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Background Spinal cord injury (SCI) often leads to neuropathic pain (NeP), severely impacting patients’ function and rehabilitation. Vitamin D deficiency, highly prevalent in SCI due to reduced sun exposure and mobility, has been implicated in NeP in other conditions, but its role in chronic SCI-related NeP remains unclear. Methods This cross-sectional study enrolled 182 adults with chronic traumatic SCI (≥6 month post-injury) currently admitted to 2 rehabilitation centers. Vitamin D status serum 25-hydroxyvitamin D 25 (OH) D was measured via high-performance liquid chromatography–tandem mass spectrometry (HPLC-MS/MS). NeP was diagnosed using the Douleur Neuropathique 4 (DN4) questionnaire (score ≥4/10) in combination with clinical assessment by a physician. Multivariate logistic regression, controlling for confounders (e. g. , age, comorbidity, Charlson Comorbidity Index, CCI), injury severity (American Spinal Injury Association Impairment Scale, and AIS grade), assessed the association between vitamin D levels and NeP. Receiver operating characteristic (ROC) curve analysis was performed to identify a predictive cutoff. Results The prevalence of NeP was 52. 7% (96/182). Vitamin D deficiency or insufficiency 25 (OH) D 30 ng/mL affected 64. 8% (118/182) of participants. Lower vitamin D levels were strongly and independently associated with NeP risk. Individuals in the lowest vitamin D tertile (2. 00–11. 68 ng/mL) had significantly higher adjusted odds of NeP compared to those in the highest tertile (16. 71–23. 03 ng/mL) adjusted odds ratio: 4. 8, 95% CI: (3. 4, 6. 8), p 0. 001. ROC analysis identified a serum 25 (OH) D level 16. 35 ng/mL as a predictive cutoff for NeP (area under the curve = 0. 812, sensitivity 79. 1%, specificity 71. 9%). Conclusion Vitamin D deficiency is highly prevalent and a strong, independent predictor of neuropathic pain in individuals with chronic SCI. These cross-sectional findings suggest routine screening for vitamin D deficiency might be indicated; however, interventional trials are needed to confirm a potential therapeutic role of vitamin D supplementation in managing SCI-related NeP.
Shi et al. (Mon,) studied this question.