School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 00132 Milan, Italy.
Institute of Endocrine and Metabolic Sciences, IRCCS San Raffaele Hospital, Via Olgettina 60, 00132 Milan, Italy.
Nutrients. 2022 Apr 26;14(9):1816. doi: 10.3390/nu14091816.
Osteosarcopenic obesity is a unique clinical condition where low bone and muscle mass coexist in individuals with obesity. Alterations in adipose tissue, skeletal muscle and bone are strictly interconnected, and vitamin D plays key roles in several metabolic pathways that are involved in maintaining musculoskeletal health and glucose homeostasis. We reviewed the available literature on mechanisms underlying osteosarcopenic obesity, with a focus on the role of vitamin D in the pathogenesis and treatment of the condition. We found that, although evidence from large observational studies and pre-clinical experiments strongly supports a role of vitamin D deficiency in the pathogenesis of osteosarcopenic obesity, the common belief that vitamin D improves musculoskeletal health lacks solid clinical evidence, as trials specifically aimed at assessing the effects of vitamin D supplementation in patients with osteosarcopenic obesity are not available, and trials that investigated the role of vitamin D on muscle and bone health in other patient populations either showed no or even detrimental effects. We conclude that large observational and interventional studies including individuals with osteosarcopenic obesity representative of different sex, age and race are needed to better define the role of vitamin D in the pathogenesis and treatment of this condition.
骨肌减少型肥胖症是一种独特的临床病症，其特征是肥胖个体同时存在低骨量和低肌肉量。脂肪组织、骨骼肌和骨骼的改变是严格相互关联的，维生素 D 在涉及维持肌肉骨骼健康和葡萄糖稳态的几个代谢途径中发挥着关键作用。我们回顾了关于骨肌减少型肥胖症发病机制的现有文献，重点关注了维生素 D 在该病症发病机制和治疗中的作用。我们发现，尽管来自大型观察性研究和临床前实验的证据强烈支持维生素 D 缺乏在骨肌减少型肥胖症发病机制中的作用，但普遍认为维生素 D 可改善肌肉骨骼健康，这一观点缺乏确凿的临床证据，因为目前尚无专门针对评估维生素 D 补充剂对骨肌减少型肥胖症患者影响的试验，而那些针对其他患者群体的维生素 D 对肌肉和骨骼健康作用的试验则显示出没有作用甚至有害作用。我们的结论是，需要进行包括具有不同性别、年龄和种族代表性的骨肌减少型肥胖症患者的大型观察性和干预性研究，以更好地确定维生素 D 在该病症发病机制和治疗中的作用。
