A Relationship Between Blood Levels of Otolin-1 and Vitamin D

Objective:Low vitamin D levels have been associated with and could play a role in the pathogenesis of idiopathic benign paroxysmal positional vertigo (iBPPV). Since otoconia degeneration contributes to iBPPV and a lack of vitamin D may impact otoconia structure and integrity, we proposed a negative association between vitamin D levels and levels of a proposed circulatory biomarker for otolithic degeneration, otolin-1.Study Design:Cross-sectional clinical study.Setting:Clinical research center.Patients:Seventy-nine men and women ranging in age from 22 to 95 years old without known vertigo.Interventions:Diagnostic.Main Outcome Measures:Blood levels of 25-OH vitamin D and otolin-1.Results:Previously, we had reported higher otolin-1 levels in older age groups. The majority of the subjects (83%) had vitamin D levels that were below 40ng/ml. Vitamin D level was lowest in the young and increased with age before declining in subjects 70 years of age and older (p=0.005). There was a negative correlation between vitamin D and otolin-1 levels of subjects over 70 (r=-0.36, p=0.036).Conclusion:Our results demonstrate a relationship between vitamin D and otolin-1. The majority of our subjects had abnormally low vitamin D levels, but only those over 70 years of age showed a negative correlation with high otolin-1 levels. We postulate that a seasonal drop in vitamin D may not be sufficient for otoconia fragmentation and ultimately iBPPV, rather, chronically low vitamin D maybe required to induce otoconia degeneration.