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. 2021 Oct 14;13(10):3589.
doi: 10.3390/nu13103589.

The Optimal Strategy of Vitamin D for Sarcopenia: A Network Meta-Analysis of Randomized Controlled Trials

Shih-Hao Cheng  1   2   3 , Kee-Hsin Chen  4   5   6   7 , Chiehfeng Chen  5   8   9   10 , Woei-Chyn Chu  1 , Yi-No Kang  5   8   11   12
Affiliations

The Optimal Strategy of Vitamin D for Sarcopenia: A Network Meta-Analysis of Randomized Controlled Trials

Shih-Hao Cheng et al. Nutrients. .

Abstract

Sarcopenia is a disease of gradual loss of muscle mass in elderly people, and the most common treatment options include nutritional supplementation and exercise. Vitamin D has potential beneficial effects for skeletal muscle tissue and has often been included in nutritional therapy formulations. However, the therapeutic effect of vitamin D for the treatment of sarcopenia has not yet been determine and there is a lack of high-quality supporting evidence. We searched three databases for randomized controlled trials (RCTs) on this topic. Changes in hand grip strength, gait speed, chair-stand test, fat mass, relative skeletal muscle index, and muscle mass were assessed for analysis. Network meta-analysis was further employed, based on the frequentist approach. Outcomes were reported as weighted mean differences (WMD) with 95% confidence intervals (CIs). A total of 9 RCTs (n = 1420) met our eligibility criteria, which treated patients with vitamin D (D), protein (P, n = 165), exercise (E, n = 124), iso-caloric product (I, n = 226), usual care without nutritional supplement (n = 65), P + D (n = 467), D + E (n = 72), P + E (n = 69), D + E + I (n = 73), and P + D + E (n = 159). The pooled estimate showed that the P + D + E intervention induced a greater improvement in hand grip strength than iso-caloric product intervention (WMD = 3.86; 95%CI, 0.52-7.21). Vitamin D intervention could lead to shorter chair-stand time (WMD = -1.32; 95%CI, -1.98 to -0.65), but no significant findings could be found for gait speed and muscle mass outcomes. Our synthesis found that combining vitamin D supplementation with protein supplementation and exercise can significantly increase grip strength and also showed a trend toward increasing muscle mass. This result implies that adding vitamin D to a standard treatment protocol for sarcopenia may be helpful for regaining function.

Keywords: gait speed; grip strength; muscle mass; sarcopenia; vitamin D.

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Conflict of interest statement

S.-H.C., K.-H.C., C.C., W.-C.C., Y.-N.K. declare that they have nothing to disclose regarding financial or non-financial conflicts of interest with respect to this manuscript.

Figures

Figure 1
Figure 1
Flowchart of this synthesis. RCT, randomized clinical trial.
Figure 2
Figure 2
Network graphs of (A) main functional outcome (changes in hand grip) and (B) main body compositional outcome (muscle mass). D, vitamin D; E/Ex, exercise; Iso, iso-caloric product; P, protein.
Figure 3
Figure 3
Forest plots of (A) change in hand grip and (B) time to chair-stand test, and (C) rainbow plot of P-scores. CI, confidence interval; D, vitamin D; E/Ex, exercise; Iso, iso-caloric product; P, protein; RSMI, relative skeletal muscle index; WMD, weighted mean difference.
Figure 4
Figure 4
Funnel plots of (A) change in hand grip, (B) change in gait speed, and (C) appendicular muscle mass.
See this image and copyright information in PMC

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