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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (3): 448-455. doi: 10.19723/j.issn.1671-167X.2024.03.011

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Relationship between serum 25-hydroxyvitamin D and handgrip strength in middle-aged and elderly people in five cities of Western China

Ting JING1,Hua JIANG2,Ting LI3,Qianqian SHEN1,Lan YE1,Yindan ZENG1,Wenxin LIANG1,Gang FENG3,Man-Yau Szeto Ignatius3,Yumei ZHANG1,*()   

  1. 1. Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing 100191, China
    2. Peking University School of Nursing, Beijing 100191, China
    3. National Dairy Technology Innovation Center, Hohhot 010110, China
  • Received:2024-01-04 Online:2024-06-18 Published:2024-06-12
  • Contact: Yumei ZHANG E-mail:zhangyumei@bjmu.edu.cn
  • Supported by:
    the Study on the Nutrition and Health Status of Adults in Western China(2020-科技兴蒙-国创中心-4)

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Abstract:

Objective: To explore the association between serum 25-hydroxyvitamin D [25(OH)D] and handgrip strength in middle-aged and elderly people in 5 cities of Western China. Methods: Based on the data of a cross-sectional survey conducted in the 5 cities of Western China from February to July 2023, the relevant demographic characteristics of people were collected by questionnaire, handgrip strength was collected by physical examination, and serum 25(OH)D was detected by HPLC-MS/MS. The association between the serum 25(OH)D and handgrip strength was analyzed using Logistic regression and Chi-square test for between-group comparisons models. Results: The prevalence of 25(OH)D deficiency and insufficiency among the middle-aged and elderly people in the 5 cities of Western China was 52.9% and 34.5%, respectively. The people who were older, female, and sampled in winter had lower serum 25(OH)D levels (P < 0.05). The prevalence of loss of handgrip strength among the middle-aged and elderly people was 25.3%. The prevalence of handgrip strength loss was higher in the aged 65-80 participants with 25(OH)D deficiency (45. 0%) than in those with 25(OH)D insufficiency (32.6%) and 25(OH)D sufficiency (20.6%). The highest prevalence of loss of handgrip strength was found in the aged 75-80 participants with 25(OH)D deficiency (62. 1%), followed by the 25(OH)D insufficient group (11.1%, P < 0.05). The study found that middle-aged and elderly people with 25(OH)D deficiency had a 1.4-fold increased risk of handgrip strength loss compared with those with 25(OH)D sufficiency (OR=2.403, 95%CI: 1.202-4.804, P=0.013). No significant association was found between 25(OH)D insufficiency and handgrip strength status in the middle-aged and elderly people. For every 5 μg/L increase in total serum 25(OH)D, the risk of handgrip strength loss reduced by 13.1% (OR=0.869, 95%CI: 0.768-0.982, P=0.025). For every 5 μg/L increase in serum 25(OH)D2, the risk of handgrip strength loss reduced by 24.1% (OR=0.759, 95%CI: 0.582-0.990, P=0.042). No significant association was found between serum 25(OH)D3 levels and the risk of handgrip strength loss. The risk of handgrip strength loss in middle-aged and elderly people was reduced by 25.2% for each incremental increase in the total serum 25(OH)D levels (deficient, insufficient and sufficient) (OR=0.748, 95%CI: 0.598-0.936, P=0.011). The risk of handgrip loss was reduced by 40.0% for each incremental increase in serum 25(OH)D levels in the aged 65-80 and aged 65-69 participants, and by 80.0% for each incremental increase in 25(OH)D levels in the aged 75-80 parti-cipants. Conclusion: Serum total 25(OH)D and 25(OH)D2 levels are associated with handgrip strength status in middle-aged and elderly people in the 5 cities of Western China.

Key words: Western China, Aged, 25-hydroxyvitamin D, Hand strength

CLC Number: 

  • R153.3

Table 1

Basic information of participants"

Items n Constituent ratio/%
Gender
  Male 219 35.1
  Female 405 64.9
Age/years
  45-64 352 56.4
  65-80 272 43.6
  65-69 143 22.9
  70-74 90 14.4
  75-80 39 6.3
Ethnic groups
  Han 397 63.6
  Other ethnic groups 227 36.4
Region
  Northwest 366 58.7
  Southwest 258 41.3
City
  Hohhot 121 19.4
  Erdos 131 21.0
  Chifeng 114 18.3
  Dali 123 19.7
  Lhasa 135 21.6

Table 2

Serum 25(OH)D deficiency in middle-aged and elderly people"

ItemsSerum total 25(OH)D levels, n(%)χ2 value P value
< 20 μg/L 20-30 μg/L ≥30 μg/L
Age/years 0.758 0.684
  45-64 181 (51.4) 126 (35.8) 45 (12.8)
  65-80 149 (54.8) 89 (32.7) 34 (12.5)
Age/years 12.035 0.017
  65-69 67 (46.9) 52 (36.4) 24 (16.8)
  70-74 53 (58.9) 28 (31.1) 9 (10.0)
  75-80 29 (74.4) 9 (23.1) 1 (2.6)
Gender 14.919 0.001
  Male 94 (42.9) 87 (39.7) 38 (17.4)
  Female 236 (58.3) 128 (31.6) 41 (10.1)
Ethnic groups 0.686 0.710
  Han 208 (52.4) 141 (35.5) 48 (12.1)
  Other ethnic groups 122 (53.7) 74 (32.6) 31 (13.7)
Incomea/yuan 8.727 0.068
   < 5 000 233 (55.2) 146 (34.6) 43 (10.2)
  5 000-9 999 79 (49.7) 51 (32.1) 29 (18.2)
  ≥10 000 17 (42.5) 17 (42.5) 6 (15.0)
Level of education 6.312 0.177
  Junior high and below 200 (52.8) 137 (36.1) 42 (11.1)
  High school/secondary/college 112 (55.7) 59 (29.4) 30 (14.9)
  Undergraduate/graduate 17 (40.5) 18 (42.9) 7 (16.7)
City 127.423 < 0.001
  Hohhot 22 (10.3) 54 (47.4) 38 (33.3)
  Erdos 52 (42.3) 56 (45.5) 15 (12.2)
  Chifeng 73 (55.7) 46 (35.1) 12 (9.2)
  Dali 101 (83.5) 19 (15.7) 1 (0.8)
  Lhasa 82 (60.7) 40 (29.6) 13 (9.6)
Region 2.178 0.337
  Northwest 196 (53.6) 119 (32.5) 51 (13.9)
  Southwest 134 (51.9) 96 (37.2) 28 (10.9)
BMI/(kg/m2) 1.888 0.389
   < 18.5 and 18.5-24.0 104 (49.1) 79 (37.3) 29 (13.7)
  24.0-28.0 and ≥28.0 226 (54.9) 136 (33.0) 50 (12.1)
Physical activity 6.055 0.195
  High 26 (40.6) 26 (40.6) 12 (18.8)
  Medium 116 (51.6) 81 (36.0) 28 (12.4)
  Low 188 (56.1) 108 (32.2) 39 (11.6)
Hypertensive 1.006 0.605
  No 208 (54.0) 132 (34.3) 45 (11.7)
  Yes 122 (51.0) 834 (34.7) 34 (14.2)
Smoking 2.829 0.587
  Never smoking 254 (54.7) 153 (33.0) 57 (12.3)
  Quit smoking 39 (49.4) 29 (36.7) 11 (13.9)
  Still smoking 37 (45.7) 33 (40.7) 11 (13.6)
Sampling season 63.016 < 0.001
  Winter 93 (82.3) 19 (16.8) 1 (0.9)
  Spring 134 (51.0) 102 (38.8) 27 (10.3)
  Summer 103 (41.5) 94 (37.9) 51 (20.6)
Total 330 (52.9) 215 (34.5) 79 (12.7)

Table 3

Comparison of handgrip strength in middle-aged and elderly people with different serum 25(OH)D status"

Handgrip strength Total, n(%)Serum total 25(OH)D levels, n(%)χ2 value P value
< 20 μg/L 20-30 μg/L ≥30 μg/L
Normal 466 (74.7) 238 (72.1) 162 (75.3) 66 (83.5) 4.476 0.107
Decreased 158 (25.3) 92 (27.9) 53 (24.7) 13 (16.5)

Table 4

Comparison of handgrip strength loss in middle-aged and elderly people by age groups and serum 25(OH)D status"

Age group/years Handgrip strengtha, n(%)Serum total 25(OH)D levelsb, n(%)χ2 value P value
< 20 μg/L 20-30 μg/L ≥30 μg/L
45-64 55 (15.6) 25 (13.8) 24 (19.0) 6 (13.3) 1.750 0.417
65-80 103 (37.9) 67 (45.0) 29 (32.6) 7 (20.6) 8.562 0.014
65-69 43 (30.1) 24 (35.8) 14 (26.9) 5 (20.8) 2.272 0.321
70-74 41 (45.6) 25 (47.2) 14 (50.0) 2 (22.2) 2.254 0.324c
75-80 19 (48.7) 18 (62.1) 1 (11.1) 0 8.087 0.017c

Table 5

Relationship between serum 25(OH)D levels and handgrip strength loss in middle-aged and elderly people"

Serum total 25(OH)D levels OR (95%CI) P value Adjusted OR (95%CI)a Adjusted P value
< 20 μg/L 1.912 (1.005, 3.635) 0.048 2.403 (1.202, 4.804) 0.013
20-30 μg/L 1.574 (0.803, 3.087) 0.187 1.783 (0.881, 3.610) 0.108
≥30 μg/L 1 1

Table 6

Relationship between different types of serum 25(OH)D levels and handgrip strength loss in middle-aged and elderly people"

Items OR (95%CI) P value Adjusted OR (95%CI)a Adjusted P value
25(OH)D (per 5 μg/L increase) 0.883 (0.791, 0.985) 0.025 0.869 (0.768, 0.982) 0.025
25(OH)D2 (per 5μg/L increase) 0.782 (0.614, 0.994) 0.045 0.759 (0.582, 0.990) 0.042
25(OH)D3 (per 5μg/L increase) 0.945 (0.836, 1.067) 0.359 0.942 (0.819, 1.084) 0.408

Figure 1

Subgroup analysis of 25(OH)D levels and handgrip strength loss in middle-aged and elderly people Logistic regression modeling was used to compare the relationship between increased grades of serum 25(OH)D levels (deficient, insufficient, and sufficient) with decreased handgrip strength, adjusting for confounders including age, gender, BMI, per capita monthly family income, education, physical activity level, and sampling season. n/N, number of participants for a given characteristic/total number of participants. HGS, handgrip strength; 25(OH)D, 25-hydroxyvitamin D; BMI, body mass index."

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