25-Hydroxyvitamin D: A potential marker of the incidence of osteoporosis and sarcopenia in diabetic mellitus patients

Purpose: To investigate the feasibility of using the 25-hydroxyvitamin D (25(OH)D) levels in assessing osteoporosis (OP) and sarcopenia in elderly patients with diabetes mellitus (DM). Methods: One hundred and forty elderly patients with DM were allocated to DM (n = 40), OP (n = 50), and DM + OP (n = 50) groups. Their clinical data were collected, and muscle function assessed. The levels of fasting insulin, glycated hemoglobin (HbAlc), t-P1NP, and 25(OH)D were determined by chemiluminescent microparticle immunoassay, high-pressure liquid chromatography, electrochemical immunoassay, and liquid chromatography-tandem mass spectrometry, respectively. Results: The 25(OH)D levels were lowest in DM + OP group, followed by the OP group, and highest in the DM group (p < 0.05). The DM + OP group showed significantly lower gait speed and grip strength than the OP and DM groups (p < 0.05). The diagnostic AUC of 25(OH)D for OP and sarcopenia were 0.9733 (95 % CI: 0.9274 - 1.000, p < 0.001) and 0.9866 (95 % CI: 0.9632 - 1.000, p < 0.001). Patients with sarcopenia had significantly lower 25(OH)D and t-PINP levels than patients without sarcopenia (p < 0.05). Logistic regression analysis revealed that the 25(OH)D level, duration of DM, and age were independent risk factors for sarcopenia (p < 0.05). Conclusion: Patients with DM and OP exhibit increase in the incidence of sarcopenia. Serum 25(OH)D may be used as a potential marker for the incidence of OP and sarcopenia in DM patients.