Журнал «Боль. Суставы. Позвоночник» 1 (21) 2016
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The role of vitamin D and exercises in correction of age-related skeletal muscle changes in postmenopausal women
Авторы: Povoroznyuk V., Dzerovych N., Balatska N., Belinska A. - Institute of gerontology named after D.F. Chebotarev NAMS Ukraine, Kyiv, Ukraine
Рубрики: Ревматология, Травматология и ортопедия
Разделы: Медицинские форумы
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The article was published on p. 81
The aim of the study was to evaluate the role of vitamin D and exercises in correction of age-related skeletal muscle changes in postmenopausal women.
Materials and methods. 38 postmenopausal women aged 53–82 years (mean age — 67.00 ± 7.08 yrs; mean height — 160.31 ± 6.83 cm; mean weight — 63.25 ± 8.59 kg, body mass index — 24.62 ± 3.09 kg/m2) were examined. All subjects were free of systemic disorders (endocrine, renal, hepatic etc.) and did not take any medications known to affect skeletal and muscle metabolism. The women were divided into the following groups: A — control group (n = 10), B — women who took an individually-targeted vitamin D therapy (n = 11), C — women who took an individually-targeted vitamin D therapy and OTAGO Exercise Programme (http://www.hfwcny.org/Tools/BroadCaster/Upload/Project13/Docs/Otago_Exercise_Programme.pdf) during 12 months. The assessment of the examined women was conducted every 3 months at the medical center. We used the following questionnaires: SARC-F, IADL-questionnaire, frailty scale, Desmond fall risk questionnaire. For evaluation of skeletal muscle function and strength, we assessed the usual gait speed and used hand dynamometry. 25(ОН)D total and iPTH levels were measured by electrochemiluminescent method i.e. Elecsys 2010 analytical system (Roche Diagnostics, Germany) and test-systems cobas. The lean mass was measured by the DXA method (Prodigy, GEHC Lunar, Madison, WI, USA). Statistika 6.0 © StatSoft, Inc. was used for the data processing purposes.
Results. At the baseline, the groups of examined women did not differ in their age, anthropometric characteristics, 25(OH)D values, data of skeletal muscle mass, strength and function. In women of the control group, the mean 25(OH)D level significantly increased after 9 months of observation (9 months — р = 0.03) purportedly due to the seasonal factors. In women of 2nd and 3rd groups, the 25(OH)D level significantly increased after 3, 6, 9 and 12 months of observations (2nd group: 3 months — р = 0.009, 6 months — p = 0.007, 9 months — р = 0.005, 12 months — р = 0.003; 3rd group: 3 months — р < 0.001, 6 months — р < 0.001, 9 months — р < 0.001, 12 months — р < 0.001). The data of SARC-F, IADL-questionnaires did not change during 12 months of observation in women of 1st and 2nd groups; however, in the 3rd group the SARC-F data significantly decreased after 12 months (р = 0,02) while the IADL data — significantly increased after 9 (р = 0.04) and 12 months (р = 0.05). The data of frailty scale and Desmond fall risk questionnaire did not differ in all groups during 12 months. The muscle strength significantly increased after 9 months (р = 0.01) in women of 3rd group while in women of 1st and 2nd group this parameter did not change. The usual gait speed and lean mass assessed by DXA did not change in all groups during 12 months. The fall frequency in women of 1st group significantly increased after 12 months, in women of 2nd group it did not change while in women of 3rd group the fall frequency significantly decreased.
Conclusion. Using individually-targeted vitamin D therapy and OTAGO Exercise Programme during 12 months significantly improves daily activity, muscle strength and decreases the fall frequency in postmenopausal women.