A1 Refereed original research article in a scientific journal

The association of frailty with serum 25-hydroxyvitamin D and parathyroid hormone levels in older European men




AuthorsTajar A, Lee DM, Pye SR, O'Connell MDL, Ravindrarajah R, Gielen E, Boonen S, Vanderschueren D, Pendleton N, Finn JD, Bartfai G, Casanueva FF, Forti G, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean MEJ, Punab M, Wu FCW, O'Neill TW

Publication year2013

JournalAge and Ageing

Number in series3

Volume42

Issue3

First page 352

Last page359

Number of pages8

ISSN0002-0729

DOIhttps://doi.org/10.1093/ageing/afs162


Abstract
Background: the link between the vitamin D endocrine axis and frailty remains undefined, with few studies examining the joint effect of vitamin D and parathyroid hormone (PTH) levels. Our objective was to determine the association of frailty with serum 25-hydroxyvitamin D (25(OH) D) and PTH.

Setting: cross-sectional analysis within the European Male Ageing Study (EMAS).

Participants: a total of 1,504 community-dwelling men aged 60-79 years.

Methods: frailty was classified using a frailty phenotype (FP) and frailty index (FI). The association of frailty with 25(OH)D and PTH was examined using multinomial logistic regression; individual FP criteria with 25(OH)D and PTH using binary logistic regression. Results were expressed as relative odds ratios (ROR) and 95% confidence intervals (CIs) for multinomial; odds ratios (OR) and 95% CIs for binary models.

Results: using the FP, 5.0% of subjects were classified as frail and 36.6% as prefrail. Lower levels of 25(OH)D were associated with being prefrail (per 1 SD decrease: ROR = 1.45; 95% CI: 1.26-1.67) and frail (ROR = 1.89; 95% CI: 1.30-2.76), after adjusting for age, centre and health and lifestyle confounders (robust group = base category). Higher levels of PTH were associated with being frail after adjustment for confounders (per 1 SD increase: ROR = 1.24; 95% CI: 1.01-1.52). Comparable results were found using the FI. Among the five FP criteria only sarcopenia was not associated with 25(OH)D levels, while only weakness was associated with PTH.

Conclusion: lower 25(OH)D and higher PTH levels were positively associated with frailty in older men. Prospective data would enable the temporal nature of this relationship to be explored further.



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