Excessive abdominal adiposity and body fat are associated with lower serum vitamin D levels: A population-based study
Keywords:
Adiposity, Adult, Nutritional Epidemiology, Vitamin DAbstract
Objective
To estimate the prevalence of 25-hydroxyvitamin D defi ciency and to analyze factors associated with lower serum vitamin levels in Brazilian adults.
Methods
A cross-sectional, population-based study consisted of 626 adult individuals of both sexes living in the urban area of Viçosa, Minas Gerais. The dependent variable used was the serum level of 25-hydroxyvitamin D and the independent variables were sociodemographic, anthropometric and body composition variables. The associations among the variables were verifi ed using simple and multiple linear regression models, considering alpha lower than 0.05 for the input in the fi nal model.
Results
The prevalence of 25-hydroxyvitamin D deficiency was 14.4% and the prevalence was 42.0%. Excess abdominal fat was higher in subjects with 25-hydroxyvitamin D sufficiency. The serum level of 25-hydroxyvitamin D was 30.34±9.85ng/ml. Body adiposity was higher in men with vitamin insufficiency. Negative associations were observed between serum 25-hydroxyvitamin D levels and age, educational level, body adiposity (p=0.028) and abdominal adiposity (p=0.023).
Conclusion
Our results showed that excess body and abdominal adiposity are strong predictors of alterations in the serum vitamin D levels, thus public policies for prevention and treatment in this population are essential.
References
Ramagopalan SV, Heger A, Berlanga AJ, Maugeri NJ, Lincoln MR, Burrell A, et al. A ChIP-seq defined genome-wide map of vitamin D receptor binding: Associations with disease and evolution. Genome Res. 2010;20(10):1352-60. http://dx.doi.org/10.1101/gr.107920.110
Zhang R, Li B, Gao X, Tian R, Pan Y, Jiang J, et al. Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: Dose-response metaanalysis of prospective studies. Am J Clin Nutr. 2017;105(4):810-9. http://dx.doi.org/10.3945/ajcn.116.140392
Goldner WS, Stoner JA, Thompson J, Taylor K, Larson L, Erickson J, et al. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: A comparison with non-obese controls. Obes Surg. 2008;18(2):145-50. http://dx.doi.org/10.1007/s11695-007-9315-8
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. 2009; 17(4):778-82. http://dx.doi.org/10.1038/oby.2008.649
Tsur A, Feldman BS, Feldhammer I, Hoshen MB, Leibowitz G, Balicer RD. Decreased serum concentrations of 25-hydroxycholecalciferol are associated with increased risk of progression to impaired fasting glucose and diabetes. Diabetes Care. 2013; 36(5):1361-7. http://dx.doi.org/10.2337/dc12-1050
Lim S, Kim MJ, Choi SH, Shin CS, Park KS, Jang HC, et al. Association of vitamin D deficiency with incidence of type 2 diabetes in high-risk Asian subjects. Am J Clin Nutr. 2013;97(3):524-30. http://dx.doi.org/10.3945/ajcn.112.048496
Labronici PJ, Blunck SS, Lana FR, Esteves BB, Franco JS, Fukuyama JM, et al. Vitamin D and its relation to bone mineral density in postmenopause women. Rev Bras Ortop. 2013;48(3):228-35. http://dx.doi.org/10.1016/j.rbo.2012.07.004
Nurbazlin M, Chee WS, Rokiah P, Tan AT, Chew YY, Nusaibah AR, et al. Effects of sun exposure on 25(OH) vitamin D concentration in urban and rural women in Malaysia. Asia Pac J Clin Nutr. 2013;22(3):391-9. http://dx.doi.org/10.6133/apjcn.2013.22.3.15.
Bandeira F, Griz L, Dreyer P, Eufrazino C, Bandeira C, Freese E. Vitamin D deficiency: A global perspective. Arq Bras Endocrinol Metabol. 2006;50(4):640-6. http://dx.doi.org/10.1590/S0004-27302006000400009
Holick MF. The D-lightful vitamin D for health. J Med Biochem. 2013;32:1-10. http://dx.doi.org/10.1177/0148607111430189
Ceglia L, Nelson J, Ware J, Alysandratos KD, Bray GA, Garganta C, et al. Association between body weight and composition and plasma 25-hydroxyvitamin D level in the diabetes prevention program. Eur J Nutr. 2017;56(1):161-70. http://dx.doi.org/10.1007/s00394-015-1066-z
Han SS, Kim M, Lee SM, Lee JP, Kim S, Joo KW, et al. Association between body fat and vitamin D status in Korean adults. Asia Pac J Clin Nutr. 2014;23(1):65-75. http://dx.doi.org/10.6133/apjcn.2014.23.1.10
McGill A, 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(28):4. http://dx.doi.org/10.1186/1475-2891-7-4
Rocha LM, Baldan DCS, Souza AL, Chaim EA, Pavim EJ, Alegre SM. Body composition and metabolic profile in adults with vitamin D deficiency. Rev Nutr. 2017;30(4):419-30. http://dx.doi.org/10.1590/1678-98652017000400002
Martini LA, Verly Jr E, Marchioni DM, Fisberg RM. Prevalence and correlates of calcium and vitamin D status adequacy in adolescents, adults, and elderly from the Health Survey - São Paulo. Nutrition. 2013;29(6):845-50. http://dx.doi.org/10.1016/j.nut.2012.12.009
Wood RJ. Vitamin D and adipogenesis: New molecular insights. Rev Nutr. 2008;66(1):40-6. http://dx.doi.org/10.1111/j.1753-4887.2007.00004.x
Abboud M, Gordon-Thomson C, Hoy AJ, Balaban S, Rybchyn MS, Cole l, et al. Uptake of 25-hydroxyvitamin D by muscle and fat cells. J Steroid Biochem Mol Biol. 2014;144:232-6. http://dx.doi.org/10.1016/j.jsbmb.2013.10.020
Papandreou D, Hamid Z. The role of vitamin D in diabetes and cardiovascular disease: An updated review of the literature. Dis Markers. 2015;2015:580474. http://dx.doi.org/10.1155/2015/580474
Mozos I, Marginean O. Links between vitamin D deficiency and cardiovascular diseases. Bio Med Res Inter. 2015;2015:109275. http://dx.doi.org/10.1155/2015/109275
Lopes VM, Lopes JR, Brasileiro JP, Oliveira I, Lacerda RP, Andrade MR, et al. Highly prevalence of vitamin D deficiency among Brazilian women of reproductive age. Arch Endocrinol Metab. 2017;61(1):21-7. http://dx.doi.org/10.1590/2359-3997000000216
Pereira-Santos M, Santos JYGD, Carvalho GQ, Santos DBD, Oliveira AM. Epidemiology of vitamin D insufficiency and deficiency in a population in a sunny country: Geospatial meta-analysis in Brazil. Crit Rev Food Sci Nutr. 2018;8:1-8. http://dx.doi.org/10.1080/10408398.2018.1437711
Instituto Brasileiro de Geografia e Estatística. Censo Demográfico, 2010 [acesso 2012 mar 10]. Rio de Janeiro: IBGE; 2010. Disponível em: https://www.ibge.gov.br/
Segheto W, Silva DCG, Coelho FA, Reis VG, Morais SHO, Marins JCB. Body adiposity index and associated factors in adults: Method and logistics of a population-based study. Nutr Hosp. 2015;32(1):101-9. http://dx.doi.org/10.3305/nh.2015. 32.1.8391
Dean AG, Dean JA, Colombier D, Brendel KA, Smith DC, Burton AH, et al. Epi Info, version 6: a word processing, database, and statistics for epidemiology on microcomputers. Atlanta: Centers for Disease Control and Prevention; 1994.
Alves M, Bastos M, Leitão F, Marques G, Ribeiro G, Carrilho F. Vitamin D: Importance of laboratory evaluation. Rev Port Endocrinol Diabetes Metabol. 2013;8(1):32-9. http://dx.doi.org/10.1016/j.rpedm.2012.12.001
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30. http://dx.doi.org/10.1210/jc.2011-0385
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640-5. http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192644
Earthman C, Traughber D, Dobratz J, Howell W. Bioimpedance spectroscopy for clinical assessment of fluid distribution and body cell mass. Nutr Clin Pract. 2007;22(4):389-405. http://dx.doi.org/10.1177/0115426507022004389
Lohman TG. Advances in body composition assessment. Champaign: Human Kinetics Publishers; 1992.
Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81. http://dx.doi.org/10.1056/NEJMra070553
James WPT. 22nd Marabou Symposium: the changing faces of vitamin D. Nutr Rev. 2008;66(5):286-90. http://dx.doi.org/10.1111/j.1753-4887.2008.00116.x
Arabi A, El Rassi R, El-Hajj Fuleihan G. Hypovitaminosis D in developing countries-prevalence, risk factors and outcomes. Nat Rev Endocrinol. 2010;6(10):550-61. http://dx.doi.org/10.1038/nrendo.2010.146
Touvier M, Deschasaux M, Montourcy M, Sutton A, Charnaux N, Kesse-Guyot E, et al. Determinants of vitamin D status in Caucasian adults: Influence of sun exposure, dietary intake, sociodemographic, lifestyle, anthropometric, and genetic factors. J Invest Dermatol. 2015;135(2):378-88. http://dx.doi.org/10.1038/jid.2014.400
Moore CE, Radcliffe JD, Liu Y. Vitamin D intakes of children differ by race/ethnicity, sex, age, and income in the United States, 2007 to 2010. Nutr Res. 2014;34(6):499-506. http://dx.doi.org/10.1016/j.nutres.2014.06.002
Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, et al. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int. 2009;20(11):1807-20. http://dx.doi.org/10.1007/s00198-009-0954-6
Maeda SS, Kunii IS, Hayashi L, Lazaretti-Castro M. The effect of sun exposure on 25-hydroxyvitamin D concentrations in young healthy subjects living in the city of São Paulo, Brazil. Braz J Med Biol Res. 2007;40(12):1653-9. http://dx.doi.org/1590/S0100-879X2006005000162
Unger MD, Cuppari L, Titan SM, Magalhães MC, Sassaki AL, Reis LM, et al. Vitamin D status in a sunny country: Where has the sun gone? Clin Nutr. 2010;29(6):784-8. http://dx.doi.org/10.1016/j.clnu.2010.06.009
Barja-Fernández S, Concepción AM, MartínezSilva I, Vazquez R, Gil-Campos M, Olza J, et al. 25-Hydroxyvitamin D levels of children are inversely related to adiposity assessed by body mass index. J Physiol Biochem. 2017;74(1):111-18. http://dx.doi.org/10.1007/s13105-017-0581-1
Daly RM, Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Sikaris KA, et al. Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: A national, populationbased study. Clin Endocrinol. 2012;77(1):26-35. http://dx.doi.org/10.1111/j.1365-2265.2011.04320.x
Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: Exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988;67(2):373-8. http://dx.doi.org/10.1210/jcem67-2-373
Schuch NJ, Garcia VC. Vitamin D and endocrine diseases. Arq Bras Endocrinol Metab. 2009;53(5):625-33. http://dx.doi.org/10.1590/S0004-27302009000500015
Leão ALM, Santos LC. Micronutrient consumption and overweight: Is there a relationship? Rev Bras Epidemiol. 2012;15(1):85-95. http://dx.doi.org/10.1590/S1415-790X2012000100008
Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72(3):690-3. http://dx.doi.org/10.1093/ajcn/72.3.690
Souza Silva J, Pereira SE, Saboya Sobrinho CJ, Ramalho A. Obesity, related diseases and their relationship with vitamin D deficiency in adolescents. Nutr Hosp. 2016;33(4):856-64. http://dx.doi.org/10.1093/ajcn/72.3.690
Khan RJ, Riestra P, Gebreab SY, Wilson JG, Gaye A, Xu R, et al. Vitamin D receptor gene polymorphisms are associated with abdominal visceral adipose tissue volume and serum adipokine concentrations but not with body mass index or waist circumference in African Americans: The Jackson Heart Study. J Nutr. 2016;146(8):1476-82. http://dx.doi.org/10.3945/jn.116.229963
Vimaleswaran KS, Berry DJ, Lu C, Tikkanen E, Pilz S, Hiraki LT, et al. Causal relationship between obesity and vitamin D status: Bi-directional Mendelian randomization analysis of multiple cohorts. PLos Med. 2013;10(2):e1001383. http://dx.doi.org/10.1371/journal.pmed.1001383
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