Longitudinal Associations Between Vitamin D Metabolites and Sarcopenia in Older Australian men: The Concord Health and Aging in Men Project
Longitudinal Associations Between Vitamin D Metabolites and Sarcopenia in Older Australian men: The Concord Health and Aging in Men Project
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DOI：
10.1093/gerona/glx086
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发表时间：
2018-01-01
影响因子：
5.1
通讯作者：
Seibel, Markus J.
中科院分区：
文献类型：
--
作者：
Hirani, Vasant;Cumming, Robert G.;Seibel, Markus J.
背景资料：探讨澳大利亚社区老年男性血清25-羟维生素D（25 D）和1，25-二羟维生素D（1，25 D）水平与肌肉减少症发病率之间的关系。方法：在1，705名年龄≥ 70岁的男子中，（2005-2007年）参与男性协和健康与老龄化项目，基线时没有肌肉减少症的人研究中纳入了2年（25 D组n = 1，312，1，25 D组n = 1，231）、2年（25 D组n = 1，024，1，25 D组n = 956）和5年随访（25 D组n = 709，1，25 D组n = 663）。主要结果测量是肌肉减少症的发生率，肌肉减少症定义为根据体重指数< 0.789和握力< 26.0 kg调整的非典型瘦体重。通过放射免疫测定法（Diasorin，Stillwater，MN）测量基线时的血清25 D和1，25 D水平，并将其分为四分位数作为预测变量。协变量包括年龄，收入，季节采血，体力活动，维生素D补充和药物使用，健康措施，血清甲状旁腺激素（PTH），估计肾小球滤过率（eGFR），白蛋白，和白色血细胞计数。结果：在这项研究中，肌肉减少症的发病率为3.9%的男性在2年的随访和8.6%在5年的随访。在校正分析中，维生素D水平处于最低四分位数（25 D <40 nmol/L; 1，25 D < 62 pmol/L）的男性与5年内维生素D水平处于最高四分位数的男性相比，显示出与肌肉减少症发生几率增加的显著相关性。[25D：比值比（OR）2.53（95%置信区间（CI）1.14，5.64）p=.02; 1，25 D：OR 2.67（95% CI 1.28，5.60）p=.01]。在进一步调整各自的其他血清维生素D测量值后，（25 D或1，25 D），相关性仍然显著[25 D：OR 2.40（95% CI 1.02，5.64）p= 0.04; 1，25 D：OR 2.23（95% CI 1.04，4.80）p=.04]。基线时低血清1、25 D和25 D浓度与随后5年的肌肉减少症发生率独立相关。虽然我们的数据没有证明任何因果关系，但可以想象，维持维生素D充足可能会降低老年男性肌肉减少症的发病率。
Background: To explore the associations between serum 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D) levels at baseline and incidence of sarcopenia over time in older Australian community-dwelling older men.Methods: Of the 1,705 men aged >= 70 years (2005-2007) participating in the Concord Health and Ageing in Men Project, those without sarcopenia at baseline (n = 1,312 for 25D and n = 1,231 for 1,25D), 2 years (n = 1,024 for 25D and n = 956 for 1,25D), and 5-year follow-up (n = 709 for 25D and n = 663 for 1,25D) were included in the study. The main outcome measurement was the incidence of sarcopenia defined as appendicular lean mass adjusted for body mass index < 0.789 and grip strength < 26.0 kg. Serum 25D and 1,25D levels were measured at baseline by radioimmunoassay (Diasorin, Stillwater, MN) and categorized into quartiles as predictor variables. Covariates included age, income, season of blood collection, physical activity, vitamin D supplement and medication use, measures of health, serum parathyroid hormone (PTH), estimated glomerular filtration rate (eGFR), albumin, and white blood cell count.Results: In this study, incidence of sarcopenia was 3.9% in men at the 2-year follow-up and 8.6% at the 5-year follow-up. In adjusted analysis, men with vitamin D levels in the lowest quartiles (25D < 40nmol/L; 1,25D < 62 pmol/L) showed significant associations with increased odds of incident sarcopenia compared to those with vitamin D levels in the highest quartiles over 5 years. [25D: odds ratio (OR) 2.53 (95% confidence interval (CI) 1.14, 5.64) p=.02; 1,25D: OR 2.67 (95% CI 1.28, 5.60) p=.01]. After further adjustments for the respective other serum vitamin D measure, (either 25D or 1,25D), the association remained significant [25D: OR 2.40 (95% CI 1.02, 5.64) p=.04; 1,25D: OR 2.23 (95% CI 1.04, 4.80) p=.04].Conclusion: Low serum 1,25D and 25D concentrations at baseline are independently associated with the incidence of sarcopenia over the subsequent 5 years. Although our data do not prove any causal relationship, it is conceivable that maintaining vitamin D sufficiency may reduce the incidence of sarcopenia in ageing men.