Department of Endocrinology and Metabolism, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
Department of Internal Medicine B, Cardiology, University Medicine Greifswald, Germany.
Nutrition. 2019 Jun;62:1-6. doi: 10.1016/j.nut.2018.11.020. Epub 2018 Nov 23.
Sex-specific differences in factors associated with aging and lifespan, such as sarcopenia and disease development, are increasingly recognized. The study aims to assess sex-specific aspects of the association between vitamin D insufficiency and low lean mass as well as between vitamin D insufficiency and the frailty phenotype.
A total of 1102 participants (51% women) from the Berlin Aging Study II were included in this cross-sectional study. Vitamin D insufficiency was defined as a 25(OH)D level <50 nmol/L. Lean mass was assessed with dual-energy x-ray absorptiometry and corrected by body mass index. Low lean mass was defined according to the Foundations for the National Institutes of Health Sarcopenia Project criteria (appendicular lean mass/body mass index <0.789 in men and <0.512 in women) and frailty defined according to the Fried criteria.
In a risk factor-adjusted analysis, the association of vitamin D insufficiency was significantly influenced by sex (P for interaction < 0.001). Men with vitamin D insufficiency had 1.8 times higher odds of having low lean mass, with no association between vitamin D insufficiency and low lean mass in women. Participants with vitamin D insufficiency had 1.5 higher odds of being prefrail/frail with no significant effect modification by sex.
We found notable sex-specific differences in the association of vitamin D insufficiency with low lean mass but not of vitamin D insufficiency with frailty. Vitamin D might play a relevant role in the loss of lean mass in men but not women and might be a biological marker of an unfavorable aging process associated with early development of frailty regardless of sex.
与衰老和寿命相关的因素（如肌肉减少症和疾病发展）存在性别特异性差异，这一点正日益得到认识。本研究旨在评估维生素 D 不足与低瘦体重以及维生素 D 不足与虚弱表型之间关联的性别特异性方面。
本横断面研究共纳入来自柏林衰老研究 II 的 1102 名参与者（51%为女性）。维生素 D 不足定义为 25(OH)D 水平 <50 nmol/L。瘦体重采用双能 X 线吸收法测定，并按体重指数校正。根据国家卫生研究院肌肉减少症项目标准（男性四肢瘦体重/体重指数<0.789，女性<0.512）定义低瘦体重，根据 Fried 标准定义虚弱。
在调整风险因素后，维生素 D 不足与性别显著相关（交互作用 P<0.001）。维生素 D 不足的男性发生低瘦体重的几率高出 1.8 倍，而女性中维生素 D 不足与低瘦体重之间无关联。维生素 D 不足的参与者出现虚弱前期/虚弱的几率高出 1.5 倍，且性别无显著的效应修饰作用。
我们发现维生素 D 不足与低瘦体重之间存在显著的性别特异性差异，但与虚弱之间无差异。维生素 D 可能在男性瘦体重丢失中发挥重要作用，而在女性中则无作用，并且可能是与虚弱早期发展相关的不利衰老过程的生物学标志物，而与性别无关。
