AUTHOR=Shen Jianlin , Lin Xiaoning , Lin Yujin , Xiao Jiecheng , Wu Changfu , Zheng Feng , Wu Xianwei , Lin Haibin , Chen Guoli , Liu Huan 

TITLE=Supplementation of hyaluronic acid injections with vitamin D improve knee function by attenuating synovial fluid oxidative stress in osteoarthritis patients with vitamin D insufficiency

JOURNAL=Frontiers in Nutrition

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1026722

DOI=10.3389/fnut.2023.1026722

ISSN=2296-861X

ABSTRACT=<sec><title>Objectives</title><p>There is still controversy about the effect of vitamin D supplementation on osteoarthritis (OA). The purpose of this study was to investigate the effects of vitamin D supplementation with Hyaluronic acid (HA) injection on OA.</p></sec><sec><title>Methods</title><p>We investigated serum vitamin D levels and oxidative stress (OS) in synovial fluid from patients with OA who underwent total knee arthroplasty (grade IV, <italic>n</italic> = 24) and HA injection (grade II and III, <italic>n</italic> = 40). The effects of HA injection with or without oral vitamin D supplementation on synovial fluid OS and knee pain and function were then further investigated. Finally, patients underwent HA injection were divided into two groups according to vitamin D levels (vitamin D &lt; or &gt; 30 ng/ml), and the efficacy of the two groups were compared.</p></sec><sec><title>Results</title><p>The results showed that the levels of glutathione peroxidase (GSH-PX) (<italic>P</italic> &lt; 0.05) in the synovial fluid were lower in patients with stage IV OA than that in patients with stage II-III OA, while the levels of malondialdehyde (MDA) (<italic>P</italic> &lt; 0.05) and lactate dehydrogenase (LDH) (<italic>P</italic> &lt; 0.01) were significantly higher. Moreover, we found that age, BMI and vitamin D levels were significantly associated with the levels of oxidants and/or antioxidants in synovial fluid, and that vitamin D was significantly negatively correlated with BMI (<italic>R</italic> = −0.3527, <italic>p</italic> = 0.0043). Supplementation of HA injections with vitamin D significantly reduced the OS status in synovial fluid, attenuated knee pain and improved knee function in OA patients with vitamin D insufficiency.</p></sec><sec><title>Conclusion</title><p>We conclude that maintenance of vitamin D sufficiency may be beneficial for the treatment of OA by improving OS in synovial fluid.</p></sec>