Bislev Lise Sofie, Wamberg Louise, Rolighed Lars, Grove-Laugesen Diana, Rejnmark Lars
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
J Clin Endocrinol Metab. 2022 Apr 19;107(5):1317-1327. doi: 10.1210/clinem/dgac004.
The role of vitamin D on muscle health is debated.
An individual participant metanalysis of 4 randomized placebo-controlled trials, investigating short-term (3-9months) effects of vitamin D3 in moderate (2800 IU) to high (7000 IU) daily oral doses on muscle health and quality of life (QoL). Inclusion criteria were either obesity (n = 52), newly diagnosed primary hyperparathyroidism (n = 41), Graves' disease (n = 86), or secondary hyperparathyroidism (n = 81).
Overall (n = 260) as well as in a subgroup analysis including only vitamin D insufficient [25(OH)D < 50 nmol/L] individuals (n = 176), vitamin D supplementation did not affect measures of muscle health (isometric muscle strength, Timed Up and Go test, chair rising test, body composition, and balance) or QoL. However, a beneficial effect was present on QoL (physical component score) in vitamin D deficient [25(OH)D < 25 nmol/L] individuals (n = 34). Overall, relative changes in 25(OH)D inversely affected maximum muscle strength in a dose-response manner. Stratified into body mass index </> 30 kg/m2, vitamin D supplementation had divergent effects on isometric muscle strength, with beneficial effects in obese individuals (n = 93) at knee flexion 90° (P = 0.04), and adverse effects in nonobese individuals (n = 167) at handgrip (P = 0.02), knee extension 60° (P = 0.03) and knee flexion 60° (P < 0.01).
Overall, short-term treatment with moderate to high daily doses of vitamin D did not affect muscle health or QoL. A potential beneficial effect was present on muscle strength in severely obese individuals and on QoL in vitamin D deficient individuals. Subgroup analyses, however, suggested negative effects of large relative increases in p-25(OH)D.
维生素D对肌肉健康的作用存在争议。
对4项随机安慰剂对照试验进行个体参与者荟萃分析，研究每日口服中等剂量（2800 IU）至高剂量（7000 IU）维生素D3对肌肉健康和生活质量（QoL）的短期（3 - 9个月）影响。纳入标准为肥胖（n = 52）、新诊断的原发性甲状旁腺功能亢进（n = 41）、格雷夫斯病（n = 86）或继发性甲状旁腺功能亢进（n = 81）。
总体（n = 260）以及仅包括维生素D不足[25(OH)D < 50 nmol/L]个体的亚组分析（n = 数176）中，补充维生素D未影响肌肉健康指标（等长肌力、计时起立行走测试、从椅子上起身测试、身体成分和平衡）或生活质量。然而，维生素D缺乏[25(OH)D < 25 nmol/L]个体（n = 34）的生活质量（身体成分评分）有有益影响。总体而言，25(OH)D的相对变化以剂量反应方式反向影响最大肌肉力量。按体重指数</> 30 kg/m2分层，补充维生素D对等长肌力有不同影响，对肥胖个体（n = 93）在膝关节屈曲90°时有有益影响（P = 0.04），而对非肥胖个体（n = 167）在握力（P = 0.02）、膝关节伸展60°（P = 0.03）和膝关节屈曲60°（P < 0.01）时有不利影响。
总体而言，每日中等至高剂量维生素D的短期治疗未影响肌肉健康或生活质量。对严重肥胖个体的肌肉力量和维生素D缺乏个体的生活质量可能有有益影响。然而，亚组分析表明p - 25(OH)D相对大幅增加有负面影响。
