Vitamin D Deficiency and its Role in Muscle-Bone Interactions in the Elderly
- 1.1k Downloads
In this commentary, we focus on common ‘downstream’ links of vitamin D between muscle and bone health. Both direct and indirect effects of 1,25 dihydroxyvitamin D (1,25(OH)D) link the mutual age-related decline in muscle function and bone density, independent of physical activity. Changes in calcium absorption associated with vitamin D deficiency affect both muscle and bone mass. The age-related decline in vitamin D receptor expression and 1,25(OH)D activity impact on proinflammatory cytokines such as tumor necrosis factor -α and interleukin-6 in skeletal muscle and vitamin D deficiency appears to enhance both bone marrow adipogenesis and intramuscular adipose tissue impacting as reduced functionality in both skeletal tissues. Controversial findings on the role of 1,25(OH)D on skeletal muscle may relate to differences in vitamin D receptor expression throughout different stages of muscle cell differentiation. Prolonged vitamin D insufficiency in the elderly is associated with reductions in both bone mineral density and type 2 muscle fibers with the outcomes of skeletal fragility in combination with reduced muscle power, leading to increased risk of falls and fracture.
KeywordsVitamin D deficiency Bone fractures Muscle Sarcopenia Osteoporosis Interaction Elderly Physical function Review
Compliance with Ethics
Conflict of Interest
K. M. Sanders declares no conflicts of interest.
D. Scott declares no conflicts of interest.
P. R. Ebeling declares no conflicts of interest.
Human and Animal Rights and Informed Consent
All studies by the authors involving animal and/or human subjects were performed after approval by the appropriate institutional review boards. When required, written informed consent was obtained from all participants.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 4.•• Edwards MH, Gregson CL, Patel HP, Jameson KA, Harvey NC, Sayer AA, et al. Muscle size, strength and physical performance and their associations with bone structure in the Hertfordshire Cohort Study. J Bone Miner Res. 2013;28(11):2295–304. Relationship between muscle size and bone structure in older adults adds to our understanding. PubMedCrossRefGoogle Scholar
- 6.•• Cawthon PM, Fox KM, Gandra SR, Delmonico MJ, Chiou CF, Anthony MS, et al. Clustering of strength, physical function, muscle, and adiposity characteristics and risk of disability in older adults. J Am Geriat Soc. 2011;59(5):781–7. Clearly written, balanced evidence on muscle and adiposity characteristics. PubMedCentralPubMedCrossRefGoogle Scholar
- 17.Ebeling PR, Daly RM, Kerr DA, Kimlin MG (2013) Building healthy bones throughout life: An evidence-informed strategy to prevent osteoporosis in Australia. Med J Aust;1–9.Google Scholar
- 23.Cranney A, Horsley T, O'Donnell S, Weiler H, Puil L, Ooi D, et al. Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess. 2007;158:1–235.Google Scholar
- 32.Sohl E, van Schoor N, de Jongh R, Visser M, Deeg D, Lips P. Vitamin D status is associated with functional limitations and functional decline in older individuals. J Clin Endocrinol Metabol. 2013.Google Scholar
- 37.Tieland M, Brouwer-Brolsma E, Nienaber-Rousseau C, van Loon L, De Groot L (2013) Low vitamin D status is associated with reduced muscle mass and impaired physical performance in frail elderly people. Eur J Clin Nutrit.Google Scholar
- 39.Sohl E, de Jongh R, Heijboer A, Swart KMA, Brouwer-Brolsma E, Enneman A, et al. Vitamin D status is associated with physical performance: the results of three independent cohorts. Osteoporos Int. 2012;1–10.Google Scholar
- 45.Redzic M, Lewis RM, Thomas DT. Relationship between 25-hydoxyvitamin D, muscle strength, and incidence of injury in healthy adults: a systematic review. Nutrit Res. 2013.Google Scholar
- 47.Janssen HC, Emmelot-Vonk MH, Verhaar HJ, van der Schouw YT. Vitamin d and muscle function: is there a threshold in the relation? JAMDA. 2013;14(8):27.Google Scholar
- 50.• Houston DK, Tooze JA, Neiberg RH, Hausman DB, Johnson MA, Cauley JA, et al. 25-Hydroxyvitamin D status and change in physical performance and strength in older adults the health, aging, and body composition study. Am J Epidemiol. 2012;176(11):1025–34. Change in physical performance is an important aspect often missed in observational studies on vitamin D status. PubMedCrossRefGoogle Scholar
- 54.Lagari V, Gómez‐Marín O, Levis S. The role of vitamin D in improving physical performance in the elderly. J Bone Miner Res. 2013.Google Scholar
- 59.• Ceglia L, Niramitmahapanya S, Morais MD, Rivas DA, Harris SS, Bischoff-Ferrari H, et al. A randomized study on the effect of vitamin D3 supplementation on skeletal muscle morphology and vitamin D receptor concentration in older women. J Clin Endocrinol Metabol. 2013;9:9. Recent evidence for the role of vitamin D supplementation in muscle hypertrophy. Google Scholar
- 67.Ebeling P, Sandgren M, DiMagno E, Lane A, DeLuca H, Riggs B. Evidence of an age-related decrease in intestinal responsiveness to vitamin D: relationship between serum 1, 25-dihydroxyvitamin D3 and intestinal vitamin D receptor concentrations in normal women. J Clin Endocrinol Metabol. 1992;75(1):176–82.Google Scholar
- 69.Scott D, Sanders KM, Ebeling PR. Vitamin D, muscle function, and falls in older adults: does reduced deposition of intramuscular adipose tissue influence the relationship? J Clin Endocrinol Metabol. 2013.Google Scholar
- 71.Marcus RL, Addison O, Dibble LE, Foreman KB, Morrell G, LaStayo P. Intramuscular adipose tissue, sarcopenia, and mobility function in older individuals. J Aging Res. 2012.Google Scholar
- 89.Kim TN, Park MS, Lim KI, Choi HY, Yang SJ, Yoo HJ, et al. Relationships between sarcopenic obesity and insulin resistance, inflammation, and Vitamin D status: the Korean Sarcopenic Obesity Study (KSOS). Clin Endocrinol. 2012.Google Scholar