Skeletal muscle strength in young Asian Indian females after vitamin D and calcium supplementation: a double-blind randomized controlled clinical trial.
BACKGROUND
Randomized control trials (RCT) of the effect of vitamin D/calcium supplementation on skeletal muscle strength have not shown promising effect in the elderly.


OBJECTIVE
Our objective was to assess the effect of vitamin D and/or calcium on muscle strength in young adults with vitamin D deficiency.


METHODS
We conducted a RCT using a factorial design at a tertiary-care center from September 2010 to April 2011.


METHODS
A total of 173 healthy females with mean age, body mass index, and 25-hydroxyvitamin D [25(OH)D] of 21.7 ± 4.4 yr, 20.8 ± 2.96 kg/m(2), and 9.3 ± 3.37 ng/ml, respectively, were block randomized to 1) double placebo, 2) calcium/placebo, 3) cholecalciferol/placebo, and 4) cholecalciferol/calcium for 6 months. Cholecalciferol was given at 60,000 IU/wk for 8 wk followed by 60,000 IU/fortnight. Elemental calcium was given in doses of 500 mg twice per day for 6 months.


METHODS
Assessment included hand grip (primary outcome) and pinch grip strength, distance walked in 6 min, dyspnea score, quality of life by Short Form (36) Health Survey (SP-36), serum 25(OH)D, 1,25-dihydroxyvitamin D, and intact PTH.


RESULTS
The serum 25(OH)D increased significantly to 29.9 ± 8.35 and 27.0 ± 9.54 ng/ml in two groups on cholecalciferol. The mean hand grip strength (19.4 ± 3.92, 21.1 ± 3.31, 20.6 ± 3.92, and 20.1 ± 4.00 kg) and its increase from baseline (0.3 ± 2.25, 0.3 ± 2.64, -0.3 ± 2.41, and 0.6 ± 2.30 kg) were comparable in four groups at 6 months. Quality of life, urinary calcium/creatinine ratio, and adverse effects were also comparable in groups.


CONCLUSIONS
Oral cholecalciferol/calcium supplementation in the dose/schedule used is effective and safe in increasing and maintaining serum 25(OH)D. However, this does not lead to improved skeletal muscle strength in young females.
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, India. gosravinder@hotmail.com
Ravinder
R
Goswami
Manju
M
Vatsa
Vishnubhatla
V
Sreenivas
Upinderpal
U
Singh
Nandita
N
Gupta
Ramakrishnan
R
Lakshmy
Sameer
S
Aggarwal
Arthi
A
Ganapathy
Poonam
P
Joshi
Himani
H
Bhatia
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044466:Asian People; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000494:pharmacology*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005080:Exercise Test; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007194:India / Q000208:ethnology; D053580:Muscle Strength / Q000187:drug effects* / Q000502:physiology; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000502:physiology; D010919:Placebos; D014807:Vitamin D / Q000008:administration & dosage / Q000494:pharmacology*; D055815:Young Adult
D002136:Calcium, Dietary; D010919:Placebos; D014807:Vitamin D