Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam

The age-related change in hormone concentrations has been hypothesized to play a role in the loss of muscle mass and muscle strength with aging, also called sarcopenia. The aim of this prospective study was to investigate whether low serum 25-hydroxyvitamin D (25-OHD) and high serum PTH concentration were associated with sarcopenia. In men and women aged 65 yr and older, participants of the Longitudinal Aging Study Amsterdam, grip strength (n = 1008) and appendicular skeletal muscle mass (n = 331, using dual-energy x-ray absorptiometry) were measured in 1995-1996 and after a 3-yr follow-up. Sarcopenia was defined as the lowest sex-specific 15th percentile of the cohort, translating into a loss of grip strength greater than 40% or a loss of muscle mass greater than 3%. After adjustment for physical activity level, season of data collection, serum creatinine concentration, chronic disease, smoking, and body mass index, persons with low (<25 nmol/liter) baseline 25-OHD levels were 2.57 (95% confidence interval 1.40-4.70, based on grip strength) and 2.14 (0.73-6.33, based on muscle mass) times more likely to experience sarcopenia, compared with those with high (>50 nmol/liter) levels. High PTH levels (>or=4.0 pmol/liter) were associated with an increased risk of sarcopenia, compared with low PTH (<3.0 pmol/liter): odds ratio = 1.71 (1.07-2.73) based on grip strength, odds ratio = 2.35 (1.05-5.28) based on muscle mass. The associations were similar in men and women. The results of this prospective, population-based study show that lower 25-OHD and higher PTH levels increase the risk of sarcopenia in older men and women.