Mert ATAS, Sevil CEYHAN DOGAN
European Journal of Therapeutics - 2026;32(4):496-505
Objective: Fatigue frequently occurs after spinal cord injury (SCI) and can markedly diminish quality of life. Studies involving different patient groups have reported links between deficient vitamin D status, fatigue, and compromised neuromuscular performance. Accordingly, we evaluated the association of circulating 25-hydroxyvitamin D [25(OH) D] with fatigue among individuals with SCI. Methods: A single-center, cross-sectional design was used to compare 25 individuals with SCI with 25 healthy participants matched for age and sex. Serum 25(OH) D was assayed to characterize vitamin D status. The Chalder Fatigue Scale (CFS) was used to quantify fatigue, whereas the Functional Independence Measure (FIM) provided the measure of functional independence. Correlations of serum 25(OH) D with CFS scores were calculated within the SCI cohort. Results: Compared with controls, participants with SCI showed reduced serum 25(OH) D concentrations (19.82 +/- 10.69 vs. 29.20 +/- 14.83 ng/mL, p = 0.014) and elevated physical, mental, and total fatigue scores (all p < 0.001). In the SCI group, serum vitamin D was inversely related to total fatigue (rs = -0.899, p < 0.001) and physical fatigue (rs=-0.955, p < 0.001); the inverse relation with mental fatigue was moderate (rs = -0.479, p = 0.015). Its association with the FIM motor score was not statistically significant. After adjustment for time since injury, AIS grade, and injury level, the inverse associations with physical and total fatigue persisted (partial rs = -0.945 and -0.882, respectively; both p < 0.001). Conclusion: Low vitamin D status was frequent among individuals with SCI and was accompanied by greater fatigue, most notably in the physical domain. Serum vitamin D was inversely associated with fatigue in this population; however, the cross-sectional design precludes causal inference, and shared determinants such as immobility and reduced sun exposure may partly explain this relationship. Larger prospective and interventional studies are required to define this relationship more clearly.
