Use of alfacalcidol in osteoporotic patients with low muscle mass might increase muscle mass: An investigation using a patient database

Abstract

Sarcopenia causes a decline in physical performance and decreased quality of life. However, there is little evidence for effective treatments. Because of the similarities between osteoporosis and sarcopenia, alfacalcidol used for osteoporosis might be beneficial for low muscle mass. Therefore, we investigated the effect of alfacalcidol on muscle mass in patients with low muscle mass. In this retrospective cohort analysis, patients from an osteoporosis database were divided into two groups: alfacalcidol-treated patients (vitamin D group; n = 156) and a control group without drug treatment (n = 233). Muscle mass was evaluated in terms of the skeletal muscle index (SMI; kg/m(2)) obtained from dual-energy X-ray absorptiometry measurements that were taken at the start and end of a 1-year period. Low muscle mass was determined using specific SMI cut-offs for Japanese individuals. Both the vitamin D group (mean age 73.7 ± 9.8 years) and the control group (mean age 72.3 ± 11.9 years) were primarily women (n = 141, 90.4%; n = 189, 81.1%, respectively). Low muscle mass was identified in 32.7% (n = 51) of the vitamin D group and 32.2% (n = 75) of the control group. The mean appendicular SMI in the vitamin D group did not change significantly over the 1-year period. The change was significant among the patients with low muscle mass (5.30 kg/m(2) vs 5.49 kg/m(2)). The mean appendicular SMI in the control group decreased significantly over the 1-year period (6.09 kg/m(2) vs 5.99 kg/m(2)). The change in the patients with low muscle mass was not significant. The vitamin D group maintained muscle mass, and the SMI increased in patients with low muscle mass. Thus, the use of alfacalcidol might be effective in osteoporotic patients with low muscle mass.