title: The association of frailty with serum 25-hydroxyvitamin D and parathyroid hormone levels in older European men.
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.
  
  
  METHODS
  cross-sectional analysis within the European Male Ageing Study (EMAS).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Oxford, Oxford, UK.
authors.forename: Abdelouahid
authors.initials: A
authors.lastname: Tajar
authors.forename: David M
authors.initials: DM
authors.lastname: Lee
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Pye
authors.forename: Matthew D L
authors.initials: MD
authors.lastname: O'Connell
authors.forename: Rathi
authors.initials: R
authors.lastname: Ravindrarajah
authors.forename: Evelien
authors.initials: E
authors.lastname: Gielen
authors.forename: Steven
authors.initials: S
authors.lastname: Boonen
authors.forename: Dirk
authors.initials: D
authors.lastname: Vanderschueren
authors.forename: Neil
authors.initials: N
authors.lastname: Pendleton
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Finn
authors.forename: György
authors.initials: G
authors.lastname: Bartfai
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Casanueva
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.forename: Aleksander
authors.initials: A
authors.lastname: Giwercman
authors.forename: Thang S
authors.initials: TS
authors.lastname: Han
authors.forename: Ilpo T
authors.initials: IT
authors.lastname: Huhtaniemi
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kula
authors.forename: Michael E J
authors.initials: ME
authors.lastname: Lean
authors.forename: Margus
authors.initials: M
authors.lastname: Punab
authors.forename: Frederick C W
authors.initials: FC
authors.lastname: Wu
authors.forename: Terence W
authors.initials: TW
authors.lastname: O'Neill
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D016330:Frail Elderly; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010281:Parathyroid Hormone / Q000097:blood*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology
chemical_list: D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D