Low Vitamin D and High Parathyroid Hormone Levels as Determinants of Loss of Muscle Strength and Muscle Mass (Sarcopenia): The Longitudinal Aging Study Amsterdam

TLDR

Age‑related changes in hormone levels are thought to contribute to sarcopenia, the loss of muscle mass and strength with aging. This prospective study examined whether low serum 25‑hydroxyvitamin D and high parathyroid hormone concentrations predict sarcopenia. In 1,008 participants aged 65 + years from the Longitudinal Aging Study Amsterdam, grip strength and appendicular muscle mass were measured at baseline and after three years, with sarcopenia defined as the lowest 15th percentile (≥40 % loss of grip or ≥3 % loss of mass). After adjusting for confounders, low vitamin D (<25 nmol/L) increased the odds of sarcopenia by 2.57 (grip) and 2.14 (mass), while high PTH (≥4.0 pmol/L) raised odds by 1.71 (grip) and 2.35 (mass), with similar effects in men and women, indicating that lower vitamin D and higher PTH elevate sarcopenia risk.

Abstract

Abstract The age-related change in hormone concentrations has been hypothesized to play a role in the loss of muscle mass and muscle strength with aging, also called sarcopenia. The aim of this prospective study was to investigate whether low serum 25-hydroxyvitamin D (25-OHD) and high serum PTH concentration were associated with sarcopenia. In men and women aged 65 yr and older, participants of the Longitudinal Aging Study Amsterdam, grip strength (n = 1008) and appendicular skeletal muscle mass (n = 331, using dual-energy x-ray absorptiometry) were measured in 1995–1996 and after a 3-yr follow-up. Sarcopenia was defined as the lowest sex-specific 15th percentile of the cohort, translating into a loss of grip strength greater than 40% or a loss of muscle mass greater than 3%. After adjustment for physical activity level, season of data collection, serum creatinine concentration, chronic disease, smoking, and body mass index, persons with low (&amp;lt;25 nmol/liter) baseline 25-OHD levels were 2.57 (95% confidence interval 1.40–4.70, based on grip strength) and 2.14 (0.73–6.33, based on muscle mass) times more likely to experience sarcopenia, compared with those with high (&amp;gt;50 nmol/liter) levels. High PTH levels (≥4.0 pmol/liter) were associated with an increased risk of sarcopenia, compared with low PTH (&amp;lt;3.0 pmol/liter): odds ratio = 1.71 (1.07–2.73) based on grip strength, odds ratio = 2.35 (1.05–5.28) based on muscle mass. The associations were similar in men and women. The results of this prospective, population-based study show that lower 25-OHD and higher PTH levels increase the risk of sarcopenia in older men and women.