Association between vitamin D3 levels and frailty in the elderly: A large sample cross-sectional study

Zitian Zheng; Wennan Xu; Fei Wang; Yudian Qiu; Qingyun Xue

doi:10.3389/fnut.2022.980908

Association between vitamin D3 levels and frailty in the elderly: A large sample cross-sectional study

Front Nutr. 2022 Sep 27:9:980908. doi: 10.3389/fnut.2022.980908. eCollection 2022.

Authors

Zitian Zheng^{1

2}, Wennan Xu³, Fei Wang¹, Yudian Qiu¹, Qingyun Xue^{1

2}

Affiliations

¹ Department of Orthopedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
² Peking University Fifth School of Clinical Medicine, Beijing, China.
³ Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Abstract

Background: Frailty is recognized as a cornerstone of geriatric medicine. Accurately screening and identifying frailty can promote better quality and personalized medical services for the elderly. Previous studies have shown that the association between vitamin D and frailty in the elderly population is still controversial. More research is needed to explore the association between them.

Materials and methods: We used three waves of data from the National Health and Nutrition Examination Survey (NHANES). Based on the widely accepted AAH FRAIL Scale, we measured and evaluated the participants' frailty from five aspects: fatigue, resistance, ambulation, illness, and loss of weight. All possible relevant variables are included. Machine learning XGboost algorithm, the Least Absolute Shrinkage Selection Operator (LASSO) regression and univariate logistic regression were used to screen variables, and multivariate logistic regression and generalized additive model (GAM) were used to build the model. Finally, subgroup analysis and interaction test were performed to further confirm the association.

Results: In our study, XGboost machine learning algorithm explored the relative importance of all included variables, which confirmed the close association between vitamin D and frailty. After adjusting for all significant covariates, the result indicated that for each additional unit of 25-hydroxyvitamin D3, the risk of frailty was reduced by 1.3% with a statisticaldifference. A smooth curve was constructed based on the GAM. It was found that there was a significant negative correlation between 25-hydroxyvitamin D3 and the risk of frailty.

Conclusion: There may be a negative correlation between 25-hydroxyvitamin D3 and the risk of frailty. However, more well-designed studies are needed to verify this relationship.

Keywords: 25-hydroxyvitamin D3; disability; endocrinology; frailty; vitamin D.