Durak Ayfer, Safer Umut
Division of Geriatrics, Department of Internal Medicine, Sancaktepe Prof. Dr. İlhan Varank Training and Research Hospital, Sancaktepe, 34785 Istanbul, Türkiye.
Division of Geriatrics, Department of Internal Medicine, Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital, 05100 Amasya, Türkiye.
Healthcare (Basel). 2025 Sep 1;13(17):2188. doi: 10.3390/healthcare13172188.
Vitamin D deficiency is linked to muscle loss and fat changes in older adults, but data regarding palliative patients are limited. Ultrasound offers a practical tool to assess these changes. This study explores the relationship between vitamin D levels and ultrasound-measured muscle, fat, and their ratio in older adult palliative patients. This prospective cross-sectional study was conducted in a tertiary palliative care unit (June-September 2024). A total of 187 patients were grouped by serum vitamin D levels (<50 vs. ≥50 nmol/L). Demographic and clinical variables included sex, BMI, Activities of Daily Living (ADLs), calf circumference (CC), and comorbidities. Ultrasonography assessed muscle thickness (MT), subcutaneous fat thickness (SFT), and cross-sectional area (CSA) of Rectus Femoris (RF) and Biceps Brachii (BB). MT/SFT ratio was calculated. Logistic regression identified independent predictors. Mean age was 75.1 ± 14.4 years; 55.6% of participants were female. Vitamin D deficiency (67.9%) was significantly associated with female sex ( = 0.037), ADL dependency ( < 0.001), lower BMI ( = 0.020), and reduced CC ( = 0.006). RF-MT, RF-SFT, RF-CSA, BB-MT, and BB-CSA were lower in the deficient group. RF-MT/SFT ratio was higher ( = 0.049). ADL dependency ( = 0.002) and RF-MT/SFT ( = 0.015) were independent predictors. Vitamin D deficiency was linked to a higher muscle-to-fat ratio, mainly due to fat loss rather than muscle gain. This may misrepresent muscle preservation and should be interpreted cautiously. Although vitamin D levels appear to be associated with physical function, additional prospective cohort and interventional supplementation studies are warranted to determine whether routine screening and targeted vitamin D supplementation can effectively support physical function in this population.
维生素D缺乏与老年人的肌肉流失和脂肪变化有关，但关于姑息治疗患者的数据有限。超声提供了一种评估这些变化的实用工具。本研究探讨了老年姑息治疗患者维生素D水平与超声测量的肌肉、脂肪及其比例之间的关系。这项前瞻性横断面研究在一家三级姑息治疗单位进行（2024年6月至9月）。共有187名患者按血清维生素D水平分组（<50 vs.≥50 nmol/L）。人口统计学和临床变量包括性别、体重指数、日常生活活动能力（ADL）、小腿围（CC）和合并症。超声检查评估了股直肌（RF）和肱二头肌（BB）的肌肉厚度（MT）、皮下脂肪厚度（SFT）和横截面积（CSA）。计算MT/SFT比值。逻辑回归确定了独立预测因素。平均年龄为75.1±14.4岁；55.6%的参与者为女性。维生素D缺乏（67.9%）与女性性别（P = 0.037）、ADL依赖（P < 0.001）、较低的体重指数（P = 0.020）和CC降低（P = 0.006）显著相关。缺乏组的RF-MT、RF-SFT、RF-CSA、BB-MT和BB-CSA较低。RF-MT/SFT比值较高（P = 0.049）。ADL依赖（P = 0.002）和RF-MT/SFT（P = 0.015）是独立预测因素。维生素D缺乏与较高的肌肉与脂肪比值有关，主要是由于脂肪减少而非肌肉增加。这可能会误判肌肉的保存情况，应谨慎解释。尽管维生素D水平似乎与身体功能有关，但仍需要进行额外的前瞻性队列研究和干预性补充研究，以确定常规筛查和有针对性的维生素D补充是否能有效支持该人群的身体功能。
