Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 1/2020

01-01-2020 | Benign Paroxysmal Positional Vertigo | Rhinology

Association between serum vitamin D levels and benign paroxysmal positional vertigo: a systematic review and meta-analysis of observational studies

Authors: Baiyuan Yang, Yongxia Lu, Dongmei Xing, Wei Zhong, Qing Tang, Jingyu Liu, Xinglong Yang

Published in: European Archives of Oto-Rhino-Laryngology | Issue 1/2020

Login to get access

Abstract

Objective

Benign paroxysmal positional vertigo (BPPV) was the most common neuro-otological disorder manifests as recurrent positional vertigo, but its risk factors are elusive. Recent studies suggest that decreased Vitamin D level may be a risk factor, but the literature is inconsistent.

Methods

The databases PubMed, Web of Science, Chinese National Knowledge Infrastructure, Wanfang, SinoMed, and Embase were systematically searched for studies on the association between BPPV and  serum Vitamin D levels published up to June 2019. Data from eligible studies were meta-analyzed using Stata 12.0.

Results

A total of 18 studies were included in the analysis. Serum Vitamin D levels were significantly lower in individuals with BPPV than in controls (WMD − 2.46, 95% CI − 3.79 to − 1.12, p < 0.001). Subgroup analysis by geographical area showed that vitamin D level was significantly lower in BPPV than in controls in China (WMD − 3.27, 95% CI − 4.12 to − 2.43, p < 0.001), but not outside China (WMD − 0.90, 95% CI − 4.36 to 2.56, p = 0.611). Vitamin D levels were significantly lower in recurrent than non-recurrent BPPV across all countries in the sample (WMD 2.59, 95% CI 0.35–4.82, p = 0.023). Vitamin D deficiency emerged as an independent risk factor of BPPV (OR 1.998, 95% CI 1.400–2.851, p < 0.001).

Conclusion

The available evidence suggests that BPPV is associated with decreased levels of serum Vitamin D, and vitamin D deficiency was an independent risk factor for BPPV.
Appendix
Available only for authorised users
Literature
1.
go back to reference von Brevern M (2013) Benign paroxysmal positional vertigo. Semin Neurol 33(3):204–211CrossRef von Brevern M (2013) Benign paroxysmal positional vertigo. Semin Neurol 33(3):204–211CrossRef
2.
go back to reference Lundberg YW, Zhao X, Yamoah EN (2006) Assembly of the otoconia complex to the macular sensory epithelium of the vestibule. Brain Res 1091(1):47–57CrossRef Lundberg YW, Zhao X, Yamoah EN (2006) Assembly of the otoconia complex to the macular sensory epithelium of the vestibule. Brain Res 1091(1):47–57CrossRef
3.
go back to reference Buki B, Ecker M, Junger H, Lundberg YW (2013) Vitamin D deficiency and benign paroxysmal positioning vertigo. Med Hypotheses 80(2):201–204CrossRef Buki B, Ecker M, Junger H, Lundberg YW (2013) Vitamin D deficiency and benign paroxysmal positioning vertigo. Med Hypotheses 80(2):201–204CrossRef
5.
go back to reference Han W, Fan Z, Zhou M, Guo X, Yan W, Lu X et al (2018) Low 25-hydroxyvitamin D levels in postmenopausal female patients with benign paroxysmal positional vertigo. Acta Otolaryngol 138(5):443–446CrossRef Han W, Fan Z, Zhou M, Guo X, Yan W, Lu X et al (2018) Low 25-hydroxyvitamin D levels in postmenopausal female patients with benign paroxysmal positional vertigo. Acta Otolaryngol 138(5):443–446CrossRef
6.
go back to reference Jeong SH, Kim JS, Shin JW, Kim S, Lee H, Lee AY et al (2013) Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol 260(3):832–838CrossRef Jeong SH, Kim JS, Shin JW, Kim S, Lee H, Lee AY et al (2013) Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol 260(3):832–838CrossRef
7.
go back to reference Wu Y, Fan Z, Jin H, Guan Q, Zhou M, Lu X et al (2018) Assessment of bone metabolism in male patients with benign paroxysmal positional vertigo. Front Neurol 9:742CrossRef Wu Y, Fan Z, Jin H, Guan Q, Zhou M, Lu X et al (2018) Assessment of bone metabolism in male patients with benign paroxysmal positional vertigo. Front Neurol 9:742CrossRef
8.
go back to reference Wu YQ, Lu XX, Fan ZY, Zhou M, Li L, Yan W et al (2018) Relationship between 25-hydroxyvitamin D levels and idiopathic benign paroxysmal positional vertigo in female patients. Zhonghua yi xue za zhi 98(16):1223–1226PubMed Wu YQ, Lu XX, Fan ZY, Zhou M, Li L, Yan W et al (2018) Relationship between 25-hydroxyvitamin D levels and idiopathic benign paroxysmal positional vertigo in female patients. Zhonghua yi xue za zhi 98(16):1223–1226PubMed
9.
go back to reference Zhang Y, Liu B, Tian XB, Bi JT (2019) An analysis of biochemical markers of bone metabolisim in patients with idiopathic benign paroxysmal positional vertigo. J Clin Otorhinolaryngol Head Neck Surg (China) 33:237–241 Zhang Y, Liu B, Tian XB, Bi JT (2019) An analysis of biochemical markers of bone metabolisim in patients with idiopathic benign paroxysmal positional vertigo. J Clin Otorhinolaryngol Head Neck Surg (China) 33:237–241
10.
go back to reference Işık GÇY, Emektar E, Çorbacıoğlu ŞK (2017) Analysis of vitamin D and calcium levels in benign paroxysmal positional vertigo. Eurasian J Emerg Med 16(3):128–132CrossRef Işık GÇY, Emektar E, Çorbacıoğlu ŞK (2017) Analysis of vitamin D and calcium levels in benign paroxysmal positional vertigo. Eurasian J Emerg Med 16(3):128–132CrossRef
11.
go back to reference Yang CJ, Kim Y, Lee HS, Park HJ (2018) Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo. J Vestib Res Equilib Orientat 27(5–6):287–294CrossRef Yang CJ, Kim Y, Lee HS, Park HJ (2018) Bone mineral density and serum 25-hydroxyvitamin D in patients with idiopathic benign paroxysmal positional vertigo. J Vestib Res Equilib Orientat 27(5–6):287–294CrossRef
12.
go back to reference Karatas A, Acar Yuceant G, Yuce T, Haci C, Cebi IT, Salviz M (2017) Association of benign paroxysmal positional vertigo with osteoporosis and vitamin D deficiency: a case controlled study. J Int Adv Otol 13(2):259–265CrossRef Karatas A, Acar Yuceant G, Yuce T, Haci C, Cebi IT, Salviz M (2017) Association of benign paroxysmal positional vertigo with osteoporosis and vitamin D deficiency: a case controlled study. J Int Adv Otol 13(2):259–265CrossRef
13.
go back to reference Stang A (2010) Critical evaluation of the Newcastle–Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605CrossRef Stang A (2010) Critical evaluation of the Newcastle–Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605CrossRef
14.
go back to reference Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560CrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560CrossRef
15.
go back to reference Egger M, Smith GD, Phillips AN (1997) Meta-analysis: principles and procedures. BMJ 315(7121):1533–1537CrossRef Egger M, Smith GD, Phillips AN (1997) Meta-analysis: principles and procedures. BMJ 315(7121):1533–1537CrossRef
16.
go back to reference AlGarni MA, Mirza AA, Althobaiti AA, Al-Nemari HH, Bakhsh LS (2018) Association of benign paroxysmal positional vertigo with vitamin D deficiency: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol Off J Eur Fed Otorhinolaryngol Soc 275(11):2705–2711CrossRef AlGarni MA, Mirza AA, Althobaiti AA, Al-Nemari HH, Bakhsh LS (2018) Association of benign paroxysmal positional vertigo with vitamin D deficiency: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol Off J Eur Fed Otorhinolaryngol Soc 275(11):2705–2711CrossRef
17.
go back to reference Chen WFJ, Shu L, Wu J, Pan H, Sun XH, Dong YR, Liu JR (2017) Serum 25-hydroxyvitamin D is decrease in patients with Benign paroxysmal positional vertigo. Acad J Second Mil Med Univ 38(11):1361–1365 Chen WFJ, Shu L, Wu J, Pan H, Sun XH, Dong YR, Liu JR (2017) Serum 25-hydroxyvitamin D is decrease in patients with Benign paroxysmal positional vertigo. Acad J Second Mil Med Univ 38(11):1361–1365
18.
go back to reference Maslovara S, Butkovic Soldo S, Sestak A, Milinkovic K, Rogic-Namacinski J, Soldo A (2018) 25 (OH) D3 levels, incidence and recurrence of different clinical forms of benign paroxysmal positional vertigo. Braz J Otorhinolaryngol 84(4):453–459CrossRef Maslovara S, Butkovic Soldo S, Sestak A, Milinkovic K, Rogic-Namacinski J, Soldo A (2018) 25 (OH) D3 levels, incidence and recurrence of different clinical forms of benign paroxysmal positional vertigo. Braz J Otorhinolaryngol 84(4):453–459CrossRef
19.
go back to reference Rhim GI (2016) Serum vitamin D and recurrent benign paroxysmal positional vertigo. Laryngoscope Investig Otolaryngol 1(6):150–153CrossRef Rhim GI (2016) Serum vitamin D and recurrent benign paroxysmal positional vertigo. Laryngoscope Investig Otolaryngol 1(6):150–153CrossRef
20.
go back to reference Talaat HS, Abuhadied G, Talaat AS, Abdelaal MS (2015) Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo. Eur Arch Otorhinolaryngol Off J Eur Fed Otorhinolaryngol Soc 272(9):2249–2253CrossRef Talaat HS, Abuhadied G, Talaat AS, Abdelaal MS (2015) Low bone mineral density and vitamin D deficiency in patients with benign positional paroxysmal vertigo. Eur Arch Otorhinolaryngol Off J Eur Fed Otorhinolaryngol Soc 272(9):2249–2253CrossRef
21.
go back to reference Wang QRJY (2018) Study on biochemical markers of bone transformation in benign paroxysmal positional vertigo. Neural Inj Funct Reconstr 13(11):578–580 Wang QRJY (2018) Study on biochemical markers of bone transformation in benign paroxysmal positional vertigo. Neural Inj Funct Reconstr 13(11):578–580
22.
go back to reference Zhang XLZN, Chen JX, Wu HY (2018) Analysis of bone mineral density, serum calcium concentration and Vitamin D status in postmenpausal women with benign paroxysmal positional vertigo. J Audiol Speech Pathol 26(6):576–579 Zhang XLZN, Chen JX, Wu HY (2018) Analysis of bone mineral density, serum calcium concentration and Vitamin D status in postmenpausal women with benign paroxysmal positional vertigo. J Audiol Speech Pathol 26(6):576–579
23.
go back to reference Lee SB, Lee CH, Kim YJ, Kim HM (2017) Biochemical markers of bone turnover in benign paroxysmal positional vertigo. PLoS One 12(5):e0176011CrossRef Lee SB, Lee CH, Kim YJ, Kim HM (2017) Biochemical markers of bone turnover in benign paroxysmal positional vertigo. PLoS One 12(5):e0176011CrossRef
24.
go back to reference Zucca G, Valli S, Valli P, Perin P, Mira E (1998) Why do benign paroxysmal positional vertigo episodes recover spontaneously? J Vestib Res Equilib Orientat 8(4):325–329CrossRef Zucca G, Valli S, Valli P, Perin P, Mira E (1998) Why do benign paroxysmal positional vertigo episodes recover spontaneously? J Vestib Res Equilib Orientat 8(4):325–329CrossRef
25.
go back to reference Yamauchi D, Nakaya K, Raveendran NN, Harbidge DG, Singh R, Wangemann P et al (2010) Expression of epithelial calcium transport system in rat cochlea and vestibular labyrinth. BMC Physiol 10:1CrossRef Yamauchi D, Nakaya K, Raveendran NN, Harbidge DG, Singh R, Wangemann P et al (2010) Expression of epithelial calcium transport system in rat cochlea and vestibular labyrinth. BMC Physiol 10:1CrossRef
26.
go back to reference Minasyan A, Keisala T, Zou J, Zhang Y, Toppila E, Syvala H et al (2009) Vestibular dysfunction in vitamin D receptor mutant mice. J Steroid Biochem Mol Biol 114(3–5):161–166CrossRef Minasyan A, Keisala T, Zou J, Zhang Y, Toppila E, Syvala H et al (2009) Vestibular dysfunction in vitamin D receptor mutant mice. J Steroid Biochem Mol Biol 114(3–5):161–166CrossRef
27.
go back to reference Sheikhzadeh M, Lotfi Y, Mousavi A, Heidari B, Monadi M, Bakhshi E (2016) Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: a longitudinal clinical study. Casp J Intern Med 7(2):93–98 Sheikhzadeh M, Lotfi Y, Mousavi A, Heidari B, Monadi M, Bakhshi E (2016) Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: a longitudinal clinical study. Casp J Intern Med 7(2):93–98
28.
go back to reference Talaat HS, Kabel AM, Khaliel LH, Abuhadied G, El-Naga HA, Talaat AS (2016) Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency. Auris Nasus Larynx 43(3):237–241CrossRef Talaat HS, Kabel AM, Khaliel LH, Abuhadied G, El-Naga HA, Talaat AS (2016) Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency. Auris Nasus Larynx 43(3):237–241CrossRef
Metadata
Title
Association between serum vitamin D levels and benign paroxysmal positional vertigo: a systematic review and meta-analysis of observational studies
Authors
Baiyuan Yang
Yongxia Lu
Dongmei Xing
Wei Zhong
Qing Tang
Jingyu Liu
Xinglong Yang
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 1/2020
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05694-0

Other articles of this Issue 1/2020

European Archives of Oto-Rhino-Laryngology 1/2020 Go to the issue