ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1576705
Individual and joint association of serum 25-hydroxyvitamin D and folate levels with the risk of sarcopenia: a cross-sectional study from the NHANES 2011-2018
Provisionally accepted
- 1Shanghai University of Medicine and Health Sciences, Shanghai, China
- 2Tsinghua University, Beijing, Beijing, China
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Background: Recent studies have indicated that vitamin D and folate are essential for muscle health and each is independently linked to the prevalence of sarcopenia. However, the potential synergistic effects of vitamin D and folate on sarcopenia have not been extensively studied. This study aims to investigate both the individual and joint associations of serum 25-hydroxyvitamin D [25(OH)D] and folate concentrations with the risk of sarcopenia. Methods: This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES), covering the years 2011 to 2018. Multivariable Logistic regression models were used to determine individual and joint associations of serum 25(OH)D and folate with sarcopenia. Additionally, the relative excess risk due to interaction (RERI) was estimated to assess additivity.Results: A significant inverse relationship was observed between serum 25(OH)D and folate levels in relation to sarcopenia. Specifically, among participants with 25(OH)D levels <50 nmol/L, the Odds ratios (ORs) for sarcopenia were 0.67 (95% CI: 0.56, 0.81) for those with 25(OH)D levels between 50-75 nmol/L, and 0.61 (95% CI: 0.48, 0.77) for those with levels >75 nmol/L. Similarly, when comparing participants in the lowest tertile of folate, the ORs for sarcopenia were 0.74 (95% CI: 0.61, 0.89) for the second tertile and 0.72 (95% CI: 0.59, 0.88) for the third tertile. Among individuals with fasting blood glucose levels <7.0 mmol/L, those with both low levels of 25(OH)D and folate exhibited a significantly higher risk of sarcopenia compared to those with high levels of 25(OH)D and folate. Furthermore, the RERI was statistically significant.In the present study, a synergistic interaction between 25(OH)D and folate was observed in relation to the risk of sarcopenia. These findings contribute new insights into the nutritional factors associated with sarcopenia and pave the way for for future longitudinal studies to further explore this association.
Keywords: 25(OH)D, Folate, Sarcopenia, Joint association, cross-sectional study
Received: 14 Feb 2025; Accepted: 29 May 2025.
Copyright: © 2025 Wei, He, Li, Di, Zhang and Na. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yaping Wei, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
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