ORIGINAL ARTICLE   Free

European Journal of Physical and Rehabilitation Medicine 2018 October;54(5):676-82

DOI: 10.23736/S1973-9087.17.04533-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Can vitamin D deficiency influence muscle performance in postmenopausal women? A multicenter retrospective study

Giovanni IOLASCON ¹ ✉, Giulia L. MAURO ², Pietro FIORE ³, Carlo CISARI ⁴, Maria G. BENEDETTI ⁵, Lorenzo PANELLA ⁶, Alessandro DE SIRE ¹, Dario CALAFIORE ¹, Antimo MORETTI ¹, Francesca GIMIGLIANO ⁷

¹ Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, Naples, Italy; ² Department of Surgical, Oncologic and Stomatologic Disciplines, University of Palermo, Palermo, Italy; ³ Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; ⁴ Department of Physical Medicine and Rehabilitation, University Hospital “Maggiore della Carità”, Novara, Italy; ⁵ Unit of Physical Medicine and Rehabilitation, Rizzoli Orthopedic Institute, Bologna, Italy; ⁶ Department of Rehabilitation and Functional Recovery, Gaetano Pini Orthopedic Institute, Milan, Italy; ⁷ Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy

BACKGROUND: The presence of the vitamin D receptor (VDR) has been recently demonstrated in human muscle supporting the theory of a role of vitamin D in the proliferation and differentiation of muscle cells. So far only few studies investigated the association between vitamin D and muscle performance in postmenopausal women.
AIM: To define the functional impact of vitamin D deficiency.
DESIGN: Multicenter retrospective study.
SETTING: Five Italian outpatient services of Physical and Rehabilitation Medicine (PRM).
POPULATION: Postmenopausal women.
METHODS: We divided the population in two groups based on the threshold of 30 ng/mL as cut-off to define sufficient and insufficient serum levels of 25-hydroxyvitamin D3 [25(OH)D3]. Outcome measures were: appendicular lean mass (ALM); ALM-to-BMI ratio (ALMBMI); total fat mass (FM); visceral adipose tissue (VAT); Hand Grip Strength (HGS); Knee Isometric Extension Strength (KES); Short Physical Performance Battery (SPPB); 4-meter gait speed (4MGS).
RESULTS: We analyzed the data records of 401 postmenopausal women (mean age 66.93±8.47 years): 203 with hypovitaminosis D (mean age 66.81±8.11 years) and 198 with normal levels of 25(OH)D3 (mean age 67.04±8.84 years). The analysis showed a significant difference between the two groups in terms of: ALMBMI (0.002), FM (P<0.001), VAT mass (0.010), VAT volume (P=0.006), HGS (P<0.001), KES (P<0.001), SPPB score (P<0.001), percentage of people with a 4MGS≤0.8 m/s (P<0.001). Furthermore, there were significant correlations (P<0.001) between serum levels of 25(OH)D3 and HGS (r=0.323), KES (r=0.510), and SPPB sit to stand (r=-0.362) and walking sub-scores (r=-0.312).
CONCLUSIONS: This multicenter study demonstrated that postmenopausal women with vitamin D deficiency had a significant reduction of appendicular muscle strength and physical performance.
CLINICAL REHABILITATION IMPACT: This study reported the frequency of hypovitaminosis D in postmenopausal women and its influence on the reduction of muscle mass, strength, and physical performance in a typical population referring to the physiatrist for musculoskeletal disorders.

KEY WORDS: Vitamin D - Vitamin D deficiency - Sarcopenia - Muscle strength