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Background <p>Cervical dizziness (CD) is associated with altered cervical musculoskeletal and proprioceptive input, leading to impaired sensorimotor integration and balance control. Vitamin D deficiency has been linked to musculoskeletal pain, muscle dysfunction, and impaired postural stability; however, its role in CD remains unclear.</p> Methods <p>This prospective observational study included 210 patients diagnosed with CD. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured at baseline, and participants were categorized into deficiency (&lt; 20 ng/mL), insufficiency (20–29 ng/mL), and sufficiency (≥ 30 ng/mL) groups. All patients received a standardized multimodal cervical rehabilitation program, with vitamin D supplementation provided to the deficient and insufficient groups. Clinical outcomes were assessed using the Neck Disability Index (NDI), Dizziness Handicap Inventory (DHI), and Vertigo Dizziness Imbalance questionnaires (VDI-SS and VDI-QOL). Associations between vitamin D levels, baseline symptom severity, and recovery duration were analyzed using correlation, multivariable regression, receiver operating characteristic (ROC) analysis, and partial least squares discriminant analysis (PLS-DA).</p> Results <p>Lower serum 25(OH)D levels were significantly associated with higher baseline NDI, DHI, VDI-SS, and VDI-QOL scores (all <i>p</i> &lt; 0.001), indicating greater symptom severity and functional impairment. Serum 25(OH)D levels showed a strong inverse correlation with recovery duration (rho = -0.77, <i>p</i> &lt; 0.001) and remained associated with a longer recovery duration in multivariable linear regression. ROC analysis demonstrated high discriminatory performance for delayed recovery (AUC = 0.937), with an exploratory optimal threshold of ≤ 17 ng/mL. In exploratory PLS-DA, serum 25(OH)D contributed more to group separation than did age, sex, or BMI.</p> Conclusions <p>Lower serum vitamin D levels were associated with greater baseline clinical severity and longer recovery duration in patients with CD. These findings suggest that vitamin D status may be clinically relevant in the assessment of disease severity and recovery in this population. Further prospective controlled studies are required to clarify the clinical significance of this association.</p>

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Association of serum vitamin D levels with clinical severity and recovery duration in cervical dizziness

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月23日

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  • Yaser Said Cetin,
  • Semra Agirbas

摘要

Background

Cervical dizziness (CD) is associated with altered cervical musculoskeletal and proprioceptive input, leading to impaired sensorimotor integration and balance control. Vitamin D deficiency has been linked to musculoskeletal pain, muscle dysfunction, and impaired postural stability; however, its role in CD remains unclear.

Methods

This prospective observational study included 210 patients diagnosed with CD. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured at baseline, and participants were categorized into deficiency (< 20 ng/mL), insufficiency (20–29 ng/mL), and sufficiency (≥ 30 ng/mL) groups. All patients received a standardized multimodal cervical rehabilitation program, with vitamin D supplementation provided to the deficient and insufficient groups. Clinical outcomes were assessed using the Neck Disability Index (NDI), Dizziness Handicap Inventory (DHI), and Vertigo Dizziness Imbalance questionnaires (VDI-SS and VDI-QOL). Associations between vitamin D levels, baseline symptom severity, and recovery duration were analyzed using correlation, multivariable regression, receiver operating characteristic (ROC) analysis, and partial least squares discriminant analysis (PLS-DA).

Results

Lower serum 25(OH)D levels were significantly associated with higher baseline NDI, DHI, VDI-SS, and VDI-QOL scores (all p < 0.001), indicating greater symptom severity and functional impairment. Serum 25(OH)D levels showed a strong inverse correlation with recovery duration (rho = -0.77, p < 0.001) and remained associated with a longer recovery duration in multivariable linear regression. ROC analysis demonstrated high discriminatory performance for delayed recovery (AUC = 0.937), with an exploratory optimal threshold of ≤ 17 ng/mL. In exploratory PLS-DA, serum 25(OH)D contributed more to group separation than did age, sex, or BMI.

Conclusions

Lower serum vitamin D levels were associated with greater baseline clinical severity and longer recovery duration in patients with CD. These findings suggest that vitamin D status may be clinically relevant in the assessment of disease severity and recovery in this population. Further prospective controlled studies are required to clarify the clinical significance of this association.