Effect of calcium and vitamin D supplementation on recurrence of benign paroxysmal positional vertigo in osteoporotic patients.

OBJECTIVE

To investigate whether calcium and vitamin D supplementation can reduce the recurrence of benign paroxysmal positional vertigo (BPPV) and improve quality of life in patients with osteoporosis.

METHODS

In this retrospective study, 334 patients with primary osteoporosis and posterior semicircular canal BPPV were included and divided into three groups based on treatment: Group A (n = 103; intravenous calcium gluconate infusion [20 mL diluted in 250 mL 5% glucose per day for 15 days per course, four courses total]), Group B (n = 112; intramuscular injection of vitamin D2, 150,000 IU every 15 days for two doses, then monthly for two additional doses over 3 months), and Group C (n = 119; supplementation with both calcium and vitamin D2 using the protocols of Group A and B). Dizziness Handicap Inventory (DHI) scores, BPPV recurrence, serum calcium and vitamin D levels, bone turnover markers, adverse effects, and Short Form Health Survey (SF-36) quality-of-life scores were compared among the groups.

RESULTS

At 6 months post-treatment, DHI scores were 40.57 ± 3.67 in Group A, 41.25 ± 4.11 in Group B, and 32.63 ± 2.11 in Group C. The score in Group C was significantly lower than those in Groups A and B (P < 0.001), while Groups A and B showed comparable scores (P = 0.2991). Additionally, Group C exhibited a significantly lower BPPV recurrence rate at 12 months post-treatment (P = 0.030 vs. Group A; P = 0.021 vs. Group B) and 24 months post-treatment (P = 0.016 vs. Group A; P = 0.017 vs. Group B). Serum calcium (P < 0.001 vs. both Groups A and B) and vitamin D levels (P = 0.0191 vs. Group A; P = 0.0423 vs. Group B) were significantly higher in Group C compared with the other two groups. Moreover, Group C showed improved bone metabolism, as indicated by higher procollagen type I N-terminal propeptide (P1NP) levels (P < 0.05) and lower beta-crosslaps (β-CTX) levels (P < 0.05) than the other two groups. Quality-of-life scores were significantly improved in Group C across several domains, including physical functioning, role-physical, role-emotional, mental health, and social functioning (all P < 0.001). Notably, adverse effects were comparable among the groups (all P > 0.05, Fisher's exact test).

CONCLUSION

Combined calcium and vitamin D supplementation may reduce BPPV recurrence and improve quality of life in patients with osteoporosis.