An Xiong, Haibo Li, Miaoying Lin, Feng Xu, Xuedi Xia, Dexing Dai, Ruoman Sun, Yali Ling, Lei Qiu, Rui Wang, Ya Ding, Zhongjian Xie
Journal: Frontiers in endocrinology 2024;15():1327623
PMID: 38362274
There is an increased risk of falls in old age due to the reduction in muscle strength and increased muscle loss. Vitamin D deficiency is considered associated with sarcopenia and decreased muscle strength. Previous research has demonstrated that different forms of vitamin D supplementation can lead to an improvement in muscle strength among elderly individuals, however, results were conflicting. This meta-analysis of twelve randomised controlled trials investigated the effects of different Vitamin D analogues such as calcitriol, alfacalcidol and eldecalcitol, on muscle strength and falls in elderly people. A subgroup analysis was conducted to assess the enhancing effect of calcium supplementation on the effect of vitamin D, either vitamin D alone or vitamin D in combination with calcium. Supplementation with vitamin D analogues significantly improved quadriceps strength and reduced the risk of falls in elderly people. The dosage of vitamin D analogues and the duration of the intervention varied highly between the included studies. Further robust studies are required to evaluate the benefits of Vitamin D and calcium supplements due to the high heterogeneity between the included studies. Healthcare professionals can use the results of this study to understand the effect of different vitamin D analogues in reducing the risk of falls in elderly people.
BACKGROUND
Elderly people are at high risk of falls due to decreased muscle strength. So far, there is currently no officially approved medication for treating muscle strength loss. The active vitamin D analogues are promising but inconsistent results have been reported in previous studies. The present study was to meta-analyze the effect of active vitamin D analogues on muscle strength and falls in elderly people.
METHODS
The protocol was registered with PROSPERO (record number: CRD42021266978). We searched two databases including PubMed and Cochrane Library up until August 2023. Risk ratio (RR) and standardized mean difference (SMD) with 95% confidence intervals (95% CI) were used to assess the effects of active vitamin D analogues on muscle strength or falls.
RESULTS
Regarding the effects of calcitriol (n= 1), alfacalcidol (n= 1) and eldecalcitol (n= 1) on falls, all included randomized controlled trials (RCT) recruited 771 participants. Regarding the effects of the effects of calcitriol (n= 4), alfacalcidol (n= 3) and eldecalcitol (n= 3) on muscle strength, all included RCTs recruited 2431 participants. The results showed that in the pooled analysis of three active vitamin D analogues, active vitamin D analogues reduced the risk of fall by 19%. Due to a lack of sufficient data, no separate subgroup analysis was conducted on the effect of each active vitamin D analogue on falls. In the pooled and separate analysis of active vitamin D analogues, no significant effects were found on global muscle, hand grip, and back extensor strength. However, a significant enhancement of quadriceps strength was observed in the pooled analysis and separate analysis of alfacalcidol and eldecalcitol. The separate subgroup analysis on the impact of calcitriol on the quadriceps strength was not performed due to the lack to sufficient data. The results of pooled and separate subgroup analysis of active vitamin D analogues with or without calcium supplementation showed that calcium supplementation did not affect the effect of vitamin D on muscle strength.
CONCLUSIONS
The use of active vitamin D analogues does not improve global muscle, hand grip, and back extensor strength but improves quadriceps strength and reduces risk of falls in elderly population.
Copyright © 2024 Xiong, Li, Lin, Xu, Xia, Dai, Sun, Ling, Qiu, Wang, Ding and Xie.
© Copyright 2026, Nutrition Evidence
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