Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764, Neuherberg, Germany.
Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig Maximilian University of Munich, 81377, Munich, Germany.
Calcif Tissue Int. 2019 Aug;105(2):173-182. doi: 10.1007/s00223-019-00558-5. Epub 2019 May 8.
Effects of low serum 25OHD on age-related changes in muscle mass and function remain unclear. Our aims were to explore associations of baseline 25OHD levels with prevalent and incident sarcopenia and changes in muscle parameters, and to examine the role of parathyroid hormone (PTH) therein. Cross-sectional (n = 975) and prospective analyses (n = 702) of older adults aged 65-93 years participating in the KORA-Age study. Sarcopenia was defined using the 2010 European Working Group on Sarcopenia in Older People (EWGSOP) criteria as low muscle mass combined with low grip strength or low physical performance. Associations with baseline 25OHD were examined in multiple regression analyses. Low vitamin D status was linked to increased odds of prevalent sarcopenia. Over three years, low baseline 25OHD < 25 vs. ≥ 50 nmol/L were associated with greater loss of muscle mass and increased time for the Timed Up and Go test. The risk for developing incident sarcopenia was not significantly elevated in individuals with low baseline 25OHD but when including death as combined outcome alongside incident sarcopenia, there was a strong positive association in multivariable analysis [OR (95% CI) 3.19 (1.54-6.57) for 25OHD < 25 vs. ≥ 50 nmol/L]. There was no evidence for a PTH-mediating effect. Low baseline 25OHD levels were associated with unfavorable changes in muscle mass and physical performance, but not with incident sarcopenia. Future randomized trials are needed to assess causality and to address the issue of competing risks such as mortality in older cohorts.
低血清 25OHD 对与年龄相关的肌肉质量和功能变化的影响仍不清楚。我们的目的是探讨基线 25OHD 水平与普遍存在和新发的肌肉减少症以及肌肉参数变化的关系，并研究甲状旁腺激素（PTH）在此过程中的作用。参加 KORA-Age 研究的 65-93 岁老年人的横断面（n=975）和前瞻性分析（n=702）。肌肉减少症根据 2010 年欧洲老年人肌肉减少症工作组（EWGSOP）标准定义为肌肉质量低，伴有握力低或身体机能低。使用多元回归分析检查与基线 25OHD 的关联。低维生素 D 状态与普遍存在的肌肉减少症的几率增加有关。在三年期间，与基线 25OHD<25 与≥50 nmol/L 相比，低基线 25OHD 与肌肉质量的更大损失和完成起立-行走测试的时间增加有关。在基线 25OHD 低的个体中，发生肌肉减少症的风险没有显著升高，但当将死亡作为与新发肌肉减少症相结合的结果纳入多变量分析时，25OHD<25 与≥50 nmol/L 相比，风险呈正相关[比值比（95%置信区间）3.19（1.54-6.57）]。没有证据表明 PTH 介导了这种关联。低基线 25OHD 水平与肌肉质量和身体机能的不利变化有关，但与新发肌肉减少症无关。未来需要进行随机试验来评估因果关系，并解决老年人队列中死亡率等竞争风险的问题。
