Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
School of Medicine, University of Tasmania, Hobart, Australia.
J Cachexia Sarcopenia Muscle. 2019 Feb;10(1):177-187. doi: 10.1002/jcsm.12364. Epub 2018 Nov 22.
The effect of vitamin D supplementation on postural muscles of the trunk is of particular interest because low 25-hydroxyvitamin D [25(OH) D] levels are associated with decreased postural balance and increased risk of falls. Understanding the role of vitamin D supplementation plays in trunk muscle function of older adults is necessary, as this is a potentially modifiable factor to improve postural muscle function and decrease the risk of falling of older adults. The objective of this randomized controlled trial was to evaluate the effect of 12 months of vitamin D supplementation compared with placebo, on morphology and function of the trunk muscles of adults aged 50 to 79 years with low serum 25(OH) D levels.
This was a secondary analysis of a randomized, placebo-controlled, and double-blind clinical trial conducted between June 2010 and December 2013 in Tasmania, Australia. The clinical trial was registered with the Australian New Zealand clinical trial registration agency, ClinicalTrials.gov identifier: NCT01176344; Australian New Zealand Clinical Trials Registry: ACTRN 12610000495022. Participants were aged 50-79 years with ongoing symptoms of knee osteoarthritis and with low serum [25(OH) D] (12.5 to 60 nmol/L, 5.2 to 24 ng/mL). Participants were randomly assigned to either monthly 50 000 IU oral vitamin D3 (n = 104) or an identical placebo (n = 113) for 24 months as per clinical trial protocol. The primary outcomes in this pre-specified secondary analysis were between-group differences in change in size of rectus abdominis, transversus abdominis, internal oblique, external oblique, and lumbar multifidus muscles and function (assessed by change in thickness on contraction) of these muscles (excepting rectus abdominis) from baseline to 12 months. Muscle size was assessed using ultrasound imaging.
Of 217 participants (mean age 63 years, 48% women), 186 (85.7%) completed the study. There were no significant between-group differences in change in size or function of the abdominal or multifidus muscles after 12 months of vitamin D supplementation.
A monthly dose of 50 000 IU of vitamin D3 alone for 12 months does not affect the size or ability to contract trunk muscles of independent community-dwelling older adults with symptomatic knee osteoarthritis and low serum 25(OH) D levels regardless of body mass index status or degree of vitamin D deficiency. An effect of vitamin D supplementation on other aspects of trunk muscle function such as strength, power, or physical function cannot be ruled out.
维生素 D 补充对躯干姿势肌的影响特别值得关注，因为低 25-羟维生素 D [25(OH)D] 水平与姿势平衡降低和跌倒风险增加有关。了解维生素 D 补充对老年人躯干肌肉功能的作用是必要的，因为这是一个潜在的可改变的因素，可以改善老年人的躯干肌肉功能，降低老年人跌倒的风险。本随机对照试验的目的是评估与安慰剂相比，12 个月的维生素 D 补充对血清 25(OH)D 水平较低的 50 至 79 岁成年人躯干肌肉形态和功能的影响。
这是一项于 2010 年 6 月至 2013 年 12 月在澳大利亚塔斯马尼亚进行的随机、安慰剂对照、双盲临床试验的二次分析。该临床试验在澳大利亚和新西兰临床试验注册机构进行了注册，ClinicalTrials.gov 标识符：NCT01176344；澳大利亚和新西兰临床试验注册处：ACTRN 12610000495022。参与者年龄在 50-79 岁之间，有持续的膝关节骨关节炎症状，且血清 [25(OH)D] 水平较低（12.5 至 60 nmol/L，5.2 至 24 ng/mL）。根据临床试验方案，参与者被随机分配每月接受 50 000 IU 口服维生素 D3（n=104）或相同的安慰剂（n=113），持续 24 个月。本预先指定的二次分析的主要结局是，从基线到 12 个月时，接受维生素 D 补充的两组之间腹直肌、横突腹直肌、内斜肌、外斜肌和腰椎多裂肌大小的变化以及这些肌肉（腹直肌除外）收缩时功能（通过收缩时的厚度变化来评估）的差异。肌肉大小使用超声成像进行评估。
在 217 名参与者（平均年龄 63 岁，48%为女性）中，有 186 名（85.7%）完成了研究。在 12 个月的维生素 D 补充后，两组腹直肌和多裂肌的大小或功能均无显著差异。
单独每月服用 50 000 IU 维生素 D3 12 个月不会影响有症状的膝关节骨关节炎和低血清 25(OH)D 水平的独立社区居住的老年成年人的躯干肌肉大小或收缩能力，无论其体重指数状况或维生素 D 缺乏程度如何。不能排除维生素 D 补充对躯干肌肉功能的其他方面（如力量、功率或身体功能）的影响。
