Correlation Between Vitamin D Deficiency And Sarcopenia In Elderly Female Patients With Primary Osteoporosis

Objective:The degree of vitamin D deficiency in Chinese women is uneven.The prevalence of sarcopenia(SP)and osteoporosis(OP)is gradually increasing,causing falls,fractures,serious disability and mortality.There are relatively few domestic studies on this.Vitamin D plays a key role in the metabolism of skeletal muscle system.By comparing the differences of grip strength,walking speed,whole-body muscle content and bone mineral density in elderly female patients with primary osteoporosis at different levels of serum 25(OH)D3,this study discusses the correlation between serum 25(OH)D3deficiency and sarcopenia,so as to improve people’s understanding,provide a certain clinical basis for the prevention of musculoskeletal diseases,and reduce the disability and mortality of osteoporosis and sarcopenia,Improve people’s quality of life.Methods:1.A total of 94 elderly female patients(aged ≥ 60 years)with primary osteoporosis who were treated in the Department of endocrinology of Shanxi Provincial People’s Hospital from August 2020 to August 2021 were selected.According to the level of serum 25(OH)D3,they were divided into group A(20ng / ml ≤ serum 25(OH)D3 <30ng / ml,a total of 31 cases),group B(10NG / ml ≤ serum 25(OH)D3 < 20 ng / ml,a total of 37 cases),group C(serum 25(OH)D3 < 10 NG / ml,A total of 26 cases).2.The age,height(CM),weight(kg),body mass index(BMI,kg / m2),menopausal age,combined diseases,medication history,smoking history,drinking history and other general data of the patients were recorded.3.The BMD and T values of lumbar spine(L1-L4),left femoral neck and left total hip joint were measured by dual energy X-ray absorptiometry(DXA).The limb skeletal muscle mass index [ASMI,limb skeletal muscle mass(kg)/ height 2(M2)] measured by DXA was the muscle mass index,the grip strength value(kg)measured by grip dynamometer was the muscle strength index,and the daily walking speed(M / s)measured by stopwatch was the physical fitness index.4.All patients fasted for 8 hours after 10 p.m.and took the serum from the elbow vein in the morning of the second day.After collecting the serum samples,they immediately sent them to the laboratory of the laboratory department of our hospital.The blood biochemical indexes such as Ca,P,Mg,ALP,PTH,serum 25(OH)D3,total type I collagen amino terminal lengthening peptide(PINP),n-segment middle Osteocalcin(OC)β-Collagen specific sequence(β-CTX)and other indicators,and statistical indicators such as the prevalence of sarcopenia in each group.5.Use statistical software spss26 0 software processes data,records and analyzes results.Results:1.Comparison of general data among groups: there was no significant difference in age,height,weight and menopausal age among groups a,B and C(P > 0.05).2.Comparison of indicators among groups:2.1 comparison of blood biochemistry(CA,P,Mg,PTH,ALP): there was no significant difference in blood Ca,P,PTH and ALP between groups a,B and C(P > 0.05).The blood mg of group C was higher than that of group A and group B(P < 0.05).2.2 bone metabolism indexes(OC,PINP β-CTX)comparison: Blood OC,PINP β-There was no significant difference in CTX(P > 0.05).2.3 comparison of BMD and T values: there was no significant difference in BMD and T values of lumbar spine(L1-L4),left femoral neck and left total hip among groups a,B and C(P > 0.05).2.4 comparison of ASMI,grip strength and walking speed: with the decrease of serum 25(OH)D3 level,the levels of ASMI,grip strength and walking speed among groups a,B and C gradually decreased.Group A was higher than group B and C,group B was higher than group C,and the prevalence of sarcopenia gradually increased.Group C was higher than groups A and B,and group B was higher than group A.the difference was statistically significant(P < 0.05).3.Correlation analysis between serum 25(OH)D3 and lumbar spine(L1-L4),left femoral neck,left total hip BMD,ASMI,grip strength and walking speed3.1 serum 25(OH)D3 was positively correlated with BMD of lumbar spine(L1-L4)(r = 0.962,P < 0.001),left femoral neck(r = 0.953,P < 0.001)and left total hip(r =0.259,P = 0.015).3.2 serum 25(OH)D3 was positively correlated with ASMI(r = 0.473,P < 0.001),grip strength(r = 0.408,P < 0.001)and walking speed(r = 0.645,P < 0.001).4.ASMI was positively correlated with BMD of lumbar spine(L1-L4)(r = 0.443,P< 0.001),left femoral neck(r = 0.300,P = 0.003),left total hip(r = 0.319,P = 0.002),grip strength was positively correlated with BMD of lumbar spine(L1-L4)(r = 0.441,P< 0.001),left femoral neck(r = 0.298,P = 0.004),left total hip(r = 0.315,P = 0.002),and walking speed was positively correlated with BMD of lumbar spine(L1-L4)(r = 0.369,P< 0.001),left femoral neck(R = 0.213,P = 0.040)There was a positive correlation between BMD of left total hip joint(r = 0.269,P = 0.009).5.Taking serum 25(OH)D3 as the independent variable and ASMI,grip strength and gait speed as the dependent variables,multiple linear regression analysis was used to adjust for confounding factors such as age,BMI and biochemical indexes.The results showed that the lack of serum 25(OH)D3 was a risk factor for the decline of ASMI,grip strength and gait speed and the increase of the prevalence of sarcopenia.6.The test variable is serum 25(OH)D3 value,and the state variable is whether the elderly postmenopausal female patients with primary osteoporosis are complicated with sarcopenia(yes = 1,no = 0).The area under the ROC curve is 0.811,P < 0.05.The optimal threshold for predicting the occurrence of sarcopenia in serum 25(OH)D3deficiency was 14.925ng/ml,the sensitivity was 0.727 and the specificity was 0.769.Conclusion:1.Serum 25(OH)D3 level in elderly postmenopausal women with primary osteoporosis is positively correlated with ASMI,grip strength and walking speed,and negatively correlated with the prevalence of sarcopenia.Vitamin D deficiency is a risk factor for the increase of the prevalence of sarcopenia.2.For elderly patients with primary osteoporosis,serum 25(OH)D3,ASMI,grip strength and walking speed are positively correlated with bone mineral density of lumbar spine(L1-L4),left femoral neck and left total hip joint.Vitamin D deficiency and sarcopenia are the risk factors of osteoporosis.3.The best predictive value of serum 25(OH)D3 concentration for the diagnosis of sarcopenia in elderly postmenopausal women with primary osteoporosis is 14.925ng/ml,which provides a new idea for clinical vitamin D supplementation in the prevention and treatment of sarcopenia.4.The degree of serum 25(OH)D3 deficiency is related to the blood magnesium level.The blood magnesium level is relatively high in patients with severe vitamin D deficiency,and the magnesium nutritional status is closely related to the vitamin D nutritional status.