RESEARCH ARTICLE

Narrative Review of Vitamin D and its Health Enhancing Potential in Older Sarcopenic Adults with or at Risk for Osteoarthritis

Ray Marks 

Osteoarthritis Research Center, Canada

Corresponding Author: Ray Marks. Unit 2, Box 5B, Willowbrook-Charnwood Postal Depot, Markham, Ont L3T, 5H3, Canada. E-mail: [email protected]

Received: May 30, 2025                                                  Published: June 10, 2025

Citation: Marks R. Narrative Review of Vitamin D and its Health Enhancing Potential in Older Sarcopenic Adults with or at Risk for Osteoarthritis. Int J Complement Intern Med. 2025;6(3): 364–373. DOI: 10. 58349/IJCIM. 3. 6. 2025. 00151

Copyright: ©2025 Marks R. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially.

Abstract 

Background: Sarcopenia, a well-established aging correlate impacting muscle and bone mass deficits induces widespread and seemingly intractable and progressive negative impacts on health and longevity in all parts of the world, especially, among older adults with chronic health conditions. 

Aim: The first aim of this article was to examine, summarize, synthesize, and report on the health condition osteoarthritis and its impact and sarcopenic attributes. A second was to uncover if vitamin-D may avert this age associated muscle strength and mass declines in older cases with osteoarthritis. A third was to provide directives for researchers or professionals who work or are likely to work in this realm in the future. 

Methods: All English language relevant publications detailing the possible efficacy of vitamin D as an intervention strategy for minimizing sarcopenia in osteoarthritis cases as published between 2020-2025. Relevant articles were carefully examined and those meeting the review criteria were carefully read, and described in narrative form. 

Results: Collectively, these data reveal vitamin D is a powerful steroid like compound that is required by the body to help many life affirming physiological functions, including optimal muscle and bone mass processes, but its deficiency may seriously impact the health status and well being of the older adult and others, especially those suffering from sarcopenia. 

Conclusion: Since vitamin D is not manufactured by the body directly, ensuring those older adults at high risk for multiple disabling osteoarthritis disease outcomes have access to safe vitamin D exposures may expect clients will benefit physically as well as mentally. 

Keywords: Aging, Osteoarthritis; Muscle Mass, Sarcopenia, Prevention, Vitamin D

References 

1. Cho MR, Lee S, Song SK. A review of sarcopenia pathophysiology, diagnosis, treatment and future direction. J Korean Med Sci. 2022;37(18):e146. 

2. Bo Y, Liu C, Ji Z, et al. A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: a double-blind randomized controlled trial. Clin Nutr. 2019;38(1):159-164. 

3. Okada S, Taniguchi M, Yagi M, et al. Degeneration of the cartilage quality is correlated with a higher intramuscular fat infiltration of the vastus medialis in older adults with pre-to-mild knee osteoarthritis. Eur J Radiol. 2025;183:111930. 

4. Wu Q, Xu Z, Ma X, et al. Association of low muscle mass index and sarcopenic obesity with knee osteoarthritis: a systematic review and meta-analysis. J Int Soc Sports Nutr. 2024;21(1):2352393. 

5. Nguyen A, Lee P, Rodriguez EK, et al. Addressing the growing burden of musculoskeletal diseases in the ageing US population: challenges and innovations. Lancet Healthy Longev. 2025. 

6. Wu T, Wang X, Cai Z, et al.Longitudinal associations between baseline sarcopenia and knee osteoarthritis progression and risk of knee replacement. Arthritis Rheumatol. 2025. 

7. Russo C, Valle MS, D'Angeli F, et al. Resveratrol and vitamin D: eclectic molecules promoting mitochondrial health in sarcopenia. Int J Mol Sci. 2024;25(14):7503. 

8. Fujita S, Lankila H, Koivunen K, et al. Vitamin D sufficiency and its relationship with muscle health across the menopausal transition and aging: Finnish cohorts of middle-aged women and older women and men. Eur J Clin Nutr. 2025. 

9. Spanouda Scimeca M, Centofanti F, Celi M, et al. Vitamin D receptor in muscle atrophy of elderly patients: a key element of osteoporosis-sarcopenia connection. Aging Dis. 2018;9(6):952- 964. 

10. Pleasure D, Wyszynski B, Sumner A, et al. Skeletal muscle calcium metabolism and contractile force in vitamin D-deficient chicks. J Clin Invest. 1979;64(5):1157- 1167. 

11. Papadopoulou SK, Papadimitriou K, Voulgaridou G, et al. Exercise and nutrition impact on osteoporosis and sarcopenia-the incidence of osteosarcopenia: a narrative review. Nutrients. 2021;13(12):4499. 

12. Abiri B, Vafa M. Vitamin D and muscle sarcopenia in aging. Methods Mol Biol. 2020;2138:29-47. 

13. Mi W, Zhang H, Zhang L, et al. Age but not vitamin D is related to sarcopenia in vitamin D sufficient male elderly in rural China. Sci Rep. 2025;15(1):765. 

14. Eggimann AK, de Godoi Rezende Costa Molino C, Freystaetter G, et al. Effect of vitamin D, omega-3 supplementation, or a home exercise program on muscle mass and sarcopenia: DO-HEALTH trial. J Am Geriatr Soc. 2025;73(4):1049-1059. 

15. Wang JJ, Quak GS, Lee HB, et al. The role of vitamin D supplementation in enhancing muscle strength post-surgery: a systemic review. Nutrients. 2025;17(9):1512. 

16. Uchitomi R, Oyabu M, Kamei Y. Vitamin D and sarcopenia: potential of vitamin D supplementation in sarcopenia prevention and treatment. Nutrients. 2020;12(10):3189. 

17. Szewczyk J, Talarek K, Szymonek P, et al. The impact of dietary factors on the outcomes of rehabilitation in individuals diagnosed with sarcopenia. Wiad Lek. 2025;78(3):544-550. 

18. Pegreffi F, Chiaramonte R, Donati Zeppa S, et al. Optimizing the preoperative preparation of sarcopenic older people: the role of prehabilitation and nutritional supplementation before knee arthroplasty. Nutrients. 2024;16(20):3462. 

19. Misra D, Fielding RA, Felson DT, et al. Risk of knee osteoarthritis with obesity, sarcopenic obesity, and sarcopenia. Arthritis Rheumatol. 2019;71(2):232-237. 

20. Scimeca M, Centofanti F, Celi M, et al. Vitamin D receptor in muscle atrophy of elderly patients: a key element of osteoporosissarcopenia connection. Aging and Disease. 2018;9(6):952. 

21. Liao CD, Chen HC, Kuo YC, et al. Effects of muscle strength training on muscle mass gain and hypertrophy in older adults with osteoarthritis: a systematic review and meta-analysis. Arthritis Care Res. 2020;72(12):1703-1718. 

22. Bollen SE, Bass JJ, Fujita S, et al. The vitamin D/vitamin D receptor (VDR) axis in muscle atrophy and sarcopenia. Cell Signal. 2022;96:110355. 

23. Remelli F, Vitali A, Zurlo A, et al. Vitamin D deficiency and sarcopenia in older persons. Nutrients. 2019;11(12):2861. 

24. Vieira FT, Godziuk K, Barazzoni R, et al. Hidden malnutrition in obesity and knee osteoarthritis: assessment, overlap with sarcopenic obesity and health outcomes. Clin Nutr. 2025;48:111- 120. 

25. Sutherland JP, Zhou A, Hyppönen E. Muscle traits, sarcopenia, and sarcopenic obesity: a vitamin D Mendelian randomization study. Nutrients. 2023;15(12):2703. 

26. Giustina A, Giustina A. Vitamin D and hip protectors in osteosarcopenia: a combined hip fracture preventing approach. Rev Endocr Metab Disord. 2025;26(1):1-18. 

27. Peng P, Wu J, Fang W, et al. Association between sarcopenia and osteoarthritis among the US adults: a cross-sectional study. Sci Rep. 2024;14(1):296. 

28. Tay MRJ, Kim JM, Ong PL, et al. Targeting osteosarcopenia and multimorbidity for frailty prevention through identification and deep phenotyping methods in healthy ageing and highburden disease cohorts (OPTIMA-C): a longitudinal observational cohort study protocol for neuromusculoskeletal muscle health. BMJ Open. 2025;15(5):e094279. 

29. Negm A, Roberts B, Vette AH, et al. The effect of sarcopenic obesity on knee biomechanics in individuals with end-stage knee osteoarthritis. Gait Posture. 2025;119:118-126. 

30. Liu S, Hu W, Lin Y, et al. Relationship between paraspinal sarcopenia and lumbar alignment and facet joint osteoarthritis in patients with degenerative lumbar spinal stenosis. Spine (Phila Pa 1976). 

31. Mathieu S, Fayet F, Salembien MH, et al. Grip strength impairment and neuropathic-like pain as predictors of functional decline in hand osteoarthritis. Open Access Rheumatol. 2025;17:47-56. 

32. Kim SY, Cho WS, Park CB, et al. Impact of sarcopenia and functional relationships between balance and gait after total hip arthroplasty. J Clin Med. 2025;14(6):2036. 

33. Liu J, Xia X, Wang Z, et al. Osteosarcopenia, osteoarthritis and frailty: a two sample Mendelian randomization study. Aging Clin Exp Res. 2025;37(1):132. 

34. Tuna S, Kavukçu E, Balcı N. Relationship between sarcopenia, femoral cartilage thickness, and knee osteoarthritis: casecontrol study. Int J Rheum Dis. 2025;28(3):e70179. 

35. Gao J, Yesihati M, Cheng H, et al. Association of sarcopenia and its prognostic value in symptomatic knee osteoarthritis among older people in China: the first longitudinal evidence from CHARLS. BMC Geriatr. 2024;24(1):977. 

36. Yang D, Chen Y, Guo J, et al. The organ-joint axes in osteoarthritis: significant pathogenesis and therapeutic targets. Aging Dis. 2024. 

37. Chiew CL, Mat S, Kamaruzzaman SB, et al. Risk of sarcopenia, hospitalization, and mortality among malaysian older adults with knee pain: five-year follow-up study. Asia Pac J Public Health. 2025;37(1):60-68. 

38. Svarnas G, Popa V, Patsiou TS, et al. Postoperative muscle atrophy and fatty degeneration with respect to surgical approaches in total hip arthroplasty. Arch Orthop Trauma Surg. 2025;145(1):177. 

39. Grosman Y, Kalichman L. The intersection of sarcopenia and musculoskeletal pain: addressing interconnected challenges in aging care. Int J Environ Res Public Health. 2025;22(4):547. 

40. Conzade R, Grill E, Bischoff-Ferrari HA, et al. Vitamin D in relation to incident sarcopenia and changes in muscle parameters among older adults: the KORA-Age Study. Calcif Tissue Int. 2019;105(2):173-182. 

41. Rozmus D, Fiedorowicz E, Płomiński J, et al. Vitamin D binding protein gene polymorphisms (rs4588 and rs7041) and VDBP levels in total hip replacement outcomes. Nutrients. 2025;17(3):378. 

42. Habib AM, Nagi K, Thillaiappan NB, et al. Vitamin D and its potential interplay with pain signaling pathways. Front Immunol. 2020;11:820. 

43. Zhang W, Yu S, Jiao B, et al. Vitamin D3 attenuates neuropathic pain via suppression of mitochondria-associated ferroptosis by inhibiting PKCα/NOX4 signaling pathway. CNS Neurosci Ther. 2024;30(9):e70067. 

44. Manoy P, Yuktanandana P, Tanavalee A, et al. Vitamin D supplementation improves quality of life and physical performance in osteoarthritis patients. Nutrients. 2017;9(8):799. 

45. Montemor CN, Fernandes MTP, Marquez AS, et al. Impact of reduced vitamin D levels on pain, function, and severity in knee or hip osteoarthritis. Nutrients. 2025;17(3):447. 

46. Romeu Montenegro K, Amarante Pufal M, Newsholme P. Vitamin D supplementation and impact on skeletal muscle function in cell and animal models and an aging population: what do we know so far?. Nutrients. 2021;13(4):1110. 

47. Gifondorwa DJ, Thompson TD, Wiley J, et al. Vitamin D and/or calcium deficient diets may differentially affect muscle fiber neuromuscular junction innervation. Muscle Nerve. 2016;54(6):1120-1132. 

48. Krasniqi E, Boshnjaku A, Wagner KH, et al. Exploring the impact of vitamin D related genetic variants on muscular fitness changes in middle-aged and older adults in Kosovo. Front Public Health. 2025;13:1476492. 

49. Lai Z, Jin F, Zhu C, Zhu Z. No independent association between dietary calcium/vitamin D and appendicular lean mass index in middle-aged women: NHANES cross-sectional analysis (2011- 2018). Sci Rep. 2025;15(1):17290. 

50. Ren Q, Liang J, Su Y, et al. A causal effect of serum 25(oh)d level on appendicular muscle mass: evidence from NHANES data and Mendelian randomization analyses. J Cachexia Sarcopenia Muscle. 2025;16(2):e13778. 

51. Zhang F, Li W. Vitamin D and sarcopenia in the senior people: a review of mechanisms and comprehensive prevention and treatment strategies. Ther Clin Risk Manag. 2024;20:577-595. 

52. Chung JY, Kim SG, Kim SH, et al. Sarcopenia: how to determine and manage. Knee Surg Relat Res. 2025;37(1):12. 

53. Kuwabara A, Matsumoto M, Hatamoto Y, et al. Vitamin D and muscle health: insights from recent studies. Curr Opin Clin Nutr Metab Care. 2024;27(6):499-506. 

54. Dominguez LJ, Veronese N, Smith L, et al. Associations between adherence to the Mediterranean diet and incident sarcopenia in prospective cohort studies. Nutrients. 2025;17(2):313. 

55. Bauer JM, Verlaan S, Bautmans I, et al. Effects of a vitamin D and leucine- enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2015;16(9):740-747. 

56. Mende LK, Kuthati Y, Wong CS. Curcumin and vitamin d supplement attenuates knee osteoarthritis progression in ACLT + MMx rat model: effect on cartilage protection and pain reduction. Nutrients. 2025;17(2):349. 

57. Rondanelli M, Klersy C, Terracol G, et al. Whey protein, amino acids, and vitamin D supplementation with physical activity increases fat-free mass and strength, functionality, and quality of life and decreases inflammation in sarcopenic elderly. Am J Clin Nutr. 2016;103(3):830-840.

58. Li G, Kawakami-Shinoda Y, Alima, et al. A combined health promotion program of exercise with protein and vitamin Denriched menu enhances skeletal muscle mass and strength in Japanese elderly men. J Med Invest. 2025;72(1.2):76-84. 

59. Zmerly H, El Ghoch M, Itani L, et al. Personalized nutritional strategies to reduce knee osteoarthritis severity and ameliorate sarcopenic obesity indices: a practical guide in an orthopedic setting. Nutrients. 2023;15(14):3085. 

60. Kawahara T, Inazu T, Mizuno S, et al. Anti-sarcopenic effects of active vitamin D through modulation of anabolic and catabolic signaling pathways in human skeletal muscle: a randomized controlled trial. Metabolism. 2025;168:156240. 

61. Pickering ME, Chapurlat R. Where two common conditions of aging meet: osteoarthritis and sarcopenia. Calcified Tissue Int. 2020;107(3):203-211. 62. Chen S, Han H, Jin J, et al. Osteoarthritis and sarcopenia-related traits: the cross sectional study from NHANES 2011-2014 and Mendelian randomization study. J Orthop Surg Res. 2023;18(1):502. 

63. Jin Z, Wang R, Jin L, et al. Causal relationship between sarcopenia with osteoarthritis and the mediating role of obesity: a univariate, multivariate, two-step Mendelian randomization study. BMC Geriatr. 2024;24(1):469. 

64. Iijima H, Aoyama T. Increased recurrent falls experience in older adults with coexisting of sarcopenia and knee osteoarthritis: a cross-sectional study. BMC Geriatr. 2021;21(1):698. 

65. Gao Q, Hu K, Yan C, et al. Associated factors of sarcopenia in community dwelling older adults: a systematic review and meta-analysis. Nutrients. 2021;13(12):4291. 

66. Mizuno T, Hosoyama T, Tomida M, et al. Influence of vitamin D on sarcopenia pathophysiology: a longitudinal study in humans and basic research in knockout mice. J Cachexia Sarcopenia Muscle. 2022;13(6):2961-2973. 

67. 5ki M, Giaginis C, Mentzelou M, et al. Sarcopenia and sarcopenic obesity and osteoarthritis: a discussion among muscles, fat, bones, and aging. Life (Basel). 2023;13(6):1242. 

68. Vernerová L, Vokurková M, Laiferová NA, et al. Vitamin D and its receptor in skeletal muscle are associated with muscle disease manifestation, lipid metabolism and physical fitness of patients with myositis. Arthritis Res Ther. 2025;27(1):48. 

69. Dzik KP, Kaczor JJ. Mechanisms of vitamin D on skeletal muscle function :oxidative stress, energy metabolism and anabolic state. Eur J Appl Physiol. 2019;119(4):825-839. 

70. Scott J, Yates M, Tanaka T, et al. Cross-sectional associations between clinical biochemistry and nutritional biomarkers and sarcopenic indices of skeletal muscle in the Baltimore Longitudinal Study of Aging. J Nutr. 2025;155(5):1535-1548. 

71. Mani A, Joseph PCP, Choudary D, et al. Vitamin D, PTH, and lipid dysregulation in osteoarthritis: a casecontrol study. J Orthop Case Rep. 2024;14(6):177- 185. 

72. Tang T, Lu T, Li B, et al. Deletion of vitamin D receptor exacerbated temporomandibular joint pathological changes under abnormal mechanical stimulation. Life Sci. 2024;353:122913. 

73. Guan J, Li Z, Niu G, et al. Protective effects of vitamin D on proteoglycans of human articular chondrocytes through TGF-β1 signaling. Nutrients. 2024;16(17):2991. 

74. Ong MT, Tsang KC, Lu VYZ, et al. Effect of serum 25-hydroxyvitamin D level on quadriceps strength: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil. 2024;16(1):215. 

75. Xu Q, Bu F, Song ZT, et al. Association of serum 25- hydroxyvitamin D with sarcopenic obesity risk: a longitudinal observational study from the UK Biobank. Obesity (Silver Spring). 2025;33(6):1136- 1144.