Muscle strength and muscle mass in elderly women after cholecalciferol supplementation in Southern Brazil
AimS: Vitamin D is known to be vital in sustaining musculoskeletal functions, with its deficiency may cause muscle weakness and decreased bone mineral density. Vitamin D inadequacy is highly prevalent and its deficiency or insufficiency estimated to affect one billion people worldwide. It causes secondary hyperparathyroidism, bone loss, fractures and it has been associated with a number of other conditions, such as impaired muscle function (1), we decided to verify if there is an association between 25(OH)D status and handgrip strength and with lean muscle mass after cholecalciferol supplementation in elderly women.
Methods : We studied fifty-four postmenopausal women with serum 25(OH)D below 30 ng/mL during three months. Cholecalciferol supplementation was divided into two levels according to classification: deficient (10000 units/day) and insufficient (2000 units/day). Changes in biochemical response and in body composition were assessed using dual-x-ray energy absormetry, handgrip strength and blood tests before and after supplementation.
Results: The majority of the sample were vitamin D deficient. There was no difference in the deficient group for handgrip strength after the supplementation (p=0,489), but PTH had a statistically significant reduction (p=0.001). Besides, the deficient group had a decrease in lean mass even after the intervention (p=0.006). The results were similar when comparing within results of the insufficient group, however lean mass remained stable (p=0.423).
Conclusion: Three-month cholecalciferol supplementation alone in elderly women with doses according to 25(OH)D serum was insufficient to change handgrip strength and total lean muscle mass, however secondary hyperparathyroidism was corrected.
Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab. 2012;97(4):1153-8.
Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J; IOF Committee of Scientific Advisors (CSA) Nutrition Working Group. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009;20(11):1807-20.
Visser M, Deeg DJ, Puts MT, Seidell JC, Lips P. Low serum concentrations of 25-hydroxyvitamin D in older persons and the risk of nursing home admission. Am J Clin Nutr. 2006;84(3):616-22; quiz 671-2.
Genaro PDS, Pinheiro MDM, Szejnfeld VL, Martini LA. Secondary hyperparathyroidism and its relationship with sarcopenia in elderly women. Arch Gerontol Geriatr. 2015;60(2):349-53.
Baczynski R, Massry SG, Magott M, el-Belbessi S, Kohan R, Brautbar N. Effect of parathyroid hormone on energy metabolism of skeletal muscle. Kidney Int. 1985;28(5):722-7.
Garber AJ. Effects of parathyroid hormone on skeletal muscle protein and amino acid metabolism in the rat. J Clin Invest. 1983;71(6):1806-21.
Han SS, Kim M, Lee SM, Lee JP, Kim S, Joo KW, Lim CS, Kim YS, Kim DK. Association between body fat and vitamin D status in Korean adults. Asia Pac J Clin Nutr. 2014;23(1):65-75.
Oh EG, Yoo JY, Lee JE, Hyun SS, Ko IS, Chu SH. Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: a randomized controlled trial. Res Nurs Health. 2014;37(4):292-301.
Plawecki K, Chapman-Novakofski K. Bone health nutrition issues in aging. Nutrients. 2010;2(11):1086-105.
Yang YJ, Kim J. Factors in relation to bone mineral density in Korean middle-aged and older men: 2008-2010 Korea National Health and Nutrition Examination Survey. Ann Nutr Metab. 2014;64(1):50-9.
Ko MJ, Yun S, Oh K, Kim K. Relation of serum 25-hydroxyvitamin D status with skeletal muscle mass by sex and age group among Korean adults. Br J Nutr. 2015;114(11):1838-44.
Hao Y, Ma X, Shen Y, Ni J, Luo Y, Xiao Y, Bao Y, Jia W. Associations of serum 25-hydroxyvitamin D3 levels with visceral adipose tissue in Chinese men with normal glucose tolerance. PLoS One. 2014;9(1):e86773.
Earthman CP, Beckman LM, Masodkar K, Sibley SD. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. Int J Obes (Lond). 2012;36(3):387-96.
Moschonis G, Tanagra S, Koutsikas K, Nikolaidou A, Androutsos O, Manios Y. Association between serum 25-hydroxyvitamin D levels and body composition in postmenopausal women: the postmenopausal Health Study. Menopause. 2009;16(4):701-7.
Vitezova A, Muka T, Zillikens MC, Voortman T, Uitterlinden AG, Hofman A, Rivadeneira F, Kiefte-de Jong JC, Franco OH. Vitamin D and body composition in the elderly. Clin Nutr. 2017;36(2):585-92.
Rosendahl-Riise H, Spielau U, Ranhoff AH, Gudbrandsen OA, Dierkes J. Vitamin D supplementation and its influence on muscle strength and mobility in communitydwelling older persons: a systematic review and metaanalysis. J Hum Nutr Diet. 2017;30(1):3-15.
Beaudart C, Buckinx F, Rabenda V, Gillain S, Cavalier E, Slomian J, Petermans J, Reginster JY, Bruyère O. The effects of vitamin d on skeletal muscle strength, muscle mass, and muscle power: A systematic review and metaanalysis of randomized controlled trials. J Clin Endocrinol Metab. 2014;99(11):4336-45.
Janssen HCJP, Emmelot-Vonk MH, Verhaar HJJ, van der Schouw YT. Vitamin D and muscle function: Is there a threshold in the relation? J Am Med Dir Assoc. 2013;14(8):627.e13-8.
Marantes I, Achenbach SJ, Atkinson EJ, Khosla S, Melton Iii LJ, Amin S. Is vitamin D a determinant of muscle mass and strength? J Bone Miner Res. 2011;26(12):2860-71.
Matheï C, Van Pottelbergh G, Vaes B, Adriaensen W, Gruson D, Degryse JM. No relation between vitamin D status and physical performance in the oldest old: results from the Belfrail study. Age Ageing. 2013;42(2):186-90.
Bischoff-Ferrari HA, Dawson-Hughes B, Orav EJ, Staehelin HB, Meyer OW, Theiler R, Dick W, Willett WC, Egli A. Monthly high-dose vitamin D treatment for the prevention of functional decline: a randomized clinical trial. JAMA Intern Med. 2016;176(2):175-83.
Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19(2):73-8.
Saraiva GL, Cendoroglo MS, Ramos LR, Araújo LM, Vieira JG, Kunii I, Hayashi LF, Corrêa MP, Lazaretti-Castro M. Influence of ultraviolet radiation on the production of 25 hydroxyvitamin D in the elderly population in the city of São Paulo (23 degrees 34'S), Brazil. Osteoporos Int. 2005;16(12):1649-54.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010; 39(4):412-23.
Gumieiro DN, Murino Rafacho BP, Buzati Pereira BL, Cavallari KA, Tanni SE, Azevedo PS, Polegato BF, Mamede Zornoff LA, Dinhane DI, Innocenti Dinhane KG, Cação Pereira GJ, de Paiva SA, Minicucci MF. Vitamin D serum levels are associated with handgrip strength but not with muscle mass or length of hospital stay after hip fracture. Nutrition. 2015;31(7-8):931-4.
Mastaglia SR, Seijo M, Muzio D, Somoza J, Nuñez M, Oliveri B. Effect of vitamin D nutritional status on muscle function and strength in healthy women aged over sixtyfive years. J Nutr Health Aging. 2011;15(5):349-54.
Redzic M, Lewis RM, Thomas DT. Relationship between 25-hydoxyvitamin D, muscle strength, and incidence of injury in healthy adults: a systematic review. Nutr Res. 2013;33(4):251-8.
El Hajj C, Fares S, Chardigny JM, Boirie Y, Walrand S. Vitamin D supplementation and muscle strength in pre-sarcopenic elderly Lebanese people: a randomized controlled trial. Arch Osteoporos. 2018;14(1):4.
Vaes AMM, Tieland M, Toussaint N, Nilwik R, Verdijk LB, van Loon LJC, de Groot LCPGM. Cholecalciferol or 25-hydroxycholecalciferol supplementation does not affect muscle strength and physical performance in prefrail and frail older adults. J Nutr. 2018;148(5): 712-20.
Clark P, Vivanco-Muñoz N, Piña JT, Rivas-Ruiz R, Huitrón G, Chico-Barba G, Reza-Albarrán AA. High prevalence of hypovitaminosis D in Mexicans aged 14 years and older and its correlation with parathyroid hormone. Arch Osteoporos. 2015;10:225.
Pinheiro MM, Schuch NJ, Genaro PS, Ciconelli RM, Ferraz MB, Martini LA. Nutrient intakes related to osteoporotic fractures in men and women: the Brazilian Osteoporosis Study (BRAZOS). Nutr J. 2009;8:6.
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