Serum 25-hydroxy vitamin D and the risk of low muscle mass in young and middle-aged Korean adults

Vitamin D sufficiency and its relationship with muscle health across the menopausal transition and aging: Finnish cohorts of middle-aged women and older women and men

BACKGROUND

Finland's national vitamin D fortification policy has significantly improved the population's vitamin D sufficiency. This study investigates the association between serum vitamin D concentration and muscle health, considering the impact of menopause and aging in Finnish cohorts.

METHODS

The study comprised two cohorts: 237 middle-aged women (aged 47-55 years) from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study and its follow-up, and 908 older adults (aged 75, 80, and 85 years) from the Active Aging (AGNES) study. Vitamin D concentration was assessed through serum 25-hydroxyvitamin D (25(OH)D) concentrations, alongside measurements of muscle mass and function.

RESULTS

High concentrations of 25(OH)D were observed across both cohorts, aligning with Finland's fortification efforts. Furthermore, no significant correlations were found between 25(OH)D concentrations and indicators of muscle mass or function in either age group. Notably, middle-aged women in menopausal transition exhibited a slight increase in 25(OH)D concentrations, yet this did not translate into improved muscle outcomes. Similarly, older adults demonstrated sufficient 25(OH)D concentrations without a corresponding enhancement in muscle health.

CONCLUSIONS

The findings indicate that, within the context of Finland's vitamin D fortification program, serum 25(OH)D sufficiency does not directly correlate with better muscle mass or function among middle-aged and older Finnish populations. These results suggest a need for a broader approach to sarcopenia prevention, incorporating factors beyond vitamin D sufficiency. Further research is warranted to explore the multifactorial nature of muscle health during aging and the menopausal transition, to develop targeted interventions for sarcopenia prevention.

A Causal Effect of Serum 25(OH)D Level on Appendicular Muscle Mass: Evidence From NHANES Data and Mendelian Randomization Analyses

BACKGROUND

Low serum vitamin D status was reported to be associated with reduced muscle mass; however, it is inconclusive whether this relationship is causal. This study used data from the National Health and Nutrition Examination Survey (NHANES) and two-sample Mendelian randomization (MR) analyses to ascertain the causal relationship between serum 25-hydroxyvitamin D [25(OH)D] and appendicular muscle mass (AMM).

METHODS

In the NHANES 2011-2018 dataset, 11 242 participants (5588 males and 5654 females) aged 18-59 years old were included, and multivariant linear regression was performed to assess the relationship between 25(OH)D and AMM measured by dual-energy X-ray absorptiometry. In two-sample MR analysis, 167 single nucleotide polymorphisms significantly associated with serum 25(OH)D at the genome-wide association level (p < 5 × 10-8) were applied as instrumental variables (IVs) to assess vitamin D effects on AMM in the UK Biobank (417 580 Europeans) using univariable and multivariable MR (MVMR) models.

RESULTS

In the NHANES dataset, serum 25(OH)D concentrations were positively associated with AMM (β = 0.013, SE = 0.001, p < 0.001) in all participants, after adjustment for age, race, season of blood collection, education, income, body mass index and physical activity. In stratification analysis by sex, males (β = 0.024, SE = 0.002, p < 0.001) showed more pronounced positive associations than females (β = 0.003, SE = 0.002, p = 0.024). In univariable MR, genetically higher serum 25(OH)D levels were positively associated with AMM in all participants (β = 0.049, SE = 0.024, p = 0.039) and males (β = 0.057, SE = 0.025, p = 0.021), but only marginally significant in females (β = 0.043, SE = 0.025, p = 0.090) based on IVW models was noticed. No significant pleiotropy effects were detected for the IVs in the two-sample MR investigations. In MVMR analysis, a positive causal effect of 25(OH)D on AMM was observed in the total population (β = 0.116, SE = 0.051, p = 0.022), males (β = 0.111, SE = 0.053, p = 0.036) and females (β = 0.124, SE = 0.054, p = 0.021).

CONCLUSIONS

Our results suggested a positive causal effect of serum 25(OH)D concentration on AMM; however, more researches are warranted to unveil the underlying biological mechanisms and evaluate the effects of vitamin D intervention on AMM.

Serum calcium levels and the risk of sarcopenia in young adults: insights from NHANES 2011-2018

Background

Sarcopenia, the accelerated loss of muscle mass and function, is commonly associated with aging, especially in older adults. While low serum calcium has been linked to muscle loss in individuals over 50, its relationship with sarcopenia in younger adults (20-60 years) is unclear. This study examines this association using data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018.

Methods

This population-based, cross-sectional study analyzed participants aged 20-60 from NHANES 2011-2018. Individuals with missing data were excluded. Sarcopenia was assessed using appendicular skeletal muscle (ASM) measured by dual-energy X-ray absorptiometry, defined by ASM/BMI or ASM/Weight. Multiple logistic regression and stratified analyses were used to explore the correlation between serum calcium levels and sarcopenia prevalence.

Results

Among 7,309 adults, 578 (7.91%) had sarcopenia by ASM/BMI and 1,363 (18.65%) by ASM/Weight. Higher serum calcium levels were significantly associated with a lower risk of sarcopenia (ASM/BMI: OR 0.07, 95% CI 0.02-0.20; ASM/Weight: OR 0.09, 95% CI 0.04-0.19). The trend was consistent across age, gender, education, poverty income ratio, and race, with some exceptions.

Conclusion

This study highlights a negative association between serum calcium and sarcopenia risk in young and middle-aged adults, suggesting that calcium interventions could be beneficial in preventing sarcopenia in this population. However, the cross-sectional design precludes any inference of causality, and further longitudinal studies are warranted to confirm these findings.

Association between dietary vitamin D intake and low muscle mass in US adults: results from NHANES 2011-2018

Purpose

To investigate the association between dietary vitamin D intake and low muscle mass (LMM) in a representative adult population, accounting for total energy intake and other potential confounders.

Materials and methods

This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) involving 8,443 participants. Dietary vitamin D intake was assessed using 24-h dietary recalls, and LMM was defined based on appendicular lean mass (ALM) adjusted for body mass index (BMI). Multivariable logistic regression models were used to examine the association between quartiles of dietary vitamin D intake and the odds of LMM, adjusting for age, gender, race/ethnicity, BMI, total energy intake, and additional covariates.

Results

In Model 1, after adjusting for age, gender, race/ethnicity, BMI, and poverty-to-income ratio, participants in the highest quartile of vitamin D intake had an odds ratio (OR) of 0.54 (95% CI: 0.37-0.79) compared to the lowest quartile, with a p for trend <0.001. In Model 2, after further adjustment for total energy intake and several covariates, the association was attenuated but remained borderline significant (p for trend = 0.051). In Model 3, after adjusting for additional health-related factors, the OR for the highest quartile was 0.70 (95% CI: 0.47-1.05), with a significant p for trend of 0.029.

Conclusion

This study suggests that higher dietary vitamin D intake may be associated with a reduced risk of LMM. Further longitudinal research is needed to confirm these findings and explore potential interactions between vitamin D and other dietary factors in muscle mass preservation.

High serum 25-hydroxyvitamin D levels are associated with greater lean tissue mass and skeletal muscle mass:a cross-sectional study on young healthy Japanese women

Studies have shown that low serum 25(OH)D levels in young women may affect not only their own health but also the health of next generation through pregnancy and childbirth. The aim of this study is to assess the serum 25(OH)D levels in young Japanese women and to determine the factors influencing the changes in their serum 25(OH)D levels. Herein, 83 healthy young Japanese women were included. Early morning fasting blood samples, habitual food intake survey, eating habits survey, and anthropometric measurements were used to analyze the relationship between the serum 25(OH)D levels and nutrient intake, intake of food groups, dietary habits, and body composition. The findings revealed that about 50% of the study participants had an adequate intake (AI) of vitamin D (8.5 µg), whereas about 88% of the study participants were vitamin D deficient and about 12% were insufficient in serum 25(OH) levels. No significant association was observed between the serum 25(OH)D levels and nutrient intake or intake of food groups. Furthermore, higher serum 25(OH)D levels were associated with higher percentages of muscle and lean tissue, indicating that regulating the serum 25(OH)D levels helps maintain muscle mass and lowers the risk of sarcopenia and locomotive syndrome. J. Med. Invest. 71 : 260-266, August, 2024.

U-Shaped Association of Standardized Serum 25-Hydroxyvitamin D with Risk of Low Muscle Mass: A Population-Based Cross-Sectional Study

Background

In the United States (U.S.) general population, the association between standardized serum 25-hydroxyvitamin D (25(OH)D) concentration and risk of low muscle mass (LMM) remains unclear. Our research aimed to determine whether or not there was a relationship between serum 25(OH)D concentration and risk of LMM.

Methods

We analyzed the cross-sectional data of the US population that participated in the National Health and Nutrition Examination Survey between 2011 and 2014. The relationship between serum 25(OH)D concentration and LMM risk was evaluated using restricted cubic spline (RCS) with multivariate logistic regression model and subgroup analysis.

Results

In all, we included 10,256 people in our analysis. The RCS plot demonstrated a U-shaped relationship between serum 25(OH)D concentration and risk of LMM (P for nonlinearity <0.05). At a Vitamin D concentration of 38.5 nmol/L, LMM risk was at its lowest. Based on analyses stratified by age, sex, hypertension, and diabetes mellitus (DM), serum 25(OH)D concentration and risk of LMM were U-curve correlated for those age 40 or older, male, with hypertension, or without DM. However, LMM risk was positively related to serum 25(OH)D concentration in those younger than age 40 or in women.

Conclusion

There is a U-shaped relationship between serum 25(OH)D concentration and the risk of LMM in the general U.S. population. Careful monitoring and appropriate Vitamin D supplementation might lessen the risk of LMM.

Sarcopenia in youth

Recent research has revealed causes other than aging that may induce sarcopenia in young people, contrary to the long-studied age-dependent reduction in muscular mass and function. The risk of sarcopenia begins in early adulthood, resulting in exaggerated muscle dysfunction in later life. Despite its clinical significance, research on youth-onset sarcopenia is still in its infancy. Due to a paucity of epidemiologic data and standardized criteria for sarcopenia in youth, determining the prevalence of sarcopenia in the young population remains challenging. Based on the evidence, >1 in every 10 young adults of most ethnicities is estimated to have sarcopenia. This review summarizes the possible etiologies of sarcopenia in young populations, including metabolic syndrome, physical inactivity, inadequate nutrition, inherent and perinatal factors, vitamin D deficiency, endocrinopathy, an imbalance of gut microbiota, neuromuscular diseases, organ failure, malignancy, and other inflammatory disorders. This is the first review of the current knowledge on the importance, prevalence, diagnosis, and causes of sarcopenia in youth.

The Effect of Vitamin D Level on Parathyroid Hormone and Alkaline Phosphatase

Over the years, we have noticed in our clinical practice that patients with 25-hydroxyvitamin D (25OHD) levels below 15 ng/mL are more symptomatic than those with higher levels. The aim of this research is to investigate changes in both parathyroid hormone (PTH) and alkaline phosphatase (ALP) at different vitamin D levels to determine if lower vitamin D levels are associated with more severe changes in PTH and ALP, which may explain the presence and severity of symptoms at those lower 25OHD levels. We looked for correlations between 25OHD level, PTH, and ALP in 1311 samples between 2015 and 2019 at our endocrine clinic to determine if vitamin D level correlates with changes in PTH and ALP. We further categorized vitamin D deficiency levels into three categories based on the severity of the reported symptoms. As expected, there were inverse but significant correlations between 25OHD, PTH, and ALP. The lower the 25OHD, the higher the PTH and ALP levels. When 25OHD was below 10 ng/mL, PTH was increased in 65% of the samples and ALP was elevated in 21% of the samples; however, PTH and ALP were normal in 70% and 87%, respectively, of patients with 25OHD levels between 15 < 20 ng/mL. The results support our clinical observations since most of the patients with 25OHD greater than 15 ng/mL had normal PTH and ALP, which may explain the lack of symptoms in these patients.

Recent Information on Vitamin D Deficiency in an Adult Korean Population Visiting Local Clinics and Hospitals

We retrospectively reviewed serum 25-hydroxy vitamin D (25(OH)D) test results from an adult Korean population visiting local clinics and hospitals between July 2017 and December 2021 to gather recent information on the prevalence of vitamin D deficiency. The prevalence of vitamin D deficiency status was investigated according to criteria offered by various clinical guidelines. During the study period, 180,289 subjects (29,658 men and 150,631 women) were tested for 25(OH)D. The overall prevalence rates of vitamin D deficiency status based on 25(OH)D level were as follows: 0.4% for <5 ng/mL, 12.5% for <10 ng/mL, 20.6% for <12 ng/mL, 49.4% for <20 ng/mL, and <75.3% for <30 ng/mL. Women tested their 25(OH)D level more frequently than men, and the overall prevalence of 25(OH)D < 10 ng/mL was higher among women than men, while that of 25(OH)D <30 ng/mL was lower among women than men. Among age groups, the prevalence of 25(OH)D <30 ng/mL was higher in younger patients (20s−40s, 79.6−85.5%) than older ones (≥50 years, 62.6−69.2%). The overall prevalence of vitamin D deficiency decreased over time from 2018 to 2021. Future studies are needed to clarify the clinical impact of this change.