Effect of the serum 25-hydroxyvitamin D level on risk for short-term residual dizziness after successful repositioning in benign paroxysmal positional vertigo stratified by sex and onset age

Jing Wu; Chun-Yan Jiang; Ying-Xia Bai; Qian Xu; Xu-Hong Sun; Hui Pan; Liang Shu; Jian-Ren Liu; Wei Chen

doi:10.3389/fneur.2023.1144958

Effect of the serum 25-hydroxyvitamin D level on risk for short-term residual dizziness after successful repositioning in benign paroxysmal positional vertigo stratified by sex and onset age

Front Neurol. 2023 Mar 31:14:1144958. doi: 10.3389/fneur.2023.1144958. eCollection 2023.

Authors

Jing Wu¹, Chun-Yan Jiang², Ying-Xia Bai², Qian Xu¹, Xu-Hong Sun¹, Hui Pan¹, Liang Shu¹, Jian-Ren Liu¹, Wei Chen¹

Affiliations

¹ Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Neurology, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Objective: A low serum 25-hydroxyvitamin D (25(OH)D) level is relevant to both the occurrence and recurrence of benign paroxysmal positional vertigo (BPPV). However, whether it also contributes to residual dizziness (RD) after successful repositioning maneuvers is unknown. Therefore, this study aimed to explore the correlation between the serum 25(OH)D level and short-term RD severity in patients with BPPV after successful repositioning maneuvers.

Methods: In total, 251 patients with BPPV after successful repositioning were enrolled and prospectively followed up for 1 week (W1). Serum 25(OH)D values were detected by chemiluminescence immunoassay at enrollment (W0). In addition, we explored the relationship between 25(OH)D values at baseline and RD severity at W1 in different subgroups stratified by sex and onset age (early-onset, ≤50 years; late-onset, >50 years).

Results: The serum 25(OH)D level of female patients was significantly lower than that of male patients (15.9 ± 6.8 vs. 19.8 ± 6.6 ng/ml, p < 0.001). Its level also decreased in early-onset patients compared to late-onset ones (15.3 ± 5.9 vs. 18.0 ± 7.3 ng/ml, p = 0.003). In addition, early-onset female patients had lower 25(OH)D values than late-onset female patients (14.0 ± 5.5 vs. 17.1 ± 7.2 ng/ml, p = 0.004). However, this difference was not observed between early- and late-onset male patients. Among early-onset female patients, the 25(OH)D values of the moderate-to-severe RD group were lower than those of the minor or no RD group (10.9 ± 3.3 vs. 14.7 ± 5.7 vs. 15.0 ± 5.9 ng/ml, p = 0.046). Multivariate analysis found that decreased 25(OH)D values were related to the occurrence of moderate-to-severe RD in early-onset female patients (OR = 0.801; p = 0.022). This effect did not exist in late-onset female or male patients with BPPV.

Conclusions: Age and sex differences in serum 25(OH)D levels exist in patients with BPPV. A decreased 25(OH)D level in early-onset female patients may increase the odds of moderate-to-severe RD 1 week after successful repositioning maneuvers.

Keywords: 25-hydroxyvitamin D; benign paroxysmal positional vertigo; dizziness handicap inventory; peripheral vestibular disorder; residual dizziness.

Grants and funding

WC received grants from the Clinical Research Program of Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (JYLJ202003) and Project of Biobank from Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (YBKB202120). J-RL received grants from 200 talent project from the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (20161422) and the Natural Science Foundation Project from the Shanghai Municipal Science and Technology Commission (22ZR1436900).