Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Osteoporosis International
Published in: Osteoporosis International 5/2009

01-05-2009 | Original Article

Sex-specific association of serum vitamin D levels with physical function in older adults

Authors: T.-T. L. Dam, D. von Mühlen, E. L. Barrett-Connor

Published in: Osteoporosis International | Issue 5/2009

Login to get access

Abstract

Summary

In women, but not men, lower 25-hydroxyvitamin D [25(OH)D] levels were associated with impaired performance on two lower extremity function tests in both cross-sectional and prospective analyses.

Introduction

Preserved physical function may explain how 25(OH)D supplementation reduces falls and fractures.

Methods

A total of 1,065 community-dwelling men and women (mean age 74.6 years) with 25(OH)D levels and performance on timed up and go (TUG) and timed chair stand (TCS) were seen in 1997–1999; 769 (72%) participants returned for follow-up. Associations were examined using generalized linear models.

Results

25(OH)D levels were higher in men than women, but the prevalence of vitamin D insufficiency defined as 25(OH)D <75 nmol/L was 14%. There were no baseline sex differences in TUG or TCS. However, after 2.5 years, decline in TCS and TUG was greater in women than men (11% vs. 3%; p < 0.001). Women in the lowest 25(OH)D quartile (<80 nmol/L) compared to the highest quartile had an accelerated rate of functional decline on the TUG and TCS independent of covariates. No significant associations were seen in men.

Conclusion

In women, but not men, lower 25(OH)D levels were associated with impaired performance on two lower extremity function tests in both cross-sectional and prospective analyses. These results provide additional evidence that 25(OH)D is associated with physical function, which may explain how vitamin D supplementation reduces falls and fractures.
Literature
1.
Holick MF (2003) Vitamin D: photobiology, metabolism, mechanism of action and clinical applications. In: Favus MJ (ed) Primer on the metabolic bone diseases and disorders of mineral metabolism. American Society for Bone and Mineral Research, Washington DC, pp 129–136
2.
Mitra D, Bell NH (1997) Racial, geographic, genetic and body habits effects on Vitamin D. In: Feldman D, Glorieux FH, Pike JW (eds) Vitamin D. Academic, San Diego, pp 521–532
3.
Chapuy MC, Meunier PJ (1997) Vitamin D insufficiency in adults and the elderly. In: Feldman D, Glorieux FH, Pike JW (eds) Vitamin D. Academic, San Diego, pp 679–693
4.
Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7:439–443PubMedCrossRef
5.
Gloth FM 3rd, Gundberg CM, Hollis BW, Haddad JG Jr, Tobin JD (1995) Vitamin D deficiency in homebound elderly persons. JAMA 274:1683–1686PubMedCrossRef
6.
Lamberg-Allardt CJ, Outila TA, Karkkainen MU, Rita HJ, Valsta LM (2001) Vitamin D deficiency and bone health in healthy adults in Finland: could this be a concern in other parts of Europe? J Bone Miner Res 16:2066–2073PubMedCrossRef
7.
Scharla SH (1998) Prevalence of subclinical vitamin D deficiency in different European countries. Osteoporos Int 8(Suppl 2):S7–S12PubMed
8.
Tareen N, Martins D, Zadshir A, Pan D, Norris KC (2005) The impact of routine vitamin supplementation on serum levels of 25 (OH) D3 among the general adult population and patients with chronic kidney disease. Ethn Dis 15:S5–102–106
9.
van der Wielen RP, Lowik MR, van den Berg H, de Groot LC, Haller J, Moreiras O, van Staveren WA (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346:207–210PubMedCrossRef
10.
Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL, Finkelstein JS (1998) Hypovitaminosis D in medical inpatients. N Engl J Med 338:777–783PubMedCrossRef
11.
Kinyamu HK, Gallagher JC, Rafferty KA, Balhorn KE (1998) Dietary calcium and vitamin D intake in elderly women: effect on serum parathyroid hormone and vitamin D metabolites. Am J Clin Nutr 67:342–348PubMed
12.
Lips P (1996) Vitamin D deficiency and osteoporosis: the role of vitamin D deficiency and treatment with vitamin D and analogues in the prevention of osteoporosis-related fractures. Eur J Clin Invest 26:436–442PubMedCrossRef
13.
Malabanan A, Veronikis IE, Holick MF (1998) Redefining vitamin D insufficiency. Lancet 351:805–806PubMedCrossRef
14.
Need AG, Horowitz M, Morris HA, Nordin BC (2000) Vitamin D status: effects on parathyroid hormone and 1, 25-dihydroxyvitamin D in postmenopausal women. Am J Clin Nutr 71:1577–1581PubMed
15.
Bischoff-Ferrari HA, Dietrich T, Orav EJ, Dawson-Hughes B (2004) Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med 116:634–639PubMedCrossRef
16.
Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP (2007) A higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 55:234–239PubMedCrossRef
17.
Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, Wong JB (2004) Effect of Vitamin D on falls: a meta-analysis. JAMA 291:1999–2006PubMedCrossRef
18.
Jackson C, Gaugris S, Sen SS, Hosking D (2007) The effect of cholecalciferol (vitamin D3) on the risk of fall and fracture: a meta-analysis. QJM 100:185–192PubMedCrossRef
19.
Endo I, Inoue D, Mitsui T, Umaki Y, Akaka M, Yoshizawa T, Kato S, Matsumoto T (2003) Deletion of vitamin D receptor gene in mice results in abnormal skeletal muscle development with deregulated expression of myoregulatory transcription factors. Endocrinology 144:5138–5144PubMedCrossRef
20.
Mingrone G, Greco AV, Castagneto M, Gasbarrini G (1999) A woman who left her wheelchair. Lancet 353:806PubMedCrossRef
21.
Prabhala A, Garg R, Dandona P (2000) Severe myopathy associated with vitamin D deficiency in western New York. Arch Intern Med 160:1199–1203PubMedCrossRef
22.
Ziambaras K, Dagogo-Jack S (1997) Reversible muscle weakness in patients with vitamin D deficiency. West J Med 167:435–439PubMed
23.
Kenny AM, Biskup B, Robbins B, Marcella G, Burleson JA (2003) Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men. J Am Geriatr Soc 51:1762–1767PubMedCrossRef
24.
Mets T (1994) Calcium, vitamin D, and hip fractures. Incidence of falls may have decreased. BMJ 309:193PubMed
25.
Mowe M, Haug E, Bohmer T (1999) Low serum calcidiol concentration in older adults with reduced muscular function. J Am Geriatr Soc 47:220–226PubMed
26.
Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB, Zhang Y, Karlson EW, Dawson-Hughes B (2004) Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr 80:752–758PubMed
27.
Wicherts IS, van Schoor NM, Boeke AJ, Visser M, Deeg DJ, Smit J, Knol DL, Lips P (2007) Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab 92:2058–2065PubMedCrossRef
28.
Verreault R, Semba RD, Volpato S, Ferrucci L, Fried LP, Guralnik JM (2002) Low serum vitamin d does not predict new disability or loss of muscle strength in older women. J Am Geriatr Soc 50:912–917PubMedCrossRef
29.
Gloth FM 3rd, Smith CE, Hollis BW, Tobin JD (1995) Functional improvement with vitamin D replenishment in a cohort of frail, vitamin D-deficient older people. J Am Geriatr Soc 43:1269–1271PubMed
30.
Johnson KR, Jobber J, Stonawski BJ (1980) Prophylactic vitamin D in the elderly. Age Ageing 9:121–127PubMedCrossRef
31.
Corless D, Dawson E, Fraser F, Ellis M, Evans SJ, Perry JD, Reisner C, Silver CP, Beer M, Boucher BJ et al (1985) Do vitamin D supplements improve the physical capabilities of elderly hospital patients? Age Ageing 14:76–84PubMedCrossRef
32.
Dhesi JK, Jackson SH, Bearne LM, Moniz C, Hurley MV, Swift CG, Allain TJ (2004) Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing 33:589–595PubMedCrossRef
33.
Verhaar HJ, Samson MM, Jansen PA, de Vreede PL, Manten JW, Duursma SA (2000) Muscle strength, functional mobility and vitamin D in older women. Aging (Milano) 12:455–460
34.
Chen TC, Turner AK, Holick MF (1990) Methods for the determination of the circulating concentration of 25-hydroxyvitamin D. J Nutr Biochem 1:315–319PubMedCrossRef
35.
Holick M, Chen T, Jamieson D, Lu Z, Mathieu J (2004) Evaluation of precision and accuracy of Nichols advantage 25-hydroxyvitamin D assay for 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3: in comparison to four other assays methods including liquid chromatography-mass spectrometry. J Bone Miner Res 19:S343CrossRef
36.
Papaioannou A, Ray JG, Ferko NC, Clarke JA, Campbell G, Adachi JD (2001) Estimation of creatinine clearance in elderly persons in long-term care facilities. Am J Med 111:569–573PubMedCrossRef
37.
Geusens P, Vandevyver C, Vanhoof J, Cassiman JJ, Boonen S, Raus J (1997) Quadriceps and grip strength are related to vitamin D receptor genotype in elderly nonobese women. J Bone Miner Res 12:2082–2088PubMedCrossRef
38.
Grundberg E, Brandstrom H, Ribom EL, Ljunggren O, Mallmin H, Kindmark A (2004) Genetic variation in the human vitamin D receptor is associated with muscle strength, fat mass and body weight in Swedish women. Eur J Endocrinol 150:323–328PubMedCrossRef
39.
Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28PubMed
40.
Lips P, Chapuy MC, Dawson-Hughes B, Pols HA, Holick MF (1999) An international comparison of serum 25-hydroxyvitamin D measurements. Osteoporos Int 9:394–397PubMedCrossRef
Metadata
Title
Sex-specific association of serum vitamin D levels with physical function in older adults
Authors
T.-T. L. Dam
D. von Mühlen
E. L. Barrett-Connor
Publication date
01-05-2009
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 5/2009
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0749-1

Other articles of this Issue 5/2009

Osteoporosis International 5/2009 Go to the issue

Original Article

Assessment of vertebral fracture risk and therapeutic effects of alendronate in postmenopausal women using a quantitative computed tomography-based nonlinear finite element method

Original Article

Secular trends in hip fracture incidence and recurrence

Original Article

Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures: a population-based cohort study

Original Article

Predictors of falls among postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA)

Original Article

Olympic fencers: adaptations in cortical and trabecular bone determined by quantitative computed tomography

Letter to the Editor

Comment on Reid et al.: Effect of calcium supplementation on hip fractures