INTRODUCTION: Osteosarcopenia (OS) is a common geriatric condition, which seriously impairs the quality of life of the elderly, but there is a lack of research on its mechanism and treatment. This study explores the efficacy of whole-body vibration (WBV) training plus vitamin D in OS intervention and its correlation with irisin and myostatin (MSTN). METHODS: Subjects meeting the enrollment criteria were recruited from the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine. Forty-eight volunteers were enrolled and divided into a control group and a WBVT group, with 24 in each. The control group takes 0.25 micrograms of calcitriol orally half an hour after breakfast daily. The WBVT group received WBV training 3 times a week in addition to the control treatment for 3 months, followed by a 3-month follow-up. Primary outcomes were lumbar, hip, and forearm bone mineral density (BMD), appendicular skeletal muscle mass measured by dual energy X-ray absorptiometry, and handgrip strength. Secondary outcomes included serum MSTN, irisin, bone turnover markers, physical performance (assessed by 5-time chair stand test, 6-m walk, and SPPB), and adverse events in the trial. RESULTS: Baseline indicators were comparable between the two groups. WBV training with oral vitamin D improved OS patients' BMD muscle mass, strength, and physical function. It increased serum vitamin D, N-MID, tPINP levels and decreased beta-CTX levels. Also, it raised irisin and lowered MSTN levels. CONCLUSION: WBV training in conjunction with oral vitamin D administration is conducive to increasing BMD augmenting muscle mass and strength, as well as improving body function in subjects with OS. The underlying mechanism might be associated with the modulation of myokines such as irisin and MSTN.

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