CME OnDemand: 2022 AOFAS Annual Meeting-Vitamin D Deficiency is Associated with Charcot Neuroarthropathy: A Case-Control Study

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The purpose of this study was to determine if patients diagnosed with Charcot Neuroarthropathy (CN) and diabetes were more likely to have vitamin D deficiency compared to patients diagnosed with diabetes alone. The researchers used the TriNetX research network to collect data from 2011-2021 using common procedural terminology (CPT) and international classification of disease (ICD-10) codes. Patients were divided into two groups: Group A consisted of patients with both diabetes and CN, and Group B consisted of patients with diabetes alone. The study also recorded demographic data such as age, sex, and race. <br /><br />The results showed that patients with both CN and diabetes were more likely to be vitamin D deficient compared to patients with diabetes alone. In Group A, 19.0% of patients had vitamin D deficiency, while in Group B, only 12.2% of patients had vitamin D deficiency. This association was statistically significant. <br /><br />Vitamin D deficiency is known to be common in the general population and even more so in diabetic patients. Low vitamin D levels can be associated with impaired bone healing and increased risk of lower extremity complications in diabetic patients, including peripheral arterial disease, chronic inflammation, and foot ulceration. CN, which is most commonly seen as a result of diabetic neuropathy, is likely to increase in prevalence as the number of diabetes cases rises.<br /><br />The findings of this study suggest that vitamin D supplementation in diabetic patients may help prevent the development of CN and other lower extremity complications. Understanding the relationship between vitamin D deficiency and CN can contribute to improving medical therapies and reducing the rates of lower extremity amputation and mortality in this patient population.<br /><br />However, there are limitations to this study. The use of diagnostic codes relies on accurate diagnosis and coding, and the TriNetX database may not represent the entire population. The retrospective analysis did not control for other medical conditions that may increase the risk of vitamin D deficiency.<br /><br />In conclusion, patients with both CN and diabetes were found to be more likely to have vitamin D deficiency compared to patients with diabetes alone. Further research is needed to fully understand the relationship between vitamin D and CN and its implications for treatment in diabetic patients.<br /><br />References are provided for further reading on the topic.

Asset Subtitle

Brandon J. Martinazzi, BS, F. Jeffrey Lorenz, Hannah Nam, Kelly Dopke, Anna Ptasinski, Kirsten N. Mansfield, Gregory Kirchner, Michael C. Aynardi, MD

Keywords

Charcot Neuroarthropathy

diabetes

vitamin D deficiency

TriNetX research network

common procedural terminology

international classification of disease

demographic data

bone healing

lower extremity complications

vitamin D supplementation