Relationship of vitamin D levels with clinical presentation and recurrence of BPPV in a Southeastern United States institution

Leah H Cobb; Victoria O Bailey; Yuan F Liu; Michael T Teixido; Habib G Rizk

doi:10.1016/j.anl.2022.05.011

Relationship of vitamin D levels with clinical presentation and recurrence of BPPV in a Southeastern United States institution

Auris Nasus Larynx. 2023 Feb;50(1):70-80. doi: 10.1016/j.anl.2022.05.011. Epub 2022 Jun 2.

Authors

Leah H Cobb¹, Victoria O Bailey¹, Yuan F Liu², Michael T Teixido³, Habib G Rizk⁴

Affiliations

¹ Department of Otolaryngology; Medical University of South Carolina, Charleston, SC, USA.
² Department of Otolaryngology, Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, USA.
³ Department of Otolaryngology, University of Pennsylvania, Philadelphia, PA, USA.
⁴ Department of Otolaryngology; Medical University of South Carolina, Charleston, SC, USA. Electronic address: rizkh@musc.edu.

PMID: 35659787
DOI: 10.1016/j.anl.2022.05.011

Abstract

Objective: To examine the relationship of 25hydroxyvitamin D serum levels with BPPV incidence and recurrence rates.

Methods: A retrospective cross-sectional, case-controlled study with follow-up phone survey was performed on patients diagnosed with BPPV between 05/2017-05/2020, who had available 25hydroxyvitamin D serology. Patients were seen at a multidisciplinary, vestibular-focused, neurotology clinic at a tertiary referral center. Controls consisted of subjects from the National Health and Nutrition Examination Survey (NHANES), and a locoregional age, sex, and race-matched group of patients from our institution.

Results: Our BPPV cohort consisted of 173 patients (mean age 66.2 ± 11.8 years), who were predominately female (75.7%) and Caucasian (76.3%). Almost all age subgroups (BPPV, NHANES, and locoregional groups) ≤60 years old had insufficient levels of vitamin D. However, the overall BPPV cohort had a significantly higher vitamin D level than the NHANES control (31.4 ± 16.5 v. 26.0 ± 11.2 ng/mL, d=0.474 [0.323, 0.626]). There was no significant difference when compared to the overall locoregional control (31.4 ± 20.5 ng/mL). Migraines were significantly correlated to increased BPPV recurrence rates on univariate (beta=0.927, p=0.037, 95% CI: [0.057, 1.798]) and multiple regression analyses (beta=0.231, 95% CI: [0.024, 2.029], p=0.045). Furthermore, patients with BPPV recurrences had significantly lower levels of vitamin D at initial presentation when compared to patients with no recurrences (29.0 ± 12.0 v. 37.6 ± 18.3 ng/mL, d=0.571[0.139,1.001]).

Conclusion: Many BPPV patients in our cohort had insufficient vitamin D levels, and patients with BPPV recurrences had insufficient and significantly lower vitamin D levels than those without. As a readily available and affordable supplement, vitamin D may be used as an adjunct treatment but prospective studies should be done to confirm if it can prevent or reduce recurrence.

Keywords: BPPV; Benign paroxysmal positional vertigo; Vitamin D; Vitamin D deficiency.

MeSH terms

Aged
Benign Paroxysmal Positional Vertigo / etiology
Cross-Sectional Studies
Female
Humans
Middle Aged
Nutrition Surveys
Prospective Studies
Retrospective Studies
Vitamin D Deficiency* / epidemiology
Vitamin D*

Substances

Vitamin D