EFFECTIVENESS OF 1-YEAR CALCIFEDIOL TREATMENT ON MUSCLE MASS, STRENGTH AND PERFORMANCE IN POSTMENOPAUSAL WOMEN: A PROSPECTIVE COHORT STUDY

Background To date, there is still no clear agreement about the appropriate vitamin D status in order to obtain an optimal effect in terms of muscle performance in individuals with bone fragility. Calcifediol demonstrated to be immediately effective in improving lower extremity function along with the correction of vitamin D deficiency [1]. The objective of this study is to investigate the effectiveness of calcifediol on muscle mass and function and its role in prevention of falls in postmenopausal women. Materials and Methods In this cohort study we included women over 55 with a diagnosis of osteoporosis, osteopenia or vitamin D deficiency [serum 25 (OH)D3 <30 ng/ml]. All participants received calcifediol (20 μg/day) for 12- months. We assessed at baseline, after 6 months, and after 1 year the following parameters: sun exposure, levels of physical activity, alcohol and smoking habits, comorbidity burden, serum 25(OH)D3, calcium and PTH, muscle mass (appendicular lean mass, ALM, by DXA), handgrip strength, the Short Physical Performance Battery (SPPB), and the percentage of fallers during treatment. Moreover, we calculated the number of patients with a ALM/BMI ratio <0.512, handgrip strength <16 kg and 4-meter gait speed<0.8 m/s [2]. Results One-hundred thirteen women were enrolled, with a mean age of 66±8.4 years, and a mean BMI of 25.3±4.1 kg/m2. After 12 months, no statistically significant variations in both mean ALM and percentage of sarcopenic patients, according to ALM/BMI cut-off, occurred at 1-year. On the other hand, statistically significant reduction in the percentage of patients with impaired muscle strength (54.9% vs. 33.6%, 0.001) and of those with reduced walking speeds (64.6 vs 25.7%, <0.001) were reported. At 1-year, a statistically significant decrease of the percentage of fallers (23.9 vs. 13.3%, p<0.040) was reported. Conclusions Our findings suggest that calcifediol is effective in improving muscle strength and performance along with a reduction in percentage of fallers after 1 year of treatment in postmenopausal women. Presumably, the stable increase of serum 25(OH)D3 might have relevant clinical implications that result in better physical performance thus enhancing the prevention of falls. References 1. Bischoff-Ferrari HA et al. Oral supplementation with 25(OH)D3 versus vitamin D3: effects on 25(OH)D levels, lower extremity function, blood pressure, and markers of innate immunity. J Bone Miner Res. 2012 Jan;27(1):160-9. 2. Studenski SA et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014 May;69(5):547-58.