Association between 25-Hydroxyvitamin D Status and Components of Body Composition and Glucose Metabolism in Older Men and Women

Abstract

Obesity and sarcopenia are major causes of morbidity and mortality among seniors. Vitamin D deficiency is very common especially among seniors and has been associated with both muscle health and obesity. This study investigated if 25-hydroxyvitamin D (25(OH)D) status is associated with body composition and insulin resistance using baseline data of a completed RCT among relatively healthy community-dwelling seniors (271 seniors age 60+ years undergoing elective surgery for unilateral total knee replacement due to osteoarthritis). Cross-sectional analysis compared appendicular lean mass index (ALMI: lean mass kg/height m2) and fat mass index (FMI: fat mass kg/height m2) assessed by DXA and insulin resistance between quartiles of serum 25(OH)D concentration using multivariable linear regression adjusted for age, sex, smoking status, physical activity, and body mass index (BMI). Participants in the lowest serum 25(OH)D quartile (4.7–17.5 ng/mL) had a higher fat mass (9.3 kg/m2) compared with participants in the third (8.40 kg/m2; Q3 = 26.1–34.8 ng/mL) and highest (8.37 kg/m2; Q4 = 34.9–62.5 ng/mL) quartile (poverall = 0.03). Higher serum 25(OH)D quartile status was associated with higher insulin sensitivity (poverall = 0.03) and better beta cell function (p = 0.004). Prevalence of insulin resistance tended to be higher in the second compared with the highest serum 25(OH)D quartile (14.6% vs. 4.8%, p = 0.06). Our findings suggest that lower serum 25(OH)D status may be associated with greater fat mass and impaired glucose metabolism, independent of BMI and other risk factors for diabetes.

Effects of Vitamin D3 Supplementation on Body Composition in the VITamin D and OmegA-3 TriaL (VITAL)

“…Although observational studies have shown an association between lower vitamin D status and higher body weight and fat mass, vitamin D supplementation did not improve adiposity measures overall in our large ancillary trial, consistent with most prior intervention studies ( 5 , 6 , 20 , 40 ). One positive intervention study was a double-blind RCT in 218 postmenopausal women engaged in a weight-loss intervention, which found that supplementation of vitamin D 3 resulted in greater weight loss, higher reductions in waist circumference, and greater reduced body fat percentage, in those for whom a total 25(OH)D level of ≥80 nmol/L was achieved ( 18 ).…”

Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study

“…Sarcopenia shares physio-pathological mechanisms, and is associated with a high prevalence of osteoporosis [5,6]. This situation has brought the introduction of the concept of osteosarcopenia, where sarcopenia and osteoporosis overlap resulting in important functional consequences like falls and hip fractures among others [7,8].…”

Effects of Vitamin D Supplementation on Body Composition and Metabolic Risk Factors in Men: A Randomized Controlled Trial

“…Evidence from observational studies has suggested an inverse association of 25(OH)D levels and obesity [8,13,21]. Recently, a cross-sectional analysis including 271 healthy community dwelling seniors found an association of lower 25(OH)D levels with greater fat mass [21]. Further, 25(OH)D was negatively associated with visceral adipose tissue suggesting a link between vitamin D status and fat distribution [13].…”