Inadequacy of Vitamin D Nutritional Status in Individuals with Metabolically Unhealthy Obesity Phenotype: The Relevance of Insulin Resistance

Overview

Journal Diabetes Metab Syndr Obes

Publisher Dove Medical Press

Specialty Endocrinology

Date 2020 Nov 12

PMID 33177853

Citations 2

Authors

A Cordeiro

B Campos

S E Pereira

C J Saboya

A Ramalho

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim was to evaluate 25(OH)D serum concentrations in metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) and its relation with biochemical and clinical parameters in both groups according to homeostatic model assessment-insulin resistance (HOMA-IR) definition of the obesity phenotypes.

Patients And Methods: Descriptive cross-sectional study was conducted with individuals of both genders. Anthropometric data [waist circumference, body mass index (BMI)] and metabolic parameters: blood glucose, glycated hemoglobin, insulin, lipid profile, calcium, phosphorus, parathyroid hormone (PTH) and high-sensitivity c-reactive protein (hs-CRP) and (25(OH)D) were obtained. The cutoff points for vitamin D deficiency and insufficiency were ≤20 and 21-29 ng/mL, respectively. Individuals were classified as MUHO according to HOMA-IR≥2.5.

Results: This study comprised 232 individuals with obesity (BMI≥35 kg/m; 42.6±4.7 kg/m). The MUHO phenotype was observed in 76.7% of the population. The mean values of glucose (<0.001), insulin (<0.001), HOMA-IR (<0.001), and triglycerides (=0.049) were significantly higher in the MUHO than in the MHO phenotype group. The mean value of 25(OH)D showed a significant difference between the MHO and MUHO phenotype groups (=0.011). Additionally, and in line, lower mean 25(OH)D values were found in the MUHO vs the MHO phenotype group in the deficiency (14.5±3.6 ng/mL/17.1±2.7 ng/mL, =0.004) and insufficiency (24.5±2.9 ng/mL/25.7±2.6 ng/mL, =0.077) 25(OH)D groups. An increase of 1 ng/mL of vitamin D increased in 1.051 (95% CI= 1.011-1.093, =0.012) the odds of the healthy phenotype.

Conclusion: The highest prevalence of inadequacy of serum concentrations of 25(OH)D and greater severity of this deficiency in individuals with MUHO phenotype were observed. Low serum concentrations of this vitamin were associated, mainly, with insulin resistance. Monitoring the nutritional status of vitamin D in individuals with obesity that present with MUHO phenotype may contribute to minimize the occurrence and aggravation of diseases associated with obesity.

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References

Compher C, Badellino K, Boullata J . Vitamin D and the bariatric surgical patient: a review. Obes Surg. 2008; 18(2):220-4. DOI: 10.1007/s11695-007-9289-6. View

Diaz-Ruiz A, Guzman-Ruiz R, Moreno N, Garcia-Rios A, Delgado-Casado N, Membrives A . Proteasome Dysfunction Associated to Oxidative Stress and Proteotoxicity in Adipocytes Compromises Insulin Sensitivity in Human Obesity. Antioxid Redox Signal. 2015; 23(7):597-612. PMC: 4554552. DOI: 10.1089/ars.2014.5939. View

Wildman R, Muntner P, Reynolds K, McGinn A, Rajpathak S, Wylie-Rosett J . The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med. 2008; 168(15):1617-24. DOI: 10.1001/archinte.168.15.1617. View

Bluher M . Are there still healthy obese patients?. Curr Opin Endocrinol Diabetes Obes. 2012; 19(5):341-6. DOI: 10.1097/MED.0b013e328357f0a3. View

Durward C, Hartman T, Nickols-Richardson S . All-cause mortality risk of metabolically healthy obese individuals in NHANES III. J Obes. 2013; 2012:460321. PMC: 3523154. DOI: 10.1155/2012/460321. View

Harinarayan C, Arvind S, Joshi S, Thennarasu K, Vedavyas V, Baindur A . IMPROVEMENT IN PANCREATIC β-CELL FUNCTION WITH VITAMIN D AND CALCIUM SUPPLEMENTATION IN VITAMIN D-DEFICIENT NONDIABETIC SUBJECTS. Endocr Pract. 2013; 20(2):129-38. DOI: 10.4158/EP13273.OR. View

Kayaniyil S, Vieth R, Harris S, Retnakaran R, Knight J, Gerstein H . Association of 25(OH)D and PTH with metabolic syndrome and its traditional and nontraditional components. J Clin Endocrinol Metab. 2010; 96(1):168-75. DOI: 10.1210/jc.2010-1439. View

Mogili K, Karuppusami R, Thomas S, Chandy A, Kamath M, Tk A . Prevalence of vitamin D deficiency in infertile women with polycystic ovarian syndrome and its association with metabolic syndrome - A prospective observational study. Eur J Obstet Gynecol Reprod Biol. 2018; 229:15-19. DOI: 10.1016/j.ejogrb.2018.08.001. View

Manzoni G, Oltolini A, Perra S, Muraca E, Ciardullo S, Pizzi M . Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes. Diabetes Metab Syndr Obes. 2020; 13:489-497. PMC: 7047991. DOI: 10.2147/DMSO.S228229. View

10.

Paniagua J . Nutrition, insulin resistance and dysfunctional adipose tissue determine the different components of metabolic syndrome. World J Diabetes. 2016; 7(19):483-514. PMC: 5107710. DOI: 10.4239/wjd.v7.i19.483. View

11.

Bhatt S, Nigam P, Misra A, Guleria R, Pasha M . Independent associations of low 25 hydroxy vitamin D and high parathyroid hormonal levels with nonalcoholic fatty liver disease in Asian Indians residing in north India. Atherosclerosis. 2013; 230(1):157-63. DOI: 10.1016/j.atherosclerosis.2013.07.006. View

12.

Yahyaoui S, Jmal L, Sammoud A, Abdenebi M, Jmal A, Boukthir S . Vitamin D deficiency is associated with metabolic syndrome in Tunisian children with obesity. Tunis Med. 2020; 97(12):1353-1356. View

13.

Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7):412-9. DOI: 10.1007/BF00280883. View

14.

Hanwell H, Vieth R, Cole D, Scillitani A, Modoni S, Frusciante V . Sun exposure questionnaire predicts circulating 25-hydroxyvitamin D concentrations in Caucasian hospital workers in southern Italy. J Steroid Biochem Mol Biol. 2010; 121(1-2):334-7. DOI: 10.1016/j.jsbmb.2010.03.023. View

15.

Mackawy A, Badawi M . Association of vitamin D and vitamin D receptor gene polymorphisms with chronic inflammation, insulin resistance and metabolic syndrome components in type 2 diabetic Egyptian patients. Meta Gene. 2015; 2:540-56. PMC: 4287888. DOI: 10.1016/j.mgene.2014.07.002. View

16.

Yaribeygi H, Maleki M, Sathyapalan T, Iranpanah H, Orafai H, Jamialahmadi T . The molecular mechanisms by which vitamin D improve glucose homeostasis: A mechanistic review. Life Sci. 2020; 244:117305. DOI: 10.1016/j.lfs.2020.117305. View

17.

Tosunbayraktar G, Bas M, Kut A, Buyukkaragoz A . Low serum 25(OH)D levels are assocıated to hıgher BMI and metabolic syndrome parameters in adult subjects in Turkey. Afr Health Sci. 2016; 15(4):1161-9. PMC: 4765420. DOI: 10.4314/ahs.v15i4.15. View

18.

Sung K, Chang Y, Ryu S, Chung H . High levels of serum vitamin D are associated with a decreased risk of metabolic diseases in both men and women, but an increased risk for coronary artery calcification in Korean men. Cardiovasc Diabetol. 2016; 15(1):112. PMC: 4983097. DOI: 10.1186/s12933-016-0432-3. View

19.

Ganji V, Tangpricha V, Zhang X . Serum Vitamin D Concentration ≥75 nmol/L Is Related to Decreased Cardiometabolic and Inflammatory Biomarkers, Metabolic Syndrome, and Diabetes; and Increased Cardiorespiratory Fitness in US Adults. Nutrients. 2020; 12(3). PMC: 7146199. DOI: 10.3390/nu12030730. View

20.

Kouvari M, Panagiotakos D, Yannakoulia M, Georgousopoulou E, Critselis E, Chrysohoou C . Transition from metabolically benign to metabolically unhealthy obesity and 10-year cardiovascular disease incidence: The ATTICA cohort study. Metabolism. 2019; 93:18-24. DOI: 10.1016/j.metabol.2019.01.003. View