Ultrasonographic measurements of the skin, fat and muscle in vitamin D deficiency

Abstract

Vitamin D is a steroid hormone which is essential for the calcium and phosphorus metabolism as well as the musculoskeletal system health. 1 Of note, its deficiency is related to various diseases and adverse outcomes. 2 Vitamin D is acquired from sunlight exposure, diet and various supplements. Although inadequate synthesis and intake are the main causes of vitamin D deficiency; body composition also affects the circulating vitamin D levels. In this sense, especially adiposity has a negative effect on the vitamin D status. [3][4][5] In the pertinent literature, there are many studies that have investigated the relationship among vitamin D levels and obesity, fat mass and adiposity. 3-6 However, to our best notice, only one study seems to have examined the relationship between skinfold thickness and vitamin D levels. 7 Considering that a significant amount/ part of vitamin D is synthesised in the skin, it would not be unsound to speculate about an association between skin thickness and vitamin D levels. Accordingly, in this study, we aimed to explore the possible relationship among vitamin D levels, body composition (ie, skin, subcutaneous fat and muscle thickness) and functionality. AbstractBackground: Vitamin D is a steroid hormone and it is essential for the musculoskeletal system health. The relationship among vitamin D levels and adiposity was shown.However, there is only one study seems to have examined the relationship between skinfold thickness and vitamin D levels.Methods: A total of 116 healthy subjects who had a recent vitamin D measurement were included. Skin, subcutaneous fat and muscle thicknesses were measured by ultrasound (US). Hand grip strength and usual gait speed were evaluated.Results: Subjects were classified into two groups according to 25-OH vitamin D levels. Skin thicknesses of anterior forearm in women and of anterior tibia in men, and trochanteric fat thicknesses of both genders were higher in lower 25-OH vitamin D group (both P < .05). There were no differences between the groups regarding muscle thicknesses, grip strength and gait speed (all P > .05). For identifying vitamin D deficiency (≤20 ng/mL); optimal skin thickness value was 1.25 mm in women (sensitivity: 91.3%, specificity: 54.7%), and optimal trochanteric fat thickness was 1.79 cm in men (sensitivity: 87.5%, specificity: 76.9). The specificity was increased to 79.2% if the cut-off value was taken as 1.35 mm for anterior forearm skin thickness in women. Conclusion:We imply that skin thicknesses (anterior forearm and tibia) and subcutaneous fat (trochanteric region) increase in subjects with low vitamin D levels. Having also ascertained the relevant cut-off values, we underscore the possible role of these measurements as regards the assessment of vitamin D status. R E FE R E N C E S

The relationship between vitamin D deficiency, body composition, and physical/cognitive functions

“…In the presence of (for instance) decreased muscle tissue and increased adipose tissue, i.e., with no change in BMI, regional US evaluation will be important to reveal such a situation. Likewise, Ata et al [ 28 ] found an inverse relationship between VitD deficiency and trochanteric subcutaneous tissue thickness by using US. In this aspect, considering the concepts of sarcopenia and sarcopenic obesity in addition to VitD deficiency, the importance of regional US evaluation can be better understood [ 29 ].The use of US in dermatology allows more detailed examination of the skin [ 9 , 30 ].…”

“…Although our skin thicknesses were consistent with the literature [ 9 ], we found no difference between the groups. However, a preliminary study including 116 adults, skin thicknesses were found to be higher in the VitD deficient group [ 28 ]. Enrollment of more patients and detailed examination of clinical factors such as VitD usage and season are the superior aspects of our study.…”

Effects of Ageing and Vitamin D Level on Plantar Fascia Stiffness

“…It increases the absorption of calcium, and positively affects bone mineralization and muscle function (16). In addition, vitamin D is a steroid hormone whose importance is known especially for the structure and functions of the musculoskeletal system (17). In adults aged 65 and over, the endogenous synthesis of vitamin D is reduced by 25% compared to young adults (18).…”