correlate with clinical outcomes after ankle fracture fixation. Archives of orthopaedic and trauma surgery, 136(3), 339–344. https://doi.org/10.1007/s00402-015-2376-6
Williams, B. R., Thomas, A. J., Collier, R. C., Boffeli, T. J., & Anderson, S. A. (2018). Vitamin D Levels Do Not Predict Risk of Metatarsal Fractures. Foot & ankle specialist, 11(1), 37–43. https://doi.org/10.1177/1938640017700973
Zalneraitis, B. H., Huuki, E., Benavides, L. C., & Benavides, J. M. (2023). Relation of Vitamin D Level, BMI, and Location of Lower Extremity Stress Fractures in Military Trainees. Military medicine, 188(7-8), e1970–e1974. https://doi.org/10.1093/mil
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Isadora Furlan Ribeiro; Marina Andrade Nogueira; Eli Ávila Souza Júnior
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.