Role of Vitamin D in Skeletal Muscle Function*

Boland, Ricardo

doi:10.1210/edrv-7-4-434

Cited by 399 publications

(267 citation statements)

References 71 publications

Supporting

Mentioning

243

Contrasting

Unclassified

Order By: Relevance

“…The low D-hormone serum levels observed with a creatinine clearance of <65 ml/min may also be one reason for the increased osteopenia and osteoporosis observed with low creatinine clearance by other authors [15,16]. Our result enhances the theory suggested by other studies [4,5,6,7,17,18,19,20,21,22] that D-hormone is an independent risk factor for falls [1,2,5,23], and that D-hormone is directly involved in the causal pathogenic pathway of decreased muscle strength related falls [9,23,24]. It has been recently confirmed in VDR gene deleted mice that the absence of VDR causes muscle abnormality independently of secondary metabolic changes, e.g.…”

Section: Discussionsupporting

confidence: 85%

Treatment with alfacalcidol in elderly people significantly decreases the high risk of falls associated with a low creatinine clearance of <65�ml/min

et al. 2004

View full text Add to dashboard Cite

We previously observed that a creatinine clearance (CrCl) of <65 ml/min is a significant and independent risk factor for the number of fallers and falls in a community-dwelling elderly population and postulated that this increased risk is due to the associated significant lower D-hormone serum levels. To test our hypothesis, we investigated in a post hoc analysis of a double-blind randomized study whether treatment with alfacalcidol, a synthetic prodrug of the D-hormone, can reduce the high incidence of fallers and the high risk of falls associated with low CrCl. Of 378 Swiss community-dwelling women (n=191) and men (n=187), aged 70 years and older, 191 received randomly 1 lg capsules of alfacalcidol (AlphaD3: Teva), and 187 received one capsule of placebo daily. With the help of questionnaires we regularly assessed the incidence and frequency of falls. The risk of becoming a faller and the risk of falling were assessed in multivariate-controlled logistic regression models according to treatment groups and according to a CrCl cut-off of 65 ml/min. The presented results are from ITT analyses. In participants with a CrCl of <65 ml/min, the 36 weeks of treatment with alfacalcidol was, compared with placebo, associated with a significant reduction in the number of fallers (14/72 versus 25/70; OR 0.26, 95% CI 0.08-0.80, P=0.019), and a significant reduction of the number of falls (16/72 versus 28/70; OR 0.29, 95% CI 0.09-0.88, P=0.028). No such association was observed in participants with a CrCl of ‡65 ml/min (for fallers 26/120 versus 21/116; OR 0.92 95% CI 0.34-2.52, P=0.875; for falls 32/120 versus 23/116; OR 0.93 95% CI 0.34-2.54, P=0.885). In the placebo group frequency of falls was dependent on CrCl (P=0.006), whereas in the alfacalcidol treatment group frequency of falls was independent of CrCl (P=0.494). No cases of clinically relevant hypercalcemia were observed. In a community-dwelling population of elderly men and women with a CrCl of <65 ml/min, treatment with alfacalcidol can significantly and safely reduce the low CrCl associated increased number of fallers and the high risk of falls.

show abstract

Section: Discussionsupporting

confidence: 85%

Treatment with alfacalcidol in elderly people significantly decreases the high risk of falls associated with a low creatinine clearance of <65�ml/min

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Low 1.25(OH) 2 D 3 serum Fig. 2 Association between 1.25(OH) 2 D 3 (D-hormone) serum levels and creatinine clearance levels and related high normal iPTH levels have been associated with subclinical myopathy [10,11,39]. In one study, 1.25(OH) 2 D 3 has been shown to reduce the release of interleukin 6 (IL-6) from human blood monocytes, while 25(OH)D 3 was ineffective [40].…”

Section: Discussionmentioning

confidence: 99%

“…Both factors-increasing IL-6 and decreasing IGF-I-are synergistic risk factors for functional disability [42]. The results from these studies [9,10,11,28,29,30,40,41,42] suggest that 1.25(OH) 2 D 3 is an independent risk factor for decreased muscle strength [12,13], reduced functional mobility [14], and for falls [8,16,17,43], suggesting a direct involvement of 1.25(OH) 2 D 3 in the causal pathogenic pathway of decreased muscle strength-related falls [39].…”

Section: Discussionmentioning

confidence: 99%

“…Sorenson et al showed that fast-twitch type II muscle fibers atrophy in the absence of 1.25(OH) 2 D 3 and reappear by treatment with alfacalcidol [35]. Analogues of 1.25(OH) 2 D 3 (D-hormone) have been shown to have an effect on muscle power and neuromuscular coordination [39,43,46,47,48]. The results of these studies, as well as our finding that the only significant difference in participants with a low creatinine clearance compared with participants with a creatinine clearance of ‡ 65 ml/min was the difference in mean 1.25(OH) 2 D 3 serum levels, suggest that the main vitamin D-dependent effect on muscle and locomotion comes from the most active form of vitamin D, the 1.25(OH) 2 D 3 (D-hormone).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A new significant and independent risk factor for falls in elderly men and women: a low creatinine clearance of less than 65�ml/min

et al. 2004

View full text Add to dashboard Cite

Objectives: Because impaired renal function is detrimental for the conversion of calcidiol to calcitriol (D-hormone) and since D-hormone analogues have been shown to decrease the risk of falls, we investigated whether creatinine clearance (CrCl) is associated with the number of fallers and falls in elderly men and women. Methods: Within a randomized controlled study, we observed for 36 weeks 186 placebo-treated community-dwelling elderly men and women over 70, in an attempt to determine the influence of baseline CrCl on calcitropic hormone serum levels, as well as the influence of baseline CrCl on the number of fallers and falls over time. With the help of questionnaires, we regularly assessed fall incidence and frequency. The risk of falls and the risk of becoming a faller were assessed in multivariate-controlled logistic regression models according to a cutoff value of the CrCl set at 65 ml/min. Results: At baseline, serum levels of 1.25(OH) 2 D 3 and iPTH were, in multivariate-controlled analyses, significantly associated with CrCl (p<0.0001, p=0.001, respectively), whereas serum levels of 25(OH)D 3 were not associated with CrCl. Below a CrCl of 65 ml/min, 1.25(OH) 2 D 3 serum levels steadily declined. We therefore chose a CrCl of 65 ml/min as cutoff for further analyses. During the 36 weeks of observation, elderly people with a CrCl of <65 ml/min had, in multivariate controlled analyses, compared with elderly with a CrCl of ‡65 ml/min, a significantly higher incidence of number of fallers (25/70 vs 21/116; OR=4.01; 95% CI, 1.48-10.98; p=0.006), and a significantly higher incidence of falls (28/70 vs 23/ 116; OR=3.68; 95% CI, 1.38-9.82; p=0.009). Conclusions: For the first time we showed that in a communitydwelling population of elderly men and women, a CrCl of less than 65 ml/min is a significant and independent risk factor for fallers and falls.

show abstract

“…This secondary hyperparathyroidism can result in increased bone turnover and bone loss mainly from cortical sites such as the femoral neck (Gloth, 1995;Schmidt-Gayk et al, 1997;Gloth, 1999). Impaired vitamin D status has also been shown to affect muscle strength (Boland, 1986), body sway and risk of falling (Stein et al, 1999). It has been recognized for some time that at temperate latitudes serum 25OHD exhibits an annual cyclic variation, with a peak in late summer and a nadir in late winter.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D insufficiency in older female community-dwelling acute hospital admissions and the response to supplementation

et al. 2006

View full text Add to dashboard Cite

Objectives: A significant proportion of the older population may exhibit vitamin D insufficiency. We sought to establish the proportion of 25-hydroxyvitamin D (25OHD) insufficient individuals in an older female cohort presenting for acute medical admission and how they responded to supplementation. Design: A prospective cohort study. Setting: Hospital admissions followed up as a population-based study. Subjects: A total of 114 consecutive female acute medical admissions aged over 65 years from November 2003 to January 2004 were enrolled. All admissions with hypercalcaemia, metabolic bone disease (other than osteoporosis/osteomalacia) and creatinine 4150 mmol/l were excluded. Interventions: iPTH, calcium and 25OHD levels were measured in each patient. Of the total, 22 were already receiving calcium and vitamin D supplementation at enrolment. The remaining 92 were commenced on 800 IU of vitamin D and 1 g calcium, and levels were reassessed after supplementation for 3 months. Results: 25-Hydroxyvitamin D insufficiency, as defined by a 25OHD concentration of o50 nmol/l, was present in 86 (75.4%) patients at initial assessment (mean 35.8 nmol/l, s.d. 23.3). Secondary hyperparathyroidism was present in only 36.7% of those with 25OHD deficiency at baseline. Of the total, 51 (44.7%) patients presented for follow-up. 25-Hydroxyvitamin D concentration increased in this group from 42.1 nmol/l (s.d. 26.6) to 59.5 nmol/l (s.d. 27.4) after supplementation, Po0.001, but 18(35.3%) still remained deficient. There was no significant change in iPTH or calcium following supplementation. Assessment of compliance revealed 6 (11.7%) admitted to partial or non-compliance. Conclusions: Insufficiency of 25OHD was very common in this cohort. Despite calcium and vitamin D supplementation, 25OHD concentrations failed to reach normality in a significant proportion. Maintaining vitamin D and calcium intake at the level of current recommended doses may not be sufficient to ensure adequate 25OHD stores.

show abstract

Role of Vitamin D in Skeletal Muscle Function*

Cited by 399 publications

References 71 publications

Treatment with alfacalcidol in elderly people significantly decreases the high risk of falls associated with a low creatinine clearance of <65�ml/min

Treatment with alfacalcidol in elderly people significantly decreases the high risk of falls associated with a low creatinine clearance of <65�ml/min

A new significant and independent risk factor for falls in elderly men and women: a low creatinine clearance of less than 65�ml/min

Vitamin D insufficiency in older female community-dwelling acute hospital admissions and the response to supplementation

Contact Info

Product

Resources

About