维生素 D 补充与老年人肌肉力量、体力和身体表现：一项随机对照试验。
Vitamin D Supplementation and Muscle Power, Strength and Physical Performance in Older Adults: A Randomized Controlled Trial.
机构信息
Department of Internal Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Department of Health and Exercise Science, Wake Forest University, Winston Salem, NC, USA.
出版信息
Am J Clin Nutr. 2023 Jun;117(6):1086-1095. doi: 10.1016/j.ajcnut.2023.04.021. Epub 2023 Apr 19.
BACKGROUND
Low 25-hydroxyvitamin D (25[OH]D) concentrations (<30 ng/mL [<50 nmol/L]) have been associated with muscle weakness and impaired physical performance in observational studies. However, the effect of vitamin D supplementation on changes in muscle strength and physical performance in randomized controlled trials has been mixed.
OBJECTIVES
To determine the effect of daily vitamin D supplementation on leg power, strength, and physical performance in low-functioning older adults with 25(OH)D concentrations of 18 to <30 ng/mL.
METHODS
In this double-blind, randomized controlled trial, 136 low-functioning [Short Physical Performance Battery (SPPB) scores ≤10] adults aged 65-89 y with 25(OH)D concentrations of 18 to <30 ng/mL were randomly assigned to 2000 IU/d vitamin D or placebo for 12 mo. Lower-extremity leg power (primary outcome), leg and grip strength, SPPB, timed up and go (TUG), postural sway, and gait velocity and spatiotemporal parameters (secondary outcomes) were assessed at baseline, 4 and 12 mo. A subset (n = 37) also underwent a muscle biopsy at baseline and 4 mo and muscle fiber composition and contractile properties were assessed.
RESULTS
Participants' mean ± SD age and SPPB scores at baseline were 73.4 ± 6.3 y and 7.8 ± 1.8, respectively. Mean ± SD 25(OH)D concentrations at baseline and 12 mo were 19.4 ± 4.2 ng/mL and 28.6 ± 6.7 ng/mL in the vitamin D group and 19.9 ± 4.9 ng/mL and 20.2 ± 5.0 ng/mL in the placebo group for a mean ± SE difference of 9.1 ± 1.1 ng/mL (P < 0.0001). However, there were no differences in change in leg power, leg or grip strength, SPPB score, TUG, postural sway, or gait velocity and spatiotemporal parameters by intervention group over 12 mo or muscle fiber composition and contractile properties over 4 mo.
CONCLUSIONS
In low-functioning older adults with 25(OH)D concentrations of 18 to <30 ng/mL, randomization to 2000 IU/d vitamin D did not result in improvements in leg power, strength, or physical performance or muscle fiber composition and contractile properties. This trial was registered at clinicaltrials.gov as NCT02015611.
背景
在观察性研究中，低 25-羟维生素 D（25[OH]D）浓度（<30ng/mL[<50nmol/L]）与肌肉无力和身体机能下降有关。然而，随机对照试验中维生素 D 补充对肌肉力量和身体机能变化的影响结果不一。
目的
确定每日维生素 D 补充对 25（OH）D 浓度为 18-<30ng/mL 的低功能老年人群中腿部力量、强度和身体机能的影响。
方法
在这项双盲、随机对照试验中，纳入 136 名低功能[短体适能电池（SPPB）评分≤10]、25（OH）D 浓度为 18-<30ng/mL 的 65-89 岁老年人，将其随机分配至 2000IU/d 维生素 D 或安慰剂组，进行为期 12 个月的治疗。下肢腿部力量（主要结局）、腿部和握力、SPPB、计时起立行走（TUG）、姿势摆动和步态速度及时空参数（次要结局）在基线、4 个月和 12 个月时进行评估。一部分（n=37）也在基线和 4 个月时进行肌肉活检，评估肌肉纤维组成和收缩特性。
结果
参与者的平均年龄±标准差和基线 SPPB 评分分别为 73.4±6.3 岁和 7.8±1.8。维生素 D 组和安慰剂组的平均±标准差 25（OH）D 浓度在基线和 12 个月时分别为 19.4±4.2ng/mL 和 28.6±6.7ng/mL，干预组的平均±SE 差值为 9.1±1.1ng/mL（P<0.0001）。然而，12 个月时，腿部力量、腿部和握力、SPPB 评分、TUG、姿势摆动或步态速度和时空参数的变化，以及 4 个月时的肌肉纤维组成和收缩特性，在干预组之间均无差异。
结论
在 25（OH）D 浓度为 18-<30ng/mL 的低功能老年人群中，随机分配至 2000IU/d 维生素 D 治疗并未导致腿部力量、强度或身体机能或肌肉纤维组成和收缩特性改善。本试验在 clinicaltrials.gov 上注册为 NCT02015611。
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