Association between serum 25-hydroxyvitamin D levels and adiposity measurements in the general Korean population

BACKGROUND/OBJECTIVES

Obesity, which is a known risk factor for many chronic diseases, has also been associated with vitamin D deficiency. This study explored the relationship between serum 25-hydroxy-vitamin D [25(OH)D] concentrations and adiposity measures in a general Korean population using the most recent, nationally representative survey data.

SUBJECTS/METHODS

The study sample consisted of 4,771 Korean adults (≥ 19 years) who participated in the fifth Korean National Health and Nutrition Examination Surveys. Serum 25(OH)D was determined by radioimmunoassay. Body mass index (BMI), waist circumference (WC) and total body fat content were measured as adiposity measurements. Total body fat content was measured by dual-energy X-ray absorptiometry.

RESULTS

The serum 25(OH)D level was significantly higher in men than in women. Serum 25(OH)D concentration was positively correlated with energy intake, and it was negatively correlated with total body fat content (P < 0.0001) and percentage body fat (P < 0.0001) after adjustment for age in both sexes, while was inversely correlated with BMI only in women. In multivariable regression analysis, serum 25(OH)D was inversely associated with the total body fat content after adjustment for age, BMI, education, region, smoking, alcohol consumption, physical activity, and energy intake only in men (P = 0.0047). However, the serum 25(OH)D concentration was not associated with WC or BMI, indicators of adiposity after adjustment for potential risk factors.

CONCLUSIONS

Serum 25(OH)D concentration was independently associated with the total body fat content in a general Korean population, but it may be not associated with the indicators for estimating adiposity, such as WC or BMI.     

Association between night-shift work and serum 25-hydroxyvitamin D levels in Japanese male indoor workers: a cross-sectional study

Although low vitamin D status resulting from night work is a suspected cause of various health disorders, few studies have investigated the association between night-shift work and vitamin D status. Here, we examined serum 25-hydroxyvitamin D (25OHD) levels in 19 Japanese indoor workers, including night-shift workers, in blood samples collected at the annual medical checkup (late July) in a metal tool factory. Analyses were finally restricted to 14 male workers (33-59 yr) in 3 groups: fixed daytime work (n=6), and rotating shift work with (n=4) and without (n=4) night shifts. No significant differences in serum 25OHD levels were observed among the three groups (p=0.98, Kruskal-Wallis test). One to two participants in each group had 25OHD levels lower than the 20 ng/ml reference value for vitamin D deficiency even in summer. These results clearly indicate the need for large-scale studies to test the hypothesis that night-shift work is associated with lower 25OHD levels.     

苏州成人血清维生素D、甲状旁腺激素、钙与血糖升高的关系

目的探讨血清25-羟基维生素D(25-OH-D)、甲状旁腺激素(PTH)及血清钙与血糖升高之间的关系。方法于2013年按照整群随机抽样的方法从苏州市4个社区抽取621名40～75岁成年居民,收集人口统计学等资料,测量身高、体重和血压,检测空腹血糖、25-OH-D、PTH、钙、磷等指标。结果与25-OH-D10.0μg/L者相比,25-OH-D介于10.0～19.9μg/L及≥20.0μg/L者的空腹血糖水平及血糖升高发生率均偏低(P0.001)。PTH≥65.0 ng/L者与65.0 ng/L者的血糖水平及血糖升高发生率差异无统计学意义。与血清钙为2.03～2.54 mmol/L者相比,血清钙≥2.54 mmol/L者的血糖水平均较高(P0.001),而血糖升高者比例却随着血清钙浓度的增加而增加。多因素Logistic回归分析发现,25-OH-D为10.0～19.9μg/L组及≥20.0μg/L组血糖升高的危险性分别为10.0μg/L组的0.467倍(95%CI 0.311～0.703,P0.001)和0.402倍(95%CI 0.205～0.790,P=0.008);血清钙≥2.54 mmol/L组血糖升高的危险性是2.03～2.54 mmol/L组的1.884倍(95%CI 1.272～2.791,P=0.001)。结论维生素D缺乏、血清钙浓度的升高会增加血糖升高的危险性。     

Association between body weight and composition and plasma 25-hydroxyvitamin D level in the Diabetes Prevention Program

Objective

We examined associations between body weight and plasma 25-hydroxyvitamin D concentration (25OHD) in prediabetes and sought to estimate the impact of adiposity on these associations.

Methods

The study was conducted in the placebo (n = 1082) and intensive lifestyle (n = 1079) groups of the Diabetes Prevention Program (DPP), a multicenter trial to prevent type 2 diabetes in adults with prediabetes. Weight and 25OHD were measured at baseline, month 6, years 1 and 2. In a subset (n = 584), visceral (VAT) and subcutaneous (SAT) adiposity were assessed by computed tomography at baseline and year 1.

Results

In cross-sectional analyses, baseline body weight, total fat, VAT, and SAT were inversely associated with plasma 25OHD concentration after multivariable adjustment. VAT accounted for 40 % [95 % CI 11, 69] of the association of body weight with plasma 25OHD concentration. There was no significant contribution by total fat or SAT. Two-year changes in plasma 25OHD concentration varied inversely with changes in body weight (p < 0.0001). One-year changes in total fat, VAT, or SAT were not significant mediators of the association between change in plasma 25OHD concentration and body weight.

Conclusion

Our study found an inverse association between body weight and plasma 25OHD concentration at baseline and over a 2-year period in adults with prediabetes. These findings in the DPP, a weight loss intervention study, raise the possibility that weight loss increases plasma 25OHD concentration. Whether adiposity mediates this association remains inconclusive.

     

Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study

The relation between the plasma level of 25-hydroxyvitamin D3, the main metabolite of sun-induced vitamin D, and myocardial infarction (MI) was investigated in a community-based case-control study. Some 179 MI patients presenting to hospital within 12 hours of the onset of symptoms were individually matched with controls by age, sex and date of blood collection. MI patients had significantly lower mean 25-hydroxyvitamin D3 levels than controls (32.0 versus 35.5 nmol/L; p = 0.017), with the case-control differences being greatest in winter and spring. The relative risk of MI for subjects with 25-hydroxyvitamin D3 levels equal to or above the median was 0.43 (95% confidence limits = 0.27, 0.69) compared to subjects below the median. The decrease in MI risk associated with raised vitamin D3 levels was observed in all seasons. These results provide support for the hypothesis that increased exposure to sunlight is protective against coronary heart disease.     

Variation of 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2 levels in human plasma obtained from 758 Japanese healthy subjects

Plasma levels of 25-hydroxyvitamin D3 (25-OH-D3) and 25-hydroxyvitamin D2 (25-OH-D2) in 758 Japanese healthy subjects (most of them adults) were determined by a high-performance liquid chromatographic method previously reported (6) and the following results were obtained: The mean and standard deviation (M +/- SD) of the assayed values of 25-OH-D (sum of 25-OH-D3 and 25-OH-D2) was 23.8 +/- 10.1 ng/ml. 25-OH-D3 was detected in all the samples and the M +/- SD was 23.0 +/- 10.1 ng/ml. The plasma levels clearly showed the seasonal variation that the levels in summer were significantly higher than those in winter. Moreover, the plasma levels were significantly correlated with the amounts of UV light in solar radiation. These results strongly suggested that 25-OH-D3 in plasma mainly originated from endogenous vitamin D3 formed by photo-conversion of 7-dehydrocholesterol in skin. 25-OH-D2 was detected only in 18.3% of the plasma samples and the M +/- SD in the detected samples was 4.4 +/- 2.9 ng/ml which was much lower than those of 25-OH-D3. The results suggested that few healthy Japanese are taking daily exogenous vitamin D2 from multivitamin preparations or others. The M +/- SD values of 25-OH-D3 plasma levels in men and women were 26.2 +/- 10.4 and 19.3 +/- 8.0 ng/ml, respectively. The formers were significantly higher than the latters. The results were thought to be due to the reason that men might be outdoors for longer periods than women. When age variation of plasma 25-OH-D3 levels was examined, the levels in the twenties were significantly lower than the other generations. This was confirmed to be due to the low values observed in the female twenties group, but the detailed reason is unclear at the present time. When 4 healthy volunteers were orally administered 400 I.U./day of vitamin D2 every day for 8 weeks, maximum levels (average: 11.5 ng/ml) were observed at the 8 weeks and the levels gradually decreased after stopping the administration. The results suggested that the half life of 25-OH-D2 in plasma might be 4-5 weeks.     

Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation

BACKGROUND: Vitamin D has been shown to have immunomodulatory effects in in vitro and in animal studies. However, data from clinical studies of inflammatory diseases are scarce. OBJECTIVE: The purpose of this study was to evaluate the association between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and gingival inflammation. DESIGN: We analyzed data from 77,503 gingival units (teeth) in 6700 never smokers aged 13 to >90 y from the third National Health and Nutrition Examination Survey. Multiple logistic regression models adjusted for subject- and site-specific covariates included age, sex, race-ethnicity, income, body mass index, diabetes, use of oral contraceptives and hormone replacement therapy among women, intake of vitamin C, missing teeth, full crown coverage, presence of calculus, frequency of dental visits, and dental examiner and survey phase. Generalized estimating equations were used to account for correlated observations within subjects. RESULTS: Compared with sites in subjects in the lowest 25(OH)D quintile, sites in subjects in the highest 25(OH)D quintile were 20% (95% CI: 8%, 31%) less likely to bleed on gingival probing (P for trend < 0.001). The association appeared to be linear over the entire 25(OH)D range, was consistent across racial or ethnic groups, and was similar among men and women as well as among users and nonusers of vitamin and mineral supplements. CONCLUSIONS: Vitamin D may reduce susceptibility to gingival inflammation through its antiinflammatory effects. Gingivitis may be a useful clinical model to evaluate the antiinflammatory effects of vitamin D.     

血清25-羟维生素D水平与2型糖尿病的关系

目的 研究血清维生素D水平在2型糖尿病发病过程中的作用。方法采用随机分层抽样,共589例志愿者纳入本研究。根据空腹血糖及口服葡萄糖耐量试验结果将志愿者区分为糖尿病人群及非糖尿病人群。共计249例检测了血清25-羟维生素D水平,应用二元Logistic回归分析糖尿病与相关因素的关系,应用Cox—Staurt趋势检验分析各年龄段血清25-羟维生素D水平,按血清25（OH）D四分位值分层,分别计算糖尿病患病优势比OR值及95％置信区间。结果所有年龄段均存在不同程度的25-羟维生素D缺乏,调节年龄、HOMA．IR、BMI后,血清25．羟维生素D水平与糖尿病发病呈剂量依赖的负相关（r=-0．9271,P〈0．01）,当血清25-羟维生素D水平达到94．6nmol／L以上时,糖尿病发病显著降低[OR=0．52,95％CI（0．23—0．78）,P〈0．01]。结论血清25-羟维生素D水平与2型糖尿病发病呈明显负相关,血清25-羟维生素D水平降低增加糖尿病发病风险。     

Association between plasma 25-hydroxyvitamin D and colorectal adenoma according to dietary calcium intake and vitamin D receptor polymorphism

The anticarcinogenic potential of vitamin D might be mediated by not only calcium metabolism but also other mechanisms initiated by vitamin D receptor (VDR). The authors measured plasma 25-hydroxyvitamin D in healthy volunteer examinees who underwent total colonoscopy in Tokyo, Japan, 2004-2005, and evaluated its influence on colorectal adenoma, both alone and in interaction with VDR polymorphisms, which correspond to the FokI and TaqI restriction sites. The main analysis of plasma 25-hydroxyvitamin D included 737 cases and 703 controls. Compared with the lowest quintile of plasma 25-hydroxyvitamin D, only the highest was related to a significantly decreased odds ratio of colorectal adenoma (odds ratio = 0.64, 95% confidence interval: 0.45, 0.92). In contrast, all but the lowest quintile of dietary calcium intake presented similarly reduced odds ratios (odds ratio for the highest = 0.67, 95% confidence interval: 0.47, 0.95). Of note, the association between plasma 25-hydroxyvitamin D levels and colorectal adenoma was modified by the TaqI polymorphism of the VDR gene (P(interaction) = 0.03) but not by dietary calcium intake (P(interaction) = 0.93). These observations highlight the importance of vitamin D in colorectal tumorigenesis. Vitamin D might protect against colorectal neoplasia, mainly through mechanisms other than the indirect mechanism via calcium metabolism.     

Serum 25-hydroxyvitamin D levels and the risk of depression: A systematic review and meta-analysis

Objective

No quantitative systematic review or meta-analysis of population-based epidemiological studies has been conducted to assess the association between serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of depression. This study aimed to summarize the current evidence from cross-sectional and prospective cohort studies that have evaluated the association between 25(OH)D levels and the risk of depression.

Methods

Relevant studies were identified by systematically searching the PubMed, EMBASE, Web of Science, and PsycINFO databases through April 2012. Cross-sectional and cohort studies that reported adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association of interest were included. The reported risk estimates for 25(OH)D categories were recalculated, employing a comprehensive trend estimation from summarized dose-response data. A pooled OR was calculated separately for cross-sectional and cohort studies using random-effects models.

Results

In the meta-analysis, 25(OH)D levels were significantly inversely associated with depression in 5 of 11 case-control studies and 2 of 5 cohort studies. The pooled estimate of the adjusted OR of depression in 11 cross-sectional studies (n = 43,137) was 0.96 (95% CI = 0.94–0.99, I² = 63%) for a 10 ng/ml increase in 25(OH)D levels. The 5 included cohort studies comprised 12,648 participants, primarily elderly individuals, whose serum 25(OH)D levels were measured, and 2,663 experienced depression events during follow-up. The pooled adjusted OR of depression was 0.92 (95% CI = 0.87–0.98, I² = 50%) for a 10 ng/ml increase in 25(OH)D levels.

Conclusions

Our results indicate an inverse association between serum 25(OH)D levels and the risk of depression. Further studies are warranted to establish whether this association is causal.     

Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population

BACKGROUND: Periodontal disease (PD) is a common chronic inflammatory disease and an important risk factor for tooth loss. Vitamin D might affect periodontal disease risk via an effect on bone mineral density (BMD) or via immunomodulatory effects. OBJECTIVE: The objective was to evaluate whether serum 25-hydroxyvitamin D(3) [25(OH)D(3)] concentrations are associated with PD in the third National Health and Nutrition Examination Survey. DESIGN: We analyzed data on periodontal attachment loss (AL) and serum 25(OH)D(3) concentrations from 11 202 subjects aged > or =20 y. Mean AL was modeled in a multiple linear regression with quintile of serum 25(OH)D(3) concentration as an independent variable. The model was stratified by age and sex and was adjusted for age within age groups, race or ethnicity, smoking, diabetes, poverty income ratio, body mass index, estrogen use, and gingival bleeding. RESULTS: 25(OH)D(3) concentrations were significantly and inversely associated with AL in men and women aged > or =50 y. Compared with men in the highest 25(OH)D(3) quintile, those in the lowest quintile had a mean AL that was 0.39 mm (95% CI: 0.17, 0.60 mm) higher; in women, the difference in AL between the lowest and highest quintiles was 0.26 mm (0.09, 0.43 mm). In men and women younger than 50 y, there was no significant association between 25(OH)D(3) and AL. The BMD of the total femoral region was not associated with AL and did not mediate the association between 25(OH)D(3) and AL. CONCLUSIONS: Low serum 25(OH)D(3) concentrations may be associated with PD independently of BMD. Given the high prevalence of PD and vitamin D deficiency, these findings may have important public health implications.     

Hip fracture risk in relation to vitamin D supplementation and serum 25-hydroxyvitamin D levels: a systematic review and meta-analysis of randomised controlled trials and observational studies

Background  

Vitamin D supplementation for fracture prevention is widespread despite conflicting interpretation of relevant randomised controlled trial (RCT) evidence. This study summarises quantitatively the current evidence from RCTs and observational studies regarding vitamin D, parathyroid hormone (PTH) and hip fracture risk.     

Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford

OBJECTIVE: To compare fracture rates in four diet groups (meat eaters, fish eaters, vegetarians and vegans) in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford). DESIGN: Prospective cohort study of self-reported fracture risk at follow-up. SETTING: The United Kingdom. SUBJECTS: A total of 7947 men and 26,749 women aged 20-89 years, including 19,249 meat eaters, 4901 fish eaters, 9420 vegetarians and 1126 vegans, recruited by postal methods and through general practice surgeries. METHODS: Cox regression. RESULTS: Over an average of 5.2 years of follow-up, 343 men and 1555 women reported one or more fractures. Compared with meat eaters, fracture incidence rate ratios in men and women combined adjusted for sex, age and non-dietary factors were 1.01 (95% CI 0.88-1.17) for fish eaters, 1.00 (0.89-1.13) for vegetarians and 1.30 (1.02-1.66) for vegans. After further adjustment for dietary energy and calcium intake the incidence rate ratio among vegans compared with meat eaters was 1.15 (0.89-1.49). Among subjects consuming at least 525 mg/day calcium the corresponding incidence rate ratios were 1.05 (0.90-1.21) for fish eaters, 1.02 (0.90-1.15) for vegetarians and 1.00 (0.69-1.44) for vegans. CONCLUSIONS: In this population, fracture risk was similar for meat eaters, fish eaters and vegetarians. The higher fracture risk in the vegans appeared to be a consequence of their considerably lower mean calcium intake. An adequate calcium intake is essential for bone health, irrespective of dietary preferences. SPONSORSHIP: The EPIC-Oxford study is supported by The Medical Research Council and Cancer Research UK.     

Predicted 25-hydroxyvitamin D score and change in fasting plasma glucose in the Framingham offspring study

Data on the association between vitamin D status and actual change in glycemic measures are limited. We examined the prospective association between a predicted 25-hydroxyvitamin D (25(OH)D) score and change in fasting plasma glucose concentration over a mean follow-up of 7 years, in 2571 men and women (mean age 54 years) without diabetes in the Framingham Offspring Study cohort. After adjustment for age, sex, body mass index and fasting plasma glucose at baseline, higher predicted 25(OH)D score at baseline was associated with a smaller 7-year increase in fasting plasma glucose concentrations (0.23?mmol/l versus 0.35?mmol/l for highest versus lowest tertile of 25(OH)D score, respectively, P-trend=0.002). Vitamin D status may be an important determinant for change in fasting plasma glucose concentration among middle-aged and older adults without diabetes.     

过敏性腹泻患儿免疫功能与其血清25-羟维生素D水平的关系研究

目的探讨过敏性腹泻患儿血清25-羟维生素D [25-(OH) D]水平与免疫水平的相关性研究。方法选取2016年12月-2017年12月该院儿科收治的61例过敏性腹泻患儿作为研究组,另选取同期在该院健康体检儿童61例作为对照组,观察两组血清25-(OH) D水平、外周血T细胞及免疫球蛋白变化情况,并分析其相关性。结果研究组血清25-(OH) D、CD3、CD4、IgA、IgG、IgM水平显著低于对照组(均P0. 05),研究组CD8、IgE水平明显高于对照组(P0. 05);研究组血清25-(OH) D水平异常比例为93. 44%,显著高于对照组的31. 15%(P0. 05),CD3、CD4在血清25-(OH) D不足与正常组水平显著高于严重缺乏组(P0. 05),而CD8明显低于严重缺乏组(P0. 05); IgA、IgG、IgM在血清25-(OH) D不足与正常组水平明显高于严重缺乏组(P0. 05),IgE显著低于严重缺乏组(P0. 05); Logistic回归分析显示,CD4、IgA、IgG、IgM降低及CD8、IgE升高是25-(OH) D水平异常的危险因素; 25-(OH) D与CD3、CD4/CD8有显著正相关性(r=0. 329,P=0. 041; r=0. 386,P=0. 024),与IgA、IgG、IgM呈明显正相关(r=0. 615,P=0. 000; r=0. 551,P=0. 000; r=0. 536,P=0. 000),与IgE呈显著负相关(r=-0. 676,P=0. 000),与CD4、CD8无明显相关性(r=0. 118,P=0. 137; r=-0. 153,P=0. 075)。结论过敏性腹泻患儿血清25-(OH) D有明显降低现象,25-(OH) D水平降低与患者免疫水平具有密切相关性。