Muscle strength and muscle mass in elderly women after cholecalciferol supplementation in Southern Brazil
DOI:
https://doi.org/10.15448/2357-9641.2019.1.32016Palavras-chave:
Cholecalciferol, Muscle strength, Elderly.Resumo
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.
*** Força muscular e massa muscular em mulheres idosas após suplementação com colecalciferol no sul do Brasil ***
OBJETIVOS: A vitamina D é conhecida por ser vital na manutenção das funções musculoesqueléticas, sua deficiência pode causar fraqueza muscular e diminuição da densidade mineral óssea. A inadequação da vitamina D é altamente prevalente e sua deficiência ou insuficiência estimada afeta um bilhão de pessoas em todo o mundo. Causa hiperparatireoidismo secundário, perda óssea, fraturas e tem sido associada a uma série de outras condições, como função muscular prejudicada, por isso decidimos verificar se há associação entre 25(OH)D e força de preensão manual e com massa muscular magra após suplementação com colecalciferol em mulheres idosas.
Métodos : Foram estudadas 55 mulheres na pós-menopausa com 25(OH)D sérica abaixo de 30 ng/mL durante três meses. A suplementação de colecalciferol foi dividida em dois níveis de acordo com a classificação: deficiente (10000 unidades/dia) e insuficiente (2000 unidades/dia). Alterações na resposta bioquímica e na composição corporal foram avaliadas usando a absorciometria de raios-x de dupla energia, força de preensão manual e exames de sangue antes e após a suplementação.
Resultados: A maioria da amostra era deficiente em vitamina D. Não houve diferença no grupo com deficiência para força de preensão manual após a suplementação (p=0,489), mas o PTH teve redução estatisticamente significativa (p=0,001). Além disso, o grupo deficiente apresentou diminuição da massa magra mesmo após a intervenção (p=0,006). Os resultados foram semelhantes quando comparados com resultados de grupo insuficiente, porém a massa magra permaneceu estável (p=0,423).
Conclusão: A suplementação isolada de colecalciferol por três meses em mulheres idosas com doses de acordo com níveis sérico de 25(OH)D foi insuficiente para alterar a força de preensão manual e a massa muscular total, porém o hiperparatireoidismo secundário foi corrigido.
Palavras-chave: Colecalciferol; Força muscular; Idoso.
Downloads
Referências
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.
https://doi.org/10.1210/jc.2011-2601
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.
https://doi.org/10.1007/s00198-009-0954-6
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.
https://doi.org/10.1093/ajcn/84.3.616
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.
https://doi.org/10.1016/j.archger.2015.01.005
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.
https://doi.org/10.1038/ki.1985.190
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.
https://doi.org/10.1172/jci110936
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.
https://doi.org/10.1002/nur.21608
Plawecki K, Chapman-Novakofski K. Bone health nutrition issues in aging. Nutrients. 2010;2(11):1086-105.
https://doi.org/10.3390/nu2111086
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.
https://doi.org/10.1159/000362425
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.
https://doi.org/10.1017/s0007114515003633
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.
https://doi.org/10.1371/journal.pone.0086773
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.
https://doi.org/10.1038/ijo.2011.119
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.
https://doi.org/10.1097/gme.0b013e318199d5d5
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.
https://doi.org/10.1016/j.clnu.2016.04.017
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.
https://doi.org/10.1111/jhn.12394
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.
https://doi.org/10.1210/jc.2014-1742
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.
https://doi.org/10.1016/j.jamda.2013.05.012
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.
https://doi.org/10.1002/jbmr.510
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.
https://doi.org/10.1093/ageing/afs186
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.
https://doi.org/10.1001/jamainternmed.2015.7148
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.
https://doi.org/10.1007/s00198-005-1895-3
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.
https://doi.org/10.1093/ageing/afq034
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.
https://doi.org/10.1016/j.nut.2014.12.022
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.
https://doi.org/10.1007/s12603-010-0287-3
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.
https://doi.org/10.1016/j.nutres.2013.02.007
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.
https://doi.org/10.1007/s11657-018-0553-2
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.
https://doi.org/10.1093/jn/nxy024
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.
https://doi.org/10.1007/s11657-015-0225-4
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.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Direitos Autorais
A submissão de originais para a PAJAR implica na transferência, pelos autores, dos direitos de publicação. Os direitos autorais para os artigos publicados nesta revista são do autor, com direitos da revista sobre a primeira publicação. Os autores somente poderão utilizar os mesmos resultados em outras publicações indicando claramente a PAJAR como o meio da publicação original.
Licença Creative Commons
Exceto onde especificado diferentemente, aplicam-se à matéria publicada neste periódico os termos de uma licença Creative Commons Atribuição 4.0 Internacional, que permite o uso irrestrito, a distribuição e a reprodução em qualquer meio desde que a publicação original seja corretamente citada.
