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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2012

Open Access 01-12-2012 | Original investigation

Plasma vitamin D and parathormone are associated with obesity and atherogenic dyslipidemia: a cross-sectional study

Authors: Alba Guasch, Mònica Bulló, Antoni Rabassa, Anna Bonada, Daniel Del Castillo, Fàtima Sabench, Jordi Salas-Salvadó

Published in: Cardiovascular Diabetology | Issue 1/2012

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Abstract

Background

Low concentrations of plasma vitamin D (25(OH)D) have been associated with the development of metabolic syndrome (MetS), obesity, diabetes and cardiovascular disease. The objective of this study was to quantify the associations between 25(OH)D and parathormone (PTH) plasma levels and obesity, the presence of MetS, diabetes or atherogenic dyslipidemia (AD) in a large sample of individuals with different degrees of adiposity.

Methods

Retrospective study of all patients who had attended the obesity clinics in a Spanish hospital between 2009 and 2011, and whose concentrations of PTH, 25(OH)D, calcium and alkaline phosphatase had been determined (n=316, 75.9% women). Individuals were categorized by degree of adiposity, presence of MetS, and other comorbidities.

Results

PTH increased but 25(OH)D and calcium decreased with increasing adiposity. The prevalence of 25(OH)D deficiency or insufficiency increased with obesity (<10% when BMI<45kg/m2, and 26% when >50). The prevalence of hyperparathyroidism increased from 12% in non-obese to 47.5% in morbidly obese individuals with BMI>50 kg/m2. Low plasma 25(OH)D and high PTH concentrations were associated with an increased risk of MetS and AD. These associations disappeared, except in the case of AD for 25(OH)D when adjusting for BMI. Regression analysis revealed that BMI and age or seasonality were independent predictors of PTH and 25(OH)D levels, respectively.

Conclusions

BMI was the variable most strongly associated with plasma 25(OH)D and PTH concentrations in our study. Low 25(OH)D and high PTH concentrations were not independently associated with an increased risk of MetS, or diabetes. Our data support a possible contribution of plasma 25(OH)D to the pathogenesis of hypertriglyceridemia and AD through inflammation.
Literature
1.
2.
Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J, IOF Committee of Scientific Advisors (CSA) Nutrition Working Group: Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009, 20 (11): 1807-1820. 10.1007/s00198-009-0954-6.CrossRefPubMed
3.
4.
Goldner WS, Stoner JA, Thompson J, Taylor K, Larson L, Erickson J, McBride C: Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: a comparison with non-obese controls. Obes Surg. 2008, 18 (2): 145-150. 10.1007/s11695-007-9315-8.CrossRefPubMed
5.
Rodriguez-Rodriguez E, Navia B, Lopez-Sobaler AM, Ortega RM: Vitamin D in overweight/obese women and its relationship with dietetic and anthropometric variables. Obesity (Silver Spring). 2009, 17 (4): 778-782. 10.1038/oby.2008.649.CrossRef
6.
Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF: Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000, 72 (3): 690-693.PubMed
7.
Drincic AT, Armas LA, Van Diest EE, Heaney RP: Volumetric Dilution, Rather Than Sequestration Best Explains the Low Vitamin D Status of Obesity. Obesity (Silver Spring). 2012, 20 (7): 1444-1448. 10.1038/oby.2011.404.CrossRef
8.
Kull M, Kallikorm R, Lember M: Body mass index determines sunbathing habits: implications on vitamin D levels. Intern Med J. 2009, 39 (4): 256-258. 10.1111/j.1445-5994.2009.01900.x.CrossRefPubMed
9.
Gemmel K, Santry HP, Prachand VN, Alverdy JC: Vitamin D deficiency in preoperative bariatric surgery patients. Surg Obes Relat Dis. 2009, 5 (1): 54-59. 10.1016/j.soard.2008.07.008.CrossRefPubMed
10.
Zhao G, Ford ES, Li C: Associations of serum concentrations of 25-hydroxyvitamin D and parathyroid hormone with surrogate markers of insulin resistance among U.S. adults without physician-diagnosed diabetes: NHANES, 2003–2006. Diabetes Care. 2010, 33 (2): 344-347. 10.2337/dc09-0924.PubMedCentralCrossRefPubMed
11.
Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Shaw JE, Zimmet PZ, Sikaris K, Grantham N, Ebeling PR, Daly RM: Serum 25-hydroxyvitamin D, calcium intake, and risk of type 2 diabetes after 5 years: results from a national, population-based prospective study (the Australian diabetes, obesity and lifestyle study). Diabetes Care. 2011, 34 (5): 1133-1138. 10.2337/dc10-2167.PubMedCentralCrossRefPubMed
12.
Bhandari SK, Pashayan S, Liu IL, Rasgon SA, Kujubu DA, Tom TY, Sim JJ: 25-hydroxyvitamin D levels and hypertension rates. J Clin Hypertens (Greenwich). 2011, 13 (3): 170-177. 10.1111/j.1751-7176.2010.00408.x.CrossRef
13.
Karhapaa P, Pihlajamaki J, Porsti I, Kastarinen M, Mustonen J, Niemela O, Kuusisto J: Diverse associations of 25-hydroxyvitamin D and 1,25-dihydroxy-vitamin D with dyslipidaemias. J Intern Med. 2010, 268 (6): 604-610. 10.1111/j.1365-2796.2010.02279.x.CrossRefPubMed
14.
Reddy Vanga S, Good M, Howard PA, Vacek JL: Role of vitamin D in cardiovascular health. Am J Cardiol. 2010, 10 (6): 798-805.CrossRef
15.
Hyppönen E, Boucher BJ, Berry DJ, Power C: 25-hydroxyvitamin D, IGF-1, and metabolic syndrome at 45 years of age: a cross-sectional study in the 1958 British Birth Cohort. Diabetes. 2008, 57 (2): 298-305.CrossRefPubMed
16.
Lee DM, Rutter MK, O'Neill TW, Boonen S, Vanderschueren D, Bouillon R, Bartfai G, Casanueva FF, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean ME, Pendleton N, Punab M, Silman AJ, Wu FC, European Male Ageing Study Group: Vitamin D, parathyroid hormone and the metabolic syndrome in middle-aged and older European men. Eur J Endocrinol. 2009, 161 (6): 947-954. 10.1530/EJE-09-0496.CrossRefPubMed
17.
Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala NB, Clarke A, Franco OH: Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas. 2010, 65 (3): 225-236. 10.1016/j.maturitas.2009.12.013.CrossRefPubMed
18.
Reis JP, von Muhlen D, Kritz-Silverstein D, Wingard DL, Barrett-Connor E: Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care. 2007, 30 (6): 1549-1555. 10.2337/dc06-2438.CrossRefPubMed
19.
Hjelmesaeth J, Hofso D, Aasheim ET, Jenssen T, Moan J, Hager H, Roislien J, Bollerslev J: Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional study. Cardiovasc Diabetol. 2009, 8: 7-10.1186/1475-2840-8-7.PubMedCentralCrossRefPubMed
20.
McGill AT, Stewart JM, Lithander FE, Strik CM, Poppitt SD: Relationships of low serum vitamin D3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity. Nutr J. 2008, 7: 4-10.1186/1475-2891-7-4.PubMedCentralCrossRefPubMed
21.
Salas-Salvado J, Rubio MA, Barbany M, Moreno B, Grupo Colaborativo de la SEEDO: SEEDO 2007 Consensus for the evaluation of overweight and obesity and the establishment of therapeutic intervention criteria. Med Clin (Barc). 2007, 128 (5): 184-196. 10.1016/S0025-7753(07)72531-9. quiz 1 p following 200CrossRef
22.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F, American Heart Association, National Heart, Lung, and Blood Institute: Diagnosis and management of the metabolic syndrome: an American heart association/national heart, lung, and blood institute scientific statement. Circulation. 2005, 112 (17): 2735-2752. 10.1161/CIRCULATIONAHA.105.169404.CrossRefPubMed
23.
Ramel A, Jonsson PV, Bjornsson S, Thorsdottir I: Vitamin D deficiency and nutritional status in elderly hospitalized subjects in Iceland. Public Health Nutr. 2009, 12 (7): 1001-1005. 10.1017/S1368980008004527.CrossRefPubMed
24.
Grethen E, McClintock R, Gupta CE, Jones R, Cacucci BM, Diaz D, Fulford AD, Perkins SM, Considine RV, Peacock M: Vitamin D and hyperparathyroidism in obesity. J Clin Endocrinol Metab. 2011, 96 (5): 1320-1326. 10.1210/jc.2010-2202.PubMedCentralCrossRefPubMed
25.
Osei K: 25-OH vitamin D: is it the universal panacea for metabolic syndrome and type 2 diabetes?. J Clin Endocrinol Metab. 2010, 95 (9): 4220-4222. 10.1210/jc.2010-1550.CrossRefPubMed
26.
Moy FM, Bulgiba A: High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia. BMC Publ Health. 2011, 11: 735-10.1186/1471-2458-11-735.CrossRef
27.
Botella-Carretero JI, Alvarez-Blasco F, Villafruela JJ, Balsa JA, Vazquez C, Escobar-Morreale HF: Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. Clin Nutr. 2007, 26 (5): 573-580. 10.1016/j.clnu.2007.05.009.CrossRefPubMed
28.
Roislien J, Van Calster B, Hjelmesaeth J: Parathyroid hormone is a plausible mediator for the metabolic syndrome in the morbidly obese: a cross-sectional study. Cardiovasc Diabetol. 2011, 10: 17-10.1186/1475-2840-10-17.PubMedCentralCrossRefPubMed
29.
Rueda S, Fernandez-Fernandez C, Romero F, Martinez De Osaba J, Vidal J: Vitamin D, PTH, and the metabolic syndrome in severely obese subjects. Obes Surg. 2008, 18 (2): 151-154. 10.1007/s11695-007-9352-3.CrossRefPubMed
30.
Muldowney S, Kiely M: Vitamin D and cardiometabolic health: a review of the evidence. Nutr Res Rev. 2010, 1: 1-20.
31.
Forouhi NG, Luan J, Cooper A, Boucher BJ, Wareham NJ: Baseline serum 25-hydroxy vitamin d is predictive of future glycemic status and insulin resistance: the medical research council Ely prospective study 1990–2000. Diabetes. 2008, 57 (10): 2619-2625. 10.2337/db08-0593.PubMedCentralCrossRefPubMed
32.
Soares MJ, Ping-Delfos WC, Sherriff JL, Nezhad DH, Cummings NK, Zhao Y: Vitamin D and parathyroid hormone in insulin resistance of abdominal obesity: cause or effect?. Eur J Clin Nutr. 2011, 65 (12): 1348-1352. 10.1038/ejcn.2011.111.CrossRefPubMed
33.
Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, Hu FB: Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006, 29 (3): 650-656. 10.2337/diacare.29.03.06.dc05-1961.CrossRefPubMed
34.
Liu E, Meigs JB, Pittas AG, McKeown NM, Economos CD, Booth SL, Jacques PF: Plasma 25-hydroxyvitamin d is associated with markers of the insulin resistant phenotype in nondiabetic adults. J Nutr. 2009, 139 (2): 329-334.PubMedCentralCrossRefPubMed
35.
Nagpal J, Pande JN, Bhartia A: A double-blind, randomized, placebo-controlled trial of the short-term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle-aged, centrally obese men. Diabet Med. 2009, 26 (1): 19-27. 10.1111/j.1464-5491.2008.02636.x.CrossRefPubMed
36.
von Hurst PR, Stonehouse W, Coad J: Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient - a randomised, placebo-controlled trial. Br J Nutr. 2010, 103 (4): 549-555. 10.1017/S0007114509992017.CrossRefPubMed
37.
Pasco JA, Henry MJ, Nicholson GC, Brennan SL, Kotowicz MA: Behavioural and physical characteristics associated with vitamin D status in women. Bone. 2009, 44 (6): 1085-1091. 10.1016/j.bone.2009.02.020.CrossRefPubMed
38.
Jorde R, Figenschau Y, Emaus N, Hutchinson M, Grimnes G: Serum 25-hydroxyvitamin D levels are strongly related to systolic blood pressure but do not predict future hypertension. Hypertension. 2010, 55 (3): 792-798. 10.1161/HYPERTENSIONAHA.109.143990.CrossRefPubMed
39.
Scragg R, Khaw KT, Murphy S: Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr. 1995, 49 (9): 640-646.PubMed
40.
Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, Felsenfeld A, Levine B, Mehrotra R, Norris K: Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the united states: data from the third national health and nutrition examination survey. Arch Intern Med. 2007, 167 (11): 1159-1165. 10.1001/archinte.167.11.1159.CrossRefPubMed
41.
Delvin EE, Lambert M, Levy E, O'Loughlin J, Mark S, Gray-Donald K, Paradis G: Vitamin D status is modestly associated with glycemia and indicators of lipid metabolism in French-Canadian children and adolescents. J Nutr. 2010, 140 (5): 987-991. 10.3945/jn.109.112250.CrossRefPubMed
42.
Pilz S, Dobnig H, Nijpels G, Heine RJ, Stehouwer CD, Snijder MB, van Dam RM, Dekker JM: Vitamin D and mortality in older men and women. Clin Endocrinol (Oxf). 2009, 71 (5): 666-672. 10.1111/j.1365-2265.2009.03548.x.CrossRef
43.
Al-Daghri NM, Alkharfy KM, Al-Othman A, El-Kholie E, Moharram O, Alokail MS, Al-Saleh Y, Sabico S, Kumar S, Chrousos GP: Vitamin D supplementation as an adjuvant therapy for patients with T2DM: an 18-month prospective interventional study. Cardiovasc Diabetol. 2012, 11 (1): 85-10.1186/1475-2840-11-85.PubMedCentralCrossRefPubMed
44.
Zittermann A, Frisch S, Berthold HK, Gotting C, Kuhn J, Kleesiek K, Stehle P, Koertke H, Koerfer R: Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers. Am J Clin Nutr. 2009, 89 (5): 1321-1327. 10.3945/ajcn.2008.27004.CrossRefPubMed
45.
Andersen R, Brot C, Mejborn H, Molgaard C, Skovgaard LT, Trolle E, Ovesen L: Vitamin D supplementation does not affect serum lipids and lipoproteins in Pakistani immigrants. Eur J Clin Nutr. 2009, 63 (9): 1150-1153. 10.1038/ejcn.2009.18.CrossRefPubMed
46.
Mason C, Xiao L, Imayama I, Duggan CR, Bain C, Foster-Schubert KE, Kong A, Campbell KL, Wang CY, Neuhouser ML, Li L, Jeffery WR, Robien K, Alfano CM, Blackburn GL, McTiernan A: Effects of weight loss on serum vitamin D in postmenopausal women. Am J Clin Nutr. 2011, 94 (1): 95-103. 10.3945/ajcn.111.015552.PubMedCentralCrossRefPubMed
47.
Martinez-Gonzalez MA, Corella D, Salas-Salvado J, Ros E, Covas MI, Fiol M, Warnberg J, Aros F, Ruiz-Gutierrez V, Lamuela-Raventos RM, Lapetra J, Munoz MA, Martinez JA, Saez G, Serra-Majem L, Pinto X, Mitjavila MT, Tur JA, Portillo MP, Estruch R, PREDIMED Study Investigators: Cohort profile: design and methods of the PREDIMED study. Int J Epidemiol. 2012, 41 (2): 377-385. 10.1093/ije/dyq250.CrossRefPubMed
Metadata
Title
Plasma vitamin D and parathormone are associated with obesity and atherogenic dyslipidemia: a cross-sectional study
Authors
Alba Guasch
Mònica Bulló
Antoni Rabassa
Anna Bonada
Daniel Del Castillo
Fàtima Sabench
Jordi Salas-Salvadó
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2012
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/1475-2840-11-149

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