Department of Laboratory Medicine, Armed Forces Capital Hospital, Seongnam, South Korea.
Osteoporos Int. 2013 Nov;24(11):2789-99. doi: 10.1007/s00198-013-2378-6. Epub 2013 May 8.
Vitamin D insufficiency and sarcopenia are crucial risk factors for osteoporosis. In a study of noninstitutionalized elderly subjects, we investigated the simultaneous effect of vitamin D and sarcopenia on bone mineral density (BMD) and found that sarcopenia was associated with low BMD in the femur, especially in those with suboptimal vitamin D levels.
Although vitamin D insufficiency and sarcopenia are prevalent in the elderly population worldwide, their possible influence on BMD has not been determined. We aimed to investigate the different effect of vitamin D insufficiency and sarcopenia on BMD in the elderly Korean population.
Individuals aged 60 or older were selected from those who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys conducted in 2009 and 2010; 1,596 males and 1,886 females were analyzed. Appendicular skeletal muscle mass (ASM) and BMD were assessed by dual-energy X-ray absorptiometry; serum 25-hydroxyvitamin D [25(OH)D] and a panel of clinical and laboratory parameters were also measured.
The study population was divided into four groups according to their vitamin D and sarcopenic status. BMD in total femur and in the femoral neck but not the lumbar spine was markedly decreased in sarcopenic subjects with vitamin D insufficiency [25(OH)D < 20 ng/ml] comparing to other groups, regardless of gender. Multivariable linear regression models showed that BMD was significantly associated with ASM and high daily calcium intake as well as conventional risk factors such as age, body mass index (BMI), and history of fracture. Independent predictors for low femur BMD included sarcopenia, low daily calcium intake, low 25(OH)D levels, age, and BMI.
These data showed that an association between vitamin D insufficiency and low BMD was more prominent in elderly subjects with sarcopenia.
尽管维生素 D 不足和肌肉减少症在全球老年人群中很普遍，但它们对骨密度（BMD）的可能影响尚未确定。我们旨在研究维生素 D 不足和肌肉减少症对韩国老年人群 BMD 的不同影响。
从 2009 年和 2010 年参加第四次和第五次韩国国家健康和营养检查调查的人群中选择 60 岁或以上的个体；分析了 1596 名男性和 1886 名女性。通过双能 X 射线吸收法评估四肢骨骼肌质量（ASM）和 BMD；还测量了血清 25-羟维生素 D [25（OH）D]和一组临床和实验室参数。
根据维生素 D 和肌肉减少症的状态，将研究人群分为四组。与其他组相比，维生素 D 不足[25（OH）D <20 ng/ml]的肌肉减少症患者的总股骨和股骨颈的 BMD 明显降低，而腰椎的 BMD 则没有降低，无论性别如何。多变量线性回归模型显示，BMD 与 ASM 和高每日钙摄入量以及年龄、体重指数（BMI）和骨折史等常规危险因素显著相关。股骨 BMD 降低的独立预测因素包括肌肉减少症、低每日钙摄入量、低 25（OH）D 水平、年龄和 BMI。
这些数据表明，维生素 D 不足和低 BMD 之间的关联在伴有肌肉减少症的老年患者中更为明显。
