血清25-羟维生素D和叶酸水平与肌肉减少症风险的个体及联合关联：一项基于2011 - 2018年美国国家健康与营养检查调查（NHANES）的横断面研究

Individual and joint association of serum 25-hydroxyvitamin D and folate levels with the risk of sarcopenia: a cross-sectional study from the NHANES 2011-2018.

作者信息

Wei Yaping, He Qiangqiang, Di Qiannan, Li Jing, Zhang Jingyi, Na Lixin

机构信息

College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China.

Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, China.

出版信息

Front Nutr. 2025 Jun 23;12:1576705. doi: 10.3389/fnut.2025.1576705. eCollection 2025.

DOI:10.3389/fnut.2025.1576705

PMID:40626218

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12229844/

Abstract

BACKGROUND

Recent studies have indicated that vitamin D and folate are essential for muscle health and each is independently linked to the prevalence of sarcopenia. However, the potential synergistic effects of vitamin D and folate on sarcopenia have not been extensively studied. This study aims to investigate both the individual and joint associations of serum 25-hydroxyvitamin D [25(OH)D] and folate concentrations with the risk of sarcopenia.

METHODS

This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES), covering the years 2011-2018. Multivariable logistic regression models were used to determine individual and joint associations of serum 25(OH)D and folate with sarcopenia. Additionally, the relative excess risk due to interaction (RERI) was estimated to assess additivity.

RESULTS

A significant inverse relationship was observed between serum 25(OH)D and folate levels in relation to sarcopenia. Specifically, among participants with 25(OH)D levels < 50 nmol/L, the odds ratios (ORs) for sarcopenia were 0.67 [95% confidence interval (CI): 0.56-0.81] for those with 25(OH)D levels between 50 and 75 nmol/L, and 0.61 (95% CI: 0.48, 0.77) for those with levels > 75 nmol/L. Similarly, when comparing participants in the lowest tertile of folate, the ORs for sarcopenia were 0.74 (95% CI: 0.61, 0.89) for the second tertile and 0.72 (95% CI: 0.59, 0.88) for the third tertile. Among individuals with fasting blood glucose levels < 7.0 mmol/L, those with both low levels of 25(OH)D and folate exhibited a significantly higher risk of sarcopenia compared to those with high levels of 25(OH)D and folate. Furthermore, the RERI was statistically significant.

CONCLUSION

In the present study, a synergistic interaction between 25(OH)D and folate was observed in relation to the risk of sarcopenia. These findings contribute new insights into the nutritional factors associated with sarcopenia and pave the way for future longitudinal studies to further explore this association.

摘要

背景

近期研究表明，维生素D和叶酸对肌肉健康至关重要，且二者均独立与肌肉减少症的患病率相关。然而，维生素D和叶酸对肌肉减少症的潜在协同作用尚未得到广泛研究。本研究旨在调查血清25-羟基维生素D[25(OH)D]和叶酸浓度与肌肉减少症风险的个体及联合关联。

方法

本研究利用2011年至2018年美国国家健康与营养检查调查（NHANES）的数据进行横断面分析。采用多变量逻辑回归模型确定血清25(OH)D和叶酸与肌肉减少症的个体及联合关联。此外，估计交互作用导致的相对超额风险（RERI）以评估相加性。

结果

观察到血清25(OH)D和叶酸水平与肌肉减少症之间存在显著的负相关关系。具体而言，在25(OH)D水平<50 nmol/L的参与者中，25(OH)D水平在50至75 nmol/L之间的参与者患肌肉减少症的比值比（OR）为0.67[95%置信区间（CI）：0.56 - 0.81]，而水平>75 nmol/L的参与者为0.61（95% CI：0.48，0.77）。同样，在比较叶酸水平最低三分位数的参与者时，第二三分位数患肌肉减少症的OR为0.74（95% CI：0.61，0.89），第三三分位数为0.72（95% CI：0.59，0.88）。在空腹血糖水平<7.0 mmol/L的个体中，25(OH)D和叶酸水平均低的个体与25(OH)D和叶酸水平高的个体相比，患肌肉减少症的风险显著更高。此外，RERI具有统计学意义。