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September 21, 2023

Muscle Loss

Low Vitamin D Linked To Low Muscle Mass and Fatty Liver Is Associated With Increased Risk Of Infections

Written by

Dr. Richard Harris

Paper Name: Genetic Variants, Serum 25-Hydroxyvitamin D Levels, and Sarcopenia A Mendelian Randomization Analysis

PMID: 37647062

Sarcopenia (low muscle mass) is projected to affect 2 billion people worldwide by 2050 and currently affects up to 27% of those 60 and older. Sarcopenia increases the risk of developing several diseases, hospitalization, and death. This study sought to examine the association of low vitamin D with the risk of developing sarcopenia.

Compared to individuals with vitamin D levels of 20-29 (not deficient, but not optimal), those with levels less than 10 had a 52% increased risk of sarcopenia and a 32% increased risk of slow walking speed. Levels under 10 were associated with lower grip strength and appendicular lean mass.

The association between sarcopenia and vitamin D in the nonlinear MR analyses showed a 74% increased risk of sarcopenia at a vitamin D level of 10 compared to 20. A level of 30 was associated with an 11% lower risk of sarcopenia compared to a level of 20. They also noted that as vitamin D levels below 20 increased, grip strength and appendicular lean mass progressively increased. This plateaued at 20, indicating a threshold effect. It is estimated that 30% of the worldwide population has a vitamin D level between 10 and 20. It was not uncommon for me to see patients with single-digit vitamin D levels.

Paper Name: Risk of Severe Infection in Patients With Biopsy-proven Nonalcoholic Fatty Liver Disease – A Population-based
Q1 Cohort Study

PMID: 37245712

It's estimated that between 25% to 33% of American adults have NAFLD (recently renamed MASLD), a chronic liver disease caused by excess fat deposition into the liver. MASLD is associated with poor metabolic health and an increased risk of developing cancer, cardiovascular disease, and kidney disease. This study sought to examine the association with MASLD and the incidence of severe infections.

They found a 71% increased risk of severe infections in the group with MASLD, and rates of severe infection increased progressively with MASLD severity. The most frequent increased  infection was respiratory infections, with a 52% increased risk of respiratory infections. The second most common type of severe infections were urinary tract infections.

A sensitivity analysis found that even in those with MASLD without any other parameters of metabolic syndrome, there was a 76% increased risk of severe infection, indicating that MASLD is an independent risk factor for contracting severe infections.

This paper adds to the weight of evidence that we must start taking MASLD seriously and utilizing lifestyle medicine principles to prevent and treat this serious liver disease.

Dr. Richard Harris

MD, PharmD, MBA
Dr. Richard Harris is a board-certified internal medicine physician and pharmacist. Dr. Harris attended the University of Texas at Austin for pharmacy school then pursued medical education at the McGovern School of Medicine in Houston. Dr. Harris became interested in men's health to help men be proactive regarding their health especially in regards to overall hormone health. He currently hosts the Strive for Great Health Podcast, has several online wellness courses, and consults for several companies. He is an avid reader, weight lifter, and video game enthusiast. Dr. Harris also enjoys sports, traveling, philanthropy, church, and keto donuts.

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