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Differences in vitamin D concentration between metabolically healthy and unhealthy obese adults: Associations with inflammatory and cardiometabolic markers in 4391 subjects
Affiliation:1. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran;2. Department of Public Health, Tehran University of Medical Sciences, Iran
Abstract:
AimThis study aimed to compare concentrations of serum 25-hydroxy vitamin D and inflammatory markers in metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO), and to determine whether the relationship between vitamin D levels and both cardiometabolic and inflammatory markers differs between MHO and MUO.MethodsThis cross-sectional study comprised 4391 obese subjects aged > 18 years. A panel of cardiometabolic and inflammatory markers, including anthropometric variables, glycaemic indices, lipid profiles, liver enzymes, homocysteine, C-reactive protein (CRP), fibrinogen and serum 25-hydroxy vitamin D levels, was investigated. All cardiometabolic and inflammatory markers in MHO and MUO as well as in vitamin D deficiency were compared.ResultsPrevalence of MHO was 41.9% in our obese subjects using International Diabetes Federation criteria. Considering insulin resistance and inflammation, the prevalence of MHO was 38.4%. Individuals with MHO had significantly higher vitamin D concentrations compared with MUO, and this difference in vitamin D status persisted after accounting for BMI and waist circumference. Subjects with MHO had significantly better metabolic status, lower liver enzymes, lower inflammatory markers and higher serum 25-hydroxy vitamin D than those with MUO. Associations between vitamin D levels and inflammatory and cardiometabolic markers differed according to MHO/MUO status. Among MUO subjects, vitamin D deficiency was associated with higher liver marker and homocysteine levels. Serum vitamin D was negatively associated with fasting plasma glucose and HbA1c in MHO only.ConclusionSerum 25-hydroxy vitamin D levels were lower in MUO vs MHO, and reduced vitamin D concentrations were more strongly associated with cardiometabolic and inflammatory markers in MUO than in MHO subjects. These findings suggest that a deficiency in vitamin D could be a key component of MUO.
Keywords:Vitamin D  Metabolic syndrome  Obesity  MetS"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0025"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  the metabolic syndrome  MHO"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0035"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  metabolically healthy obesity  MUO"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0045"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  metabolically unhealthy obesity  DM"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0055"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  diabetes mellitus  NAFLD"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0065"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  non-alcoholic fatty liver disease  BMI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0075"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  body mass index  HDL-C"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0085"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  high-density lipoprotein cholesterol  LDL-C"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0095"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  low-density lipoprotein cholesterol  TG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0105"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  triglyceride  FPG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0115"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  fasting plasma glucose  HOMA"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0125"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  homoeostasis model assessment  glycated haemoglobin  HTN"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0145"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  hypertension  CRP"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0155"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  C-reactive protein  ALT"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0165"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  alanine transaminase  AST"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0175"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  aspartate transaminase  ALP"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kw0185"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  alkaline phosphatase
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