Department of Neuroscience and Aging, Division of Geriatric Medicine and Memory Clinic, Research Centre on Autonomy and Longevity, Angers University Hospital, UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
Department of Sports Medicine and Vascular Investigations, University Hospital, Angers, France.
Maturitas. 2017 Dec;106:8-25. doi: 10.1016/j.maturitas.2017.07.012. Epub 2017 Aug 8.
Vitamin D is involved in musculoskeletal health. There is no consensus on a possible association between circulating 25-hydroxyvitamin D (25OHD) concentrations and walking speed, a 'vital sign' in older adults. Our objective was to systematically review and quantitatively assess the association of 25OHD concentration with walking speed. A Medline search was conducted on June 2017, with no limit of date, using the MeSH terms "Vitamin D" OR "Vitamin D Deficiency" combined with "Gait" OR "Gait disorders, Neurologic" OR "Walking speed" OR "Gait velocity". Fixed-effect meta-analyses were performed to compute: i) mean differences in usual and fast walking speeds and Timed Up and Go test (TUG) between participants with severe vitamin D deficiency (≤25nmol/L) (SVDD), vitamin D deficiency (≤50nmol/L) (VDD), vitamin D insufficiency (≤75nmol/L) (VDI) and normal vitamin D (>75nmol/L) (NVD); ii) risk of slow walking speed according to vitamin D status. Of the 243 retrieved studies, 22 observational studies (17 cross-sectional, 5 longitudinal) met the selection criteria. The number of participants ranged between 54 and 4100 (0-100% female). Usual walking speed was slower among participants with hypovitaminosis D, with a clinically relevant difference compared with NVD of -0.18m/s for SVDD, -0.08m/s for VDD and -0.12m/s for VDI. We found similar results regarding the fast walking speed (mean differences -0.04m/s for VDD and VDI compared with NVD) and TUG (mean difference 0.48s for SVDD compared with NVD). A slow usual walking speed was positively associated with SVDD (summary OR=2.17[95%CI:1.52-3.10]), VDD (OR=1.38[95%CI:1.01-1.89]) and VDI (OR=1.38[95%CI:1.04-1.83]), using NVD as the reference. In conclusion, this meta-analysis provides robust evidence that 25OHD concentrations are positively associated with walking speed among adults.
维生素 D 与骨骼肌肉健康有关。目前对于循环 25-羟维生素 D（25OHD）浓度与老年人行走速度（生命体征之一）之间的可能关联尚无定论。我们的目的是系统地综述和定量评估 25OHD 浓度与行走速度之间的关联。2017 年 6 月，我们使用“维生素 D”或“维生素 D 缺乏症”和“步态”或“步态障碍，神经病学”或“行走速度”或“步态速度”的 MeSH 术语，在 Medline 上进行了无日期限制的搜索。进行固定效应荟萃分析以计算：i）严重维生素 D 缺乏症（≤25nmol/L）（SVDD）、维生素 D 缺乏症（≤50nmol/L）（VDD）、维生素 D 不足症（≤75nmol/L）（VDI）和正常维生素 D（>75nmol/L）（NVD）参与者之间的常规和快速行走速度以及计时起立行走测试（TUG）的平均差异；ii）根据维生素 D 状况，行走速度较慢的风险。在 243 项检索研究中，有 22 项观察性研究（17 项横断面研究，5 项纵向研究）符合选择标准。参与者人数在 54 到 4100 人之间（0-100%为女性）。与 NVD 相比，患有维生素 D 不足症的参与者的常规行走速度较慢，与 NVD 相比，SVDD 为-0.18m/s，VDD 为-0.08m/s，VDI 为-0.12m/s，存在临床相关差异。我们发现，对于快速行走速度（与 NVD 相比，VDD 和 VDI 的平均差异为-0.04m/s）和 TUG（与 NVD 相比，SVDD 的平均差异为 0.48s），也有类似的结果。通常，行走速度较慢与 SVDD（综合 OR=2.17[95%CI：1.52-3.10]）、VDD（OR=1.38[95%CI：1.01-1.89]）和 VDI（OR=1.38[95%CI：1.04-1.83]）呈正相关，以 NVD 为参考。总之，这项荟萃分析提供了有力的证据表明，25OHD 浓度与成年人的行走速度呈正相关。
