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Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis

Abstract

Summary

This systematic review demonstrates that vitamin D supplementation does not have a significant effect on muscle strength in vitamin D replete adults. However, a limited number of studies demonstrate an increase in proximal muscle strength in adults with vitamin D deficiency.

Introduction

The purpose of this study is to systematically review the evidence on the effect of vitamin D supplementation on muscle strength in adults.

Methods

A comprehensive systematic database search was performed. Inclusion criteria included randomised controlled trials (RCTs) involving adult human participants. All forms and doses of vitamin D supplementation with or without calcium supplementation were included compared with placebo or standard care. Outcome measures included evaluation of strength. Outcomes were compared by calculating standardised mean difference (SMD) and 95% confidence intervals.

Results

Of 52 identified studies, 17 RCTs involving 5,072 participants met the inclusion criteria. Meta-analysis showed no significant effect of vitamin D supplementation on grip strength (SMD −0.02, 95%CI −0.15,0.11) or proximal lower limb strength (SMD 0.1, 95%CI −0.01,0.22) in adults with 25(OH)D levels >25 nmol/L. Pooled data from two studies in vitamin D deficient participants (25(OH)D <25 nmol/L) demonstrated a large effect of vitamin D supplementation on hip muscle strength (SMD 3.52, 95%CI 2.18, 4.85).

Conclusion

Based on studies included in this systematic review, vitamin D supplementation does not have a significant effect on muscle strength in adults with baseline 25(OH)D >25 nmol/L. However, a limited number of studies demonstrate an increase in proximal muscle strength in adults with vitamin D deficiency.

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Correspondence to K. A. Stockton.

Appendix 1—search strategy

Appendix 1—search strategy

The databases, searched with language restrictions (English only) included: MEDLINE, CINAHL, EMBASE, Pubmed, Cochrane Controlled Trials Register, Sportdiscus, Scopus and Full text clinicians’ health journals @ Ovid from the earliest time to May 2010.

Database*

1. Muscle 725,556
2. Vitamin D 46,203
3. Vitamin D2 3,330
4. Vitamin D3 21,590
5. 1-alpha hydroxyvitamin D3 924
6. 1-alpha hydroxycalciferol 6
7. 1,25 dihydroxyvitamin D3 15,436
8. 1,25 dihydroxycholecalciferol 14,828
9. 25 hydroxycholecalciferol 2,901
10. 25 hydroxyvitamin D 3,660
11. Calcitriol 14,347
12. Ergocalciferol 2,791
13. Cholecalciferol 19,270
14. Calcifediol 2,319
15. Alfacalcidiol 871
16. Calcidiol 2,438
17. Calciferol 2,931
18. 2 to 17 “OR” 48,722
19. 1. “AND” 18 1,611
20. 19 limits RCT, clinical trial, meta-analysis, review 315
21. eliminate review 53
22. 21 “AND” English 51

*Medline

Search format repeated for Cinahl, Sportdiscus, Cochrane library, Pubmed and Embase.

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Stockton, K.A., Mengersen, K., Paratz, J.D. et al. Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis. Osteoporos Int 22, 859–871 (2011). https://doi.org/10.1007/s00198-010-1407-y

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Keywords

  • Muscle
  • Muscle fibre
  • Strength
  • Vitamin D