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

Institute for Research in Extramural Medicine (M.V., D.J.H.D., P.L.) and Department of Endocrinology (P.L.), VU University Medical Center, 1081 BT Amsterdam, The Netherlands; and Department of Psychiatry (D.J.H.D.), Vrije University, 1075 BG Amsterdam, The Netherlands

Address all correspondence and requests for reprints to: Dr. M. Visser, EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. E-mail: m.visser.emgo{at}med.vu.nl.

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 (<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 (>50 nmol/liter) levels. High PTH levels (4.0 pmol/liter) were associated with an increased risk of sarcopenia, compared with low PTH (<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.

This work was supported by a fellowship of the Royal Netherlands Academy of Arts and Sciences. The Longitudinal Aging Study Amsterdam study is financially supported by the Dutch Ministry of Public Health, Welfare, and Sports.

Abbreviations: ASMM, Appendicular skeletal muscle mass; CI, confidence interval; DXA, dual-energy x-ray absorptiometry; LASA, Longitudinal Aging Study Amsterdam; 1,25-(OH)2D3, 1,25-dihydroxyvitamin D₃; 25-OHD, 25-hydroxyvitamin D.

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