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Poor handgrip strength in 5-year-old girls 3X more likely if low vitamin D – May 2018

S-25OHD is Associated with Hand Grip Strength and Myopathy at Five Years in Girls: An Odense Child Cohort Study.

J Clin Endocrinol Metab. 2018 May 16. doi: 10.1210/jc.2018-00281. [Epub ahead of print]


Al-Jwadi RF1,2, Jespersen E3, Dalgård C4, Bilenberg N5, Christesen HT2.
1 The faculty of health sciences, University of Southern Denmark, Odense, Denmark.
2 Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
3 Dept. of Rehabilitation and Research, Odense University Hospital, Denmark.
4 Dept. of Public Health - Environmental Medicine, University of Southern Denmark.
5 Dept. of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern.

CONTEXT:
Severe vitamin D deficiency may lead to myopathy in adults. Little is known about vitamin D and muscle strength in children.

OBJECTIVE:
To test whether hand grip strength (HGS) in 5-year-old-children associates with serum 25-hydroxyvitamin D (s-25OHD) from pregnancy to five years.

METHODS:
Observational study in the population-based Odense Child Cohort, Denmark. At five years, anthropometrics, body fat percentage by skin fold measurements and HGS were obtained (n=881). Myopathy was defined as HGS <10th percentile. S-25OHD2+3 was analyzed with liquid chromatography mass spectrometry (5-y; n=499).

RESULTS:
Mean (SD) HGS was higher for boys compared to girls, 8.76 (1.76) vs. 8.1 (1.64) kg, p<0.001. Mean (SD) 5-year s-25OHD was 70.7 (24.5) nmol/L. HGS was directly associated with height in girls, and with weight (directly) and body fat percentage (inversely) in both sexes (p<0.01 for all). In girls, 5-year s-25OHD was associated with HGS, adjusting for height, weight and body fat percentage, β=0.011 (95% CI 0.004;0.019), p=0.003. S-25OHD ≥75nmol/L associated with higher HGS compared to values <50nmol/L, adjusted β=0.783 (0.325;1.241), p=0.001. The odds of having myopathy were reduced by approximately 70% for s-25OHD ≥50 vs. <50 nmol/L, adjusted odds ratio 0.310 (95% CI 0.126;0.762), p=0.011. No associations were seen for boys. S-25OHD at other time points did not associate with 5-year HGS.

CONCLUSIONS:
Five-year s-25OHD was independently associated with HGS and myopathy in girls, but not in boys. Muscle strength may be dependent on vitamin D status even in the higher range in preschool girls. The sex difference remains unexplained.

PMID: 29788436 DOI: 10.1210/jc.2018-00281

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