Effect of Daily Vitamin D3 Supplementation on Muscle Health: An Individual Participant Meta-analysis

J Clin Endocrinol Metab. 2022 Apr 19;107(5):1317-1327. doi: 10.1210/clinem/dgac004.

Abstract

Background: The role of vitamin D on muscle health is debated.

Methods: An individual participant metanalysis of 4 randomized placebo-controlled trials, investigating short-term (3-9months) effects of vitamin D3 in moderate (2800 IU) to high (7000 IU) daily oral doses on muscle health and quality of life (QoL). Inclusion criteria were either obesity (n = 52), newly diagnosed primary hyperparathyroidism (n = 41), Graves' disease (n = 86), or secondary hyperparathyroidism (n = 81).

Results: Overall (n = 260) as well as in a subgroup analysis including only vitamin D insufficient [25(OH)D < 50 nmol/L] individuals (n = 176), vitamin D supplementation did not affect measures of muscle health (isometric muscle strength, Timed Up and Go test, chair rising test, body composition, and balance) or QoL. However, a beneficial effect was present on QoL (physical component score) in vitamin D deficient [25(OH)D < 25 nmol/L] individuals (n = 34). Overall, relative changes in 25(OH)D inversely affected maximum muscle strength in a dose-response manner. Stratified into body mass index </> 30 kg/m2, vitamin D supplementation had divergent effects on isometric muscle strength, with beneficial effects in obese individuals (n = 93) at knee flexion 90° (P = 0.04), and adverse effects in nonobese individuals (n = 167) at handgrip (P = 0.02), knee extension 60° (P = 0.03) and knee flexion 60° (P < 0.01).

Conclusion: Overall, short-term treatment with moderate to high daily doses of vitamin D did not affect muscle health or QoL. A potential beneficial effect was present on muscle strength in severely obese individuals and on QoL in vitamin D deficient individuals. Subgroup analyses, however, suggested negative effects of large relative increases in p-25(OH)D.

Trial registration: ClinicalTrials.gov NCT01037140 NCT00674154 NCT02572960 NCT02384668.

Keywords: individual participant data; meta-analysis; muscle strength; quality of life; vitamin D.

Publication types

  • Meta-Analysis

MeSH terms

  • Cholecalciferol / therapeutic use
  • Dietary Supplements
  • Double-Blind Method
  • Graves Disease* / chemically induced
  • Hand Strength
  • Humans
  • Muscle Strength
  • Muscles
  • Obesity / chemically induced
  • Obesity / drug therapy
  • Postural Balance
  • Quality of Life
  • Time and Motion Studies
  • Vitamin D
  • Vitamin D Deficiency* / drug therapy
  • Vitamins

Substances

  • Vitamins
  • Vitamin D
  • Cholecalciferol

Associated data

  • ClinicalTrials.gov/NCT01037140
  • ClinicalTrials.gov/NCT00674154
  • ClinicalTrials.gov/NCT02572960
  • ClinicalTrials.gov/NCT02384668