- •Vitamin D plus protein supplementation increases muscle strength in patients with sarcopenia.
- •There is no evidence of improvement in muscle mass and performance by vitamin D plus protein in patients with sarcopenia.
- •Further RCTs are needed to clarify the optimal dose and duration of vitamin D and/or protein supplementation on sarcopenia indices.
The exact effect of vitamin D supplementation, either as monotherapy or in combination with protein, on musculoskeletal health in patients with sarcopenia is currently unknown. This study aimed to determine the effect of vitamin D alone or with protein supplementation on muscle strength, mass, and performance in this population.
A comprehensive search was conducted in Medline, Cochrane Central and Scopus databases, up to March 31st, 2020. Data were expressed as standardized mean difference (SMD) with 95 % confidence intervals (CI). I2 index was employed for heterogeneity.
The initial search identified 1164 studies, eight of which met the eligibility criteria for qualitative and quantitative analysis, yielding a total of 776 patients. Vitamin D (100–1600 IU/day) plus protein (10–44 g/day) supplementation exhibited a beneficial effect on muscle strength, as demonstrated by an improvement in handgrip strength (SMD 0.38 ± 0.07, 95 % CI 0.18–0.47, p = 0.04; I2 76.2 %) and a decrease in the sit-to-stand time (SMD 0.25 ± 0.09, 95 % CI 0.06–0.43, p = 0.007; I2 0%) compared with placebo. However, the effect on muscle mass, assessed by skeletal muscle index, was marginally non-significant (SMD 0.25 ± 0.13, 95 % CI -0.006–0.51, p = 0.05; I2 0%). No effect on appendicular skeletal muscle mass or muscle performance (assessed by walking speed) was observed with vitamin D plus protein.
Vitamin D supplementation, combined with protein, improves muscle strength in patients with sarcopenia, but has no effect on muscle mass or performance.
Abbreviations:CI (confidence intervals), SMD (standardized mean difference), PRISMA (preferred reporting items for systematic reviews and meta-analyses), PROSPERO (Prospective Register of Systematic Reviews), PICO (P: Population, I: Intervention or Exposure, C: Comparison, O: Outcome), rcts (randomized clinical trials), EWGSOP (European Working Group on Sarcopenia in Older People), AWGS (Asian Working Group for Sarcopenia), SD (standard deviation), 25(OH)D (25-hydroxy-vitamin D), HS (handgrip strength), ASMM (appendicular skeletal muscle mass), ALMM (appendicular lean muscle mass), SMI (skeletal muscle index), STSt (sit-to-stand time), BCAA (branched-chain amino acids), VDR (vitamin D receptor)
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Published online: January 11, 2021
Accepted: January 6, 2021
Received in revised form: January 2, 2021
Received: October 26, 2020
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