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Lin HR, Xu F, Chen D, Xie K, Yang Y, Hu W, Li BY, Jiang Z, Liang Y, Tang XY, Zheng JS, Chen YM. The gut microbiota-bile acid axis mediates the beneficial associations between plasma vitamin D and metabolic syndrome in Chinese adults: A prospective study. Clin Nutr 2023; 42:887-898. [PMID: 37086617 DOI: 10.1016/j.clnu.2023.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND & AIMS Previous studies have suggested that circulating 25-hydroxyvitamin D (25 [OH]D, VD) and the gut microbiota-bile acid axis play crucial roles in metabolic health. Exploring the mediating role of the gut microbiota-bile acid axis would improve our understanding of the mechanisms underlying the effects of VD on human metabolic health. This study examined the association between plasma 25(OH)D and the prevalence/incidence of metabolic syndrome (MetS) and the mediating role of the gut microbiota-bile acid axis. METHODS This prospective study included 3180 participants with plasma 25(OH)D data at baseline and 2966 participants with a 9-year follow-up. MetS was determined every three years. The gut microbiota was analyzed by 16S rRNA sequencing in 1752 participants, and targeted bile acid metabolites in feces were further determined in 974 participants using UPLC‒MS/MS at the middle of the study. Mediating roles of microbiota and bile acids in the VD-MetS associations were analyzed using mediation/path analyses adjusted for potential confounders. RESULTS Among the 2966 participants who were followed-up, 1520, 193, 647, and 606 were MetS-free (normal), recovered, had incident MetS, and had persistent MetS, respectively. The multivariable-adjusted ORs (95% CIs) of MetS prevalence were 0.65 (0.50, 0.84) for baseline MetS and 0.46 (0.33, 0.65) for 9-year persistent MetS in quartile 4 (compared to quartile 1) of plasma 25(OH)D (median: 37.7 vs. 19.6, ng/ml). The corresponding HR (95% CI) of 9-year MetS incidence was 0.71 (0.56, 0.90) (all P-trend < 0.05). Higher VD concentrations were associated with greater α-diversity of the gut microbiota, which was inversely correlated with MetS risk. The groups classified by VD and MetS status had significantly different β-diversity. Ruminiclostridium-6 and Christensenellaceae R-7 group were enriched in the high-VD group and were inversely associated with MetS. However, opposite associations were observed for Lachnoclostridium and Acidaminococcus. The overlapping differential microbial score (ODMS) developed from the four differential genera explained 12.2% of the VD-MetS associations (Pmediation = 0.015). Furthermore, the fecal bile acid score created from 11 differential bile acids related to ODMS and MetS mediated 34.2% of the association between ODMS and MetS (Pmediation = 0.029). Path analyses showed that the inverse association between plasma 25(OH)D and MetS could be mediated by the gut microbiota-bile acid axis. CONCLUSIONS The findings suggest that the gut microbiota-bile acid axis partially mediates the beneficial association between plasma 25(OH)D and the risk of persistent MetS and incident MetS in the Chinese population.
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Affiliation(s)
- Hong-Rou Lin
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Fengzhe Xu
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China
| | - Danyu Chen
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Keliang Xie
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Yingdi Yang
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Wei Hu
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Bang-Yan Li
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Zengliang Jiang
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China
| | - Yuhui Liang
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China
| | - Xin-Yi Tang
- The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
| | - Ju-Sheng Zheng
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China.
| | - Yu-Ming Chen
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China.
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Bahadorpour S, Hajhashemy Z, Saneei P. Serum 25-hydroxyvitamin D levels and dyslipidemia: a systematic review and dose-response meta-analysis of epidemiologic studies. Nutr Rev 2022; 81:1-25. [PMID: 35831956 DOI: 10.1093/nutrit/nuac038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
CONTEXT Findings of previous observational studies that examined the association between circulating vitamin D levels and lipid profiles have been inconsistent. OBJECTIVE A dose-response meta-analysis of epidemiologic studies was conducted to investigate the relationship between serum 25-hydroxyvitamin D levels and dyslipidemia in adults. DATA SOURCES Electronic databases were searched systematically for articles published up to June 2021. DATA EXTRACTION Fifty-seven observational studies and 2 cohort studies that reported odds ratios (ORs) or relative risks (RRs) with 95%CIs for dyslipidemia in relation to serum 25-hydroxyvitamin D levels in adults were included. DATA ANALYSIS A high level, vs a low level, of serum 25-hydroxyvitamin D was related to a significant 19% decrease in the odds of hypertriglyceridemia (OR 0.81; 95%CI, 0.74-0.89), an 18% reduction in low high-density lipoprotein cholesterol (HDL-C) (OR 0.82; 95%CI, 0.76-0.89), and an 18% reduction in dyslipidemia (OR 0.82; 95%CI, 0.75-0.91). No significant association was found between a high vs a low level of serum 25-hydroxyvitamin D and risk of high low-density lipoprotein cholesterol (LDL-C) levels (OR 0.86; 95%CI, 0.62-1.19) or hypercholesterolemia (OR 1.03; 95%CI, 0.93-1.15). Dose-response analyses demonstrated that each 10 ng/mL increase in the serum 25-hydroxyvitamin D level was linked, respectively, to a 7% (OR 0.93;95%CI, 0.85-1.02), a 3% (OR 0.97; 95%CI, 0.90-1.05), and a 4% (OR 0.96; 95%CI, 0.92-1.00) marginally significant decrease in the odds of hypertriglyceridemia, low HDL-C, and dyslipidemia. CONCLUSION Higher serum 25-hydroxyvitamin D levels are associated with significant reductions in the odds of hypertriglyceridemia, low HDL-C, and dyslipidemia in a dose-response trend. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021219484.
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Affiliation(s)
- Sedigheh Bahadorpour
- are with the Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.,are with the Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- are with the Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.,are with the Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- are with the Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Nurhayati I, Hidayat AR, Widiyanto A, Putri SI, Atmojo JT, Fajriah AS. The Effect of Vitamin D Deficiency with Stunting and Overweight: A Meta-analysis Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Childhood malnutrition such as stunting and obesity is an international public health problem leading to an increased risk of mortality and morbidity. Vitamin D deficiency has also been identified as a worldwide public health issue that is associated with an increase in the prevalence of related-chronic diseases.
Aim: The purpose of this study was to investigating the relation between vitamin D deficiency with stunting and overweight among children.
Methods: This was a systematic review and meta analysis study used articles from online database of PubMed, which published in 2011 to 2021. The dependent variables was stunting and overweight. The independent variable was vitamin D deficiency. The data was analyzed by RevMan.
Results: Subjects with below-standard vitamin D levels in the body had 1.86 higher risk of experiencing stunting (OR = 1.86; 95% CI 0.90-3.84; p = 0.09) and 2.76 higher being overweight (OR = 2.76; 95% CI 0.96-7.99 ; p = 0.09) compared with those with normal vitamin D levels, this result was not statistically significant.
Conclusion: There is a relation between vitamin D deficiency with stunting and overweight among children under 18 years
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Mokhtari E, Hajhashemy Z, Saneei P. Serum Vitamin D Levels in Relation to Hypertension and Pre-hypertension in Adults: A Systematic Review and Dose–Response Meta-Analysis of Epidemiologic Studies. Front Nutr 2022; 9:829307. [PMID: 35360696 PMCID: PMC8961407 DOI: 10.3389/fnut.2022.829307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/04/2022] [Indexed: 02/03/2023] Open
Abstract
Background Findings of observational studies that evaluated the association of serum vitamin D status and high blood pressure were contradictory. This meta-analysis of epidemiologic studies assessed the relation of serum vitamin D levels to hypertension (HTN) and pre-hypertension in adults. Methods We conducted a systematic search of all published articles up to March 2021, in four electronic databases (MEDLINE (PubMed), Web of Science (ISI), Embase and Scopus), and Google scholar. Seventy epidemiologic studies (10 prospective cohort, one nested case–control, and 59 cross-sectional investigations) that reported relative risks (RRs), odds ratios (ORs), hazard ratios, or prevalence ratios with 95% CIs for HTN or pre-hypertension in relation to serum vitamin D concentrations in adults were included in the analysis. Results In prospective studies, a 16% decrease in risk of hypertension was observed in participants with high levels of serum vitamin D compared to low levels (RR: 0.84; 95%CI: 0.73, 0.96; 12 effect sizes). Dose–response analysis in prospective studies revealed that each 25 nmol/L increase in serum vitamin D concentrations resulted in 5% reduced risk of HTN (RR: 0.95; 95% CI: 0.90, 1.00). Also, a significant nonlinear relationship between serum vitamin D levels and HTN was found (Pnonlinearity < 0.001). In cross-sectional investigations, highest vs. lowest level of serum vitamin D was related to reduced odds of HTN (OR: 0.84; 95%CI: 0.79, 0.90; 66 effect sizes) and pre-hypertension (OR: 0.75; 0.95%CI: 0.68, 0.83; 9 effect sizes). Dose–response analysis in these studies showed that each 25 nmol/L increase in serum vitamin D levels was related to a significant 6% reduction in odds of hypertension in all populations (RR: 0.94; 95%CI: 0.90, 0.99) and 3% in studies with representative populations (RR: 0.97; 95%CI: 0.95, 0.99). Conclusion This meta-analysis of epidemiologic studies disclosed that serum vitamin D concentrations were inversely related to the risk of HTN in adults, in a dose–response manner in both prospective cohort and cross-sectional studies. Systematic Review Registration:http://www.crd.york.ac.uk/Prospero, identifier: CRD42021251513.
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Affiliation(s)
- Elahe Mokhtari
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- *Correspondence: Parvane Saneei ;
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Amelia R, Harahap J, Yunanda Y, Wijaya H, Fujiati II, Yamamoto Z. Early detection of macrovascular complications in type 2 diabetes mellitus in Medan, North Sumatera, Indonesia: A cross-sectional study. F1000Res 2021; 10:808. [PMID: 34527220 PMCID: PMC8411276 DOI: 10.12688/f1000research.54649.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Macrovascular complications occur very frequently in patients with type 2 diabetes mellitus (T2DM) with a high mortality rate, due to the development of cardiovascular disease (CVD), such as stroke, atherosclerosis acceleration, and atrial fibrillation. T2DM is a significant risk factor for CVD and has become the leading cause of death. The purpose of this study was to detect the early risk of macrovascular complications by using the ankle brachial index (ABI) as a marker. Methods: This study was an analytic study with a cross-sectional approach. The study population was patients with T2DM from several primary health care centers in Medan. In total, 89 subjects who met the inclusion and exclusion criteria were recruited with consecutive sampling. ABI was determined as the ratio of systolic blood pressure in the brachial artery to the posterior tibial artery after the subjects had been relaxed and felt comfortable in a supine position. Examination of vitamin D and lipid profile was derived from examination of venous blood. Data were processed using SPSS and analyzed with one-way ANOVA. Results: The study found that there was a relationship between LDL-C, triglyceride, and vitamin D (25OH-D) based on the ABI (p > 0.05). Conclusions: ABI can be used for an early detection of macrovascular complications. Apart from being easy to perform, ABI was non-invasive. Some other risk factors that can also be used to assess complications and have relationships with ABI were LDL-C, triglyceride, and vitamin D (25OH-D). Complications in T2DM patients can be prevented with reasonable blood sugar control and lifestyle changes. Education and motivation need to be given to patients so that they become more independent in controlling their disease and improving their quality of life.
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Affiliation(s)
- Rina Amelia
- 1Department of Community Medicine/Public Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, 20155, Indonesia
| | - Juliandi Harahap
- 1Department of Community Medicine/Public Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, 20155, Indonesia
| | - Yuki Yunanda
- 1Department of Community Medicine/Public Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, 20155, Indonesia
| | - Hendri Wijaya
- Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, 20155, Indonesia
| | - Isti Ilmiati Fujiati
- 1Department of Community Medicine/Public Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, 20155, Indonesia
| | - Zulham Yamamoto
- Department of Histology, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, 20155, Indonesia
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Chen H, Zhang H, Xie H, Zheng J, Lin M, Chen J, Tong Y, Jin J, Xu K, Yang J, Sun C, Xu X, Zheng J. Maternal, umbilical arterial metabolic levels and placental Nrf2/CBR1 expression in pregnancies with and without 25-hydroxyvitamin D deficiency. Gynecol Endocrinol 2021; 37:807-813. [PMID: 34232092 DOI: 10.1080/09513590.2021.1942451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The aim of this case-control study was to document maternal, umbilical arterial metabolic levels and correlations in pregnancies with and without 25-hydroxyvitamin D [25(OH)D] deficiency, while, also investigating the expression of nuclear factor erythroid 2 related factor 2 (Nrf2) and carbonyl reductase 1 (CBR1) in the placenta. METHODS One hundred participants, 50 deficient for 25(OH)D and 50 normal, were recruited from among hospitalized single-term pregnant women who had elected for cesarean section. Umbilical arterial and placental samples were collected during cesarean section. Metabolic levels were assessed for the 25(OH)D deficiency and control groups' maternal, umbilical arterial samples. Nrf2 and CBR1 expression levels were investigated in the placentas of 12 pregnant women with 25(OH)D deficiency and 12 controls. RESULTS Compared with the control participants, the 25(OH)D deficient women had significantly higher triglyceride (TG) levels (3.80 ± 2.11 vs. 2.93 ± 1.16 mmol/L, 3.64 ± 1.84 vs. 2.81 ± 1.16 mmol/L, p < .01, .001); lower high density lipoprotein cholesterol (HDL-C) levels (1.54 ± 0.32 vs. 1.82 ± 0.63 mmol/L, 1.41 ± 0.72 vs. 2.44 ± 1.68 mmol/L, p < .001, .01) in both material blood and the umbilical artery. In addition, Nrf2 and CBR1 expression levels were lower in the maternal 25(OH)D deficient placenta. CONCLUSION 25(OH)D deficient pregnant women have higher TG levels and lower HDL-C levels in both material blood and the umbilical artery. TG level is negatively correlated with 25(OH)D in both the maternal serum and infant umbilical artery. 25(OH)D deficiency also lowers placental expression of Nrf2 and CBR1. UNLABELLED Supplemental data for this article is available online at here.
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Affiliation(s)
- Haiying Chen
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Shanghai University, Wenzhou, PR China
| | - Hongping Zhang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Shanghai University, Wenzhou, PR China
| | - Han Xie
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Jiayong Zheng
- Department of Wenzhou Key Laboratory of Gynecology and Obstetrics, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, PR China
| | - Meimei Lin
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Shanghai University, Wenzhou, PR China
| | - Jingjing Chen
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Shanghai University, Wenzhou, PR China
| | - Yu Tong
- Department of Clinical Laboratory, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou Peoples Hospital, Wenzhou, PR China
| | - Jiang Jin
- Department of Clinical Laboratory, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou Peoples Hospital, Wenzhou, PR China
| | - Kai Xu
- Department of Clinical Laboratory, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou Peoples Hospital, Wenzhou, PR China
| | - Jie Yang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Shanghai University, Wenzhou, PR China
| | - Congcong Sun
- Department of Wenzhou Key Laboratory of Gynecology and Obstetrics, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, PR China
| | - Xiaoming Xu
- Department of Wenzhou Key Laboratory of Gynecology and Obstetrics, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, PR China
| | - Jianqiong Zheng
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Shanghai University, Wenzhou, PR China
- Department of Obstetrics and Gynecology, The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, PR China
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Hajhashemy Z, Shahdadian F, Moslemi E, Mirenayat FS, Saneei P. Serum vitamin D levels in relation to metabolic syndrome: A systematic review and dose-response meta-analysis of epidemiologic studies. Obes Rev 2021; 22:e13223. [PMID: 33829636 DOI: 10.1111/obr.13223] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Abstract
Several epidemiological studies examined the association of serum vitamin D with metabolic syndrome (MetS), but the findings were inconsistent. We conducted a systematic review and dose-response meta-analysis to quantify the association between blood vitamin D levels and MetS in adults. A systematic search up to December 2020 was conducted in MEDLINE (PubMed), ISI (Web of Science), Scopus, and Google Scholar databases for epidemiological studies that assessed the relation of serum 25-hydroxyvitamin D (as the exposure) and MetS (as the outcome) in adults. Eligible cross-sectional studies were restricted to those with representative populations. Finally, 43 studies were included in the analysis (38 cross-sectional, one nested case-control, and four cohorts studies). Combining 41 effect sizes from 38 cross-sectional studies included 298,187 general adult population revealed that the highest level of serum vitamin D, compared with the lowest level, was significantly related to a 43% decreased odds of MetS in developed countries (odds ratio [OR]: 0.57; 95% confidence interval [CI]: 0.49-0.65) and 40% in developing countries (OR: 0.60; 95% CI: 0.52-0.70). Linear dose-response analysis (including 222,175 healthy individuals and 39,308 MetS patients) revealed that each 25 nmol/L increase in serum vitamin D level was significantly associated with a 15% decreased odds of MetS (OR: 0.85; 95% CI: 0.80-0.91); however, we found no significant nonlinear association. Meta-analysis of five prospective studies with 11,019 participants revealed no significant relation (relative risk [RR]: 0.70; 95% CI: 0.37-1.32). This meta-analysis indicated an inverse association between serum vitamin D concentrations and risk of MetS in general adult populations in cross-sectional studies in a dose-response manner. However, no significant association was found in a small number of cohorts. More prospective studies are needed to confirm the causality of this relationship.
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Affiliation(s)
- Zahra Hajhashemy
- Department of Community Nutrition, School of Nutrition and Food Sciences, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farnaz Shahdadian
- Department of Community Nutrition, School of Nutrition and Food Sciences, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Moslemi
- Department of Biochemistry and Diet Therapy, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fateme Sadat Mirenayat
- Department of Community Nutrition, School of Nutrition and Food Sciences, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Sciences, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Hajhashemy Z, Shahdadian F, Ziaei R, Saneei P. Serum vitamin D levels in relation to abdominal obesity: A systematic review and dose-response meta-analysis of epidemiologic studies. Obes Rev 2021; 22:e13134. [PMID: 32881271 DOI: 10.1111/obr.13134] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/08/2020] [Accepted: 08/08/2020] [Indexed: 12/14/2022]
Abstract
Although several observational studies have investigated the relationship between vitamin D deficiency and risk of central obesity, the results were inconsistent. We performed a dose-response meta-analysis on epidemiologic studies that evaluated the association of vitamin D status and abdominal obesity in adults. A systematic search was carried out of all published articles, up to May 2020, in five electronic databases, including MEDLINE (Pubmed), EMBASE, Institute for Scientific Information (ISI) (Web of science), Scopus and Google scholar. Forty-one observational studies reported odds ratios (ORs) or relative risks (RRs) with 95% confidence intervals (CIs) for abdominal obesity in relation to serum vitamin D levels in adults were included in the analysis. Using a random effects model, the overall effect size was calculated. Combining 44 effect sizes from 36 cross-sectional studies with 257,699 participants revealed that the highest versus the lowest serum vitamin D level was significantly associated with a 23% decreased odds of abdominal obesity (OR: 0.77; 95% CI [0.71, 0.83]). This inverse association was significant in almost all subgroups based on different covariates. Dose-response analysis showed that each 25 nmol/L increase in serum vitamin D was related to 8% reduced risk of abdominal obesity (OR: 0.92; 95% CI [0.85, 0.99]). When we confined the analysis to 23 effect sizes from 17 studies with representative population (242,135 participants), the same results were obtained (OR: 0.79; 95% CI [0.71, 0.87]). Dose-response analysis indicated that each 25 nmol/L increase in blood vitamin D levels was linked to 10% decreased central adiposity risk in representative populations (OR: 0.90; 95% CI [0.82, 0.99]). This meta-analysis of epidemiologic studies revealed that serum vitamin D level was inversely associated with risk of abdominal obesity in adults, in a dose-response manner. The same findings were obtained in representative populations. Further prospective studies are required to examine the causal association between serum vitamin D levels and abdominal obesity.
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Affiliation(s)
- Zahra Hajhashemy
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farnaz Shahdadian
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Chen H, Zhang H, Yang J, Huang Z, Xu H, Jin J, Xu K, Tong Y, Dong Q, Zheng J. The relationship between maternal vitamin D deficiency and glycolipid metabolism and adverse pregnancy outcome. Clin Endocrinol (Oxf) 2020; 93:713-720. [PMID: 32713029 PMCID: PMC7754337 DOI: 10.1111/cen.14298] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Maternal vitamin D deficiency is associated with glucose and lipid metabolism in the mother and offspring. Meanwhile, it can also lead to adverse pregnancy outcomes. The aim of this case-control study was to document maternal, umbilical arterial glucose and lipid metabolic levels and correlations in pregnancies with or without vitamin D deficiency, while also investigating adverse pregnancy outcomes. DESIGN/PARTICIPANTS/MEASUREMENTS A total of 425 pregnant women who received antenatal care and delivered at Wenzhou People's Hospital were enrolled. According to their serum 25-hydroxyvitamin D [25(OH)D] level, the pregnant women were divided into the vitamin D deficiency group [25(OH)D < 20 ng/mL, 185 participants] and the control group [25(OH)D ≥ 20 ng/mL, 240 participants]. Maternal blood samples were collected at 24-28 weeks of gestation and delivery for 75-g oral glucose tolerance test (OGTT), and measurements of glucose and lipid metabolite levels and 25(OH)D levels. Umbilical arterial samples were collected during delivery (33.57-41.43 gestational weeks). RESULTS Compared with control participants, vitamin D deficiency women had significantly higher concentrations of fasting blood-glucose (P < .01), 1-h OGTT plasma glucose (P < .01), 2-h OGTT plasma glucose (P < .01), insulin (P < .01), HOMA-IR (P < .01), LDL (P < .01) and triglycerides (P = .02) and lower concentrations of HOMA-S (P < .01). Compared with the control group, vitamin D deficiency women had higher concentrations of triglycerides (P < .01) and lower concentrations of HDL-C (P < .01) and HOMA-β (P = .01) in infant umbilical arterial blood. Pearson's correlation analysis demonstrated that the maternal 25(OH)D level was negatively correlated with maternal plasma glucose, insulin, LDL-C, cholesterol, triglyceride and HOMA-IR (r = -.38, -.27, -.2, -.11, -.11, -.33 and .11; P < .01, <.01, <.01, <.05, <.05 and <.01, respectively), while there was a positive correlation between maternal serum 25(OH)D and HOMA-S (r = .11, P < .05). The triglyceride level in the umbilical artery was negatively correlated with maternal serum 25(OH)D concentration (r = -.286, P < .01), while the HDL-C and HOMA-β in umbilical artery were positively related (r = .154, .103, P < .01). Compared with the control group, the incidences of pre-eclampsia [4.8% (9/185) vs 1.25% (3/240), P = .03], gestational diabetes mellitus [19.45% (36/185) vs 12.08% (29/240), P = .04] and premature rupture of membranes [15.68% (29/185) vs 5.42% (13/240), P < .01] were higher in the vitamin D deficiency group. CONCLUSION Vitamin D deficiency during pregnancy is associated with maternal glucose and lipid metabolism and pregnancy outcomes. Therefore, it is worth recommending to maintain vitamin D status at an optimal level in pregnant women to prevent metabolic disorders and pregnancy complications.
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Affiliation(s)
- Hai‐Ying Chen
- Department of Obstetrics and GynecologyThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhou Maternal and Child Health Care HospitalWenzhouChina
| | - Hong‐Ping Zhang
- Department of Obstetrics and GynecologyThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhou Maternal and Child Health Care HospitalWenzhouChina
| | - Jie Yang
- Department of Obstetrics and GynecologyThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhou Maternal and Child Health Care HospitalWenzhouChina
| | - Zhi‐Qiong Huang
- Department of Obstetrics and GynecologyThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhou Maternal and Child Health Care HospitalWenzhouChina
| | - Hai‐Xia Xu
- Department of Obstetrics and GynecologyThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhou Maternal and Child Health Care HospitalWenzhouChina
| | - Jiang Jin
- Department of Clinical LaboratoryThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhouChina
| | - Kai Xu
- Department of Clinical LaboratoryThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhouChina
| | - Yu Tong
- Department of Clinical LaboratoryThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhouChina
| | - Qian‐Qian Dong
- Department of Obstetrics and GynecologyThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhou Maternal and Child Health Care HospitalWenzhouChina
| | - Jian‐Qiong Zheng
- Department of Obstetrics and GynecologyThe Third Clinical Institute Affiliated to Wenzhou Medical UniversityWenzhou People’s HospitalWenzhou Maternal and Child Health Care HospitalWenzhouChina
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Long-Term Effects of Vitamin D Supplementation in Obese Children During Integrated Weight-Loss Programme-A Double Blind Randomized Placebo-Controlled Trial. Nutrients 2020; 12:nu12041093. [PMID: 32326621 PMCID: PMC7230345 DOI: 10.3390/nu12041093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Vitamin D was studied in regards to its possible impact on body mass reduction and metabolic changes in adults and children with obesity yet there were no studies assessing the impact of vitamin D supplementation during a weight management program in children and adolescence. The aim of our study was to assess the influence of 26 weeks of vitamin D supplementation in overweight and obese children undergoing an integrated 12–months’ long weight loss program on body mass reduction, body composition and bone mineral density. Methods: A double–blind randomized placebo–controlled trial. Vitamin D deficient patients (<30 ng/ml level of vitamin D) aged 6–14, participating in multidisciplinary weight management program were randomly allocated to receiving vitamin D (1200 IU) or placebo for the first 26 weeks of the intervention. Results: Out of the 152 qualified patients, 109 (72%) completed a full cycle of four visits scheduled in the program. There were no difference in the level of BMI (body mass index) change – both raw BMI and BMI centiles. Although the reduction of BMI centiles was greater in the vitamin D vs. placebo group (−4.28 ± 8.43 vs. −2.53 ± 6.10) the difference was not statistically significant (p = 0.319). Similarly the reduction in fat mass—assessed both using bioimpedance and DEXa was achieved, yet the differences between the groups were not statistically significant. Conclusions: Our study ads substantial results to support the thesis on no effect of vitamin D supplementation on body weight reduction in children and adolescents with vitamin D insufficiency undergoing a weight management program.
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11
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Yuan J, Jia P, Hua L, Xin Z, Yang JK. Vitamin D deficiency is associated with risk of developing peripheral arterial disease in type 2 diabetic patients. BMC Cardiovasc Disord 2019; 19:145. [PMID: 31208330 PMCID: PMC6580529 DOI: 10.1186/s12872-019-1125-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/02/2019] [Indexed: 12/26/2022] Open
Abstract
Background The relationship between vitamin D levels and peripheral arterial disease (PAD) remains unclear. We assessed the association of serum 25-hydroxyvitamin D (25(OH)D) levels with the prevalence of PAD in patients with type 2 diabetes mellitus(T2DM). Methods A total of 1018 T2DM patients participated in this cross-sectional study. Serum 25(OH)D levels were measured and risk factors of PAD were recorded. PAD was diagnosed as an ankle-brachial index (ABI) < 0.9. Results The mean age of the diabetic patients was 58.59 ± 11.34 years. Of all the patients, only 20.1% had a 25(OH)D level ≥ 20 ng/mL. Compared to patients without PAD, serum 25(OH)D levels were significantly lower in those with PAD (14.81 ± 8.43 vs. 11.55 ± 5.65 ng/mL, P < 0.001). The overall prevalence of PAD was 7.7%. From the highest level (≥ 20 ng/mL) to the lowest level (< 10 ng/mL) of serum 25(OH)D, the prevalence of PAD was 2.8, 7.5 and 10.7% respectively. After adjustment for age, sex, body mass index (BMI), smoking status and season, compared to patients with serum 25(OH)D levels ≥20 ng/mL, the odds ratios of PAD in patients with a level of 10 to < 20 ng/mL and < 10 ng/mL was 3.587(95% CI: 1.314–9.790) and 5.540(95% CI: 2.004–15.320), respectively. When further considering the influence of coronary heart disease (CHD), hypertension and cerebral infarction, the ratios changed to 3.824(95% CI: 1.378–10.615) and 5.729(95% CI: 2.028–16.187), respectively. And after further adjustment for the duration of diabetes, glycated hemoglobin (HbA1c) and glomerular filtration rate (GFR), the ratios changed to 3.489(95% CI: 1.100–11.062) and 3.872(95% CI: 1.168–12.841), respectively. Conclusions Reduced serum vitamin D levels were associated with an increased risk of PAD in T2DM patients. Randomized interventive clinical studies are required to verify the effects of vitamin D supplementation on PAD.
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Affiliation(s)
- Jing Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Beijing, 100730, China
| | - Pu Jia
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Lin Hua
- Department of Mathematics, School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China
| | - Zhong Xin
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Beijing, 100730, China
| | - Jin-Kui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Beijing, 100730, China.
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12
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Mukhopadhyay P, Ghosh S, Pandit K, Chatterjee P, Mukherjee PS, Chowdhury S. Pandemic of Vitamin D Deficiency: Cardiometabolic Concern or Skeletal Biochemical Abnormality? Indian J Endocrinol Metab 2019; 23:215-221. [PMID: 31161106 PMCID: PMC6540882 DOI: 10.4103/ijem.ijem_59_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
CONTEXT Biochemical Vitamin D deficiency is said to be present universally in recent times. However, its effect is more profound in modulation of anthropometric and biochemical risk factors of various chronic metabolic disorders rather than its influence on bone mineral abnormalities. The present study was undertaken to compare various anthropometric and biochemical parameters including basic bone mineral biochemistry in various strata of Vitamin D status. MATERIALS AND METHODS A population based study was done in the rural area of West Bengal comprising 405 people (initially targeted 400) to look for various anthropometric and biochemical parameters. RESULTS Anthropometric metabolic markers like BMI, WC, waist to height ratio and biochemical parameters like total cholesterol, LDL, TG, insulin, ALT, FPG were statistically significantly higher in vitamin D deficient (<20 ng/ml) (n = 228) subjects compared to Vitamin D non-deficient subjects (≥20 ng/ml) (n = 177) which persisted even after adjustment for BMI except for FPG. The difference was similarly present when severely Vitamin D deficient (<10 ng/ml) (n = 39) subjects were compared to Vitamin D sufficient subjects (≥30 ng/ml) (n = 38) and persisted after adjustment for BMI except for FPG. However, WHR, blood pressure (both systolic and diastolic), HbA1c, HDL, AST, Uric acid, freeT4, TSH, HOMA-IR were not different in both the above-mentioned comparisons. Metabolic syndrome was statistically significantly lower in vitamin D non-deficient subjects. Though iPTH was statistically significantly higher in the low vitamin D cohorts in both the comparisons, bone mineral markers like serum calcium, phosphorus and alkaline phosphatase were not different even when severely vitamin D deficient subjects were compared to vitamin D sufficient subjects. CONCLUSION Pandemic of vitamin D deficiency is more likely to be associated with cardio-metabolic risk factors than biochemical bone mineral abnormality.
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Affiliation(s)
| | - Sujoy Ghosh
- Department of Endocrinology, IPGME and R, Kolkata, West Bengal, India
| | - Kaushik Pandit
- Department of Endocrinology, Belle Vue Clinic, Kolkata, West Bengal, India
| | | | - Partha Sarathi Mukherjee
- Department of Public Health, Indian Institute of Liver and Digestive Sciences, Kolkata, West Bengal, India
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Kjalarsdottir L, Tersey SA, Vishwanath M, Chuang JC, Posner BA, Mirmira RG, Repa JJ. 1,25-Dihydroxyvitamin D 3 enhances glucose-stimulated insulin secretion in mouse and human islets: a role for transcriptional regulation of voltage-gated calcium channels by the vitamin D receptor. J Steroid Biochem Mol Biol 2019; 185:17-26. [PMID: 30071248 DOI: 10.1016/j.jsbmb.2018.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 06/26/2018] [Accepted: 07/06/2018] [Indexed: 12/12/2022]
Abstract
AIM Vitamin D deficiency in rodents negatively affects glucose-stimulated insulin secretion (GSIS) and human epidemiological studies connect poor vitamin D status with type 2 diabetes. Previous studies performed primarily in rat islets have shown that vitamin D can enhance GSIS. However the molecular pathways linking vitamin D and insulin secretion are currently unknown. Therefore, experiments were undertaken to elucidate the transcriptional role(s) of the vitamin D receptor (VDR) in islet function. METHODS Human and mouse islets were cultured with vehicle or 1,25-dihydroxyvitamin-D3 (1,25D3) and then subjected to GSIS assays. Insulin expression, insulin content, glucose uptake and glucose-stimulated calcium influx were tested. Microarray analysis was performed. In silico analysis was used to identify VDR response elements (VDRE) within target genes and their activity was tested using reporter assays. RESULTS Vdr mRNA is abundant in islets and Vdr expression is glucose-responsive. Preincubation of mouse and human islets with 1,25D3 enhances GSIS and increases glucose-stimulated calcium influx. Microarray analysis identified the R-type voltage-gated calcium channel (VGCC) gene, Cacna1e, which is highly upregulated by 1,25D3 in human and mouse islets and contains a conserved VDRE in intron 7. Results from GSIS assays suggest that 1,25D3 might upregulate a variant of R-type VGCC that is resistant to chemical inhibition. CONCLUSION These results suggest that the role of 1,25D3 in regulating calcium influx acts through the R-Type VGCC during GSIS, thereby modulating the capacity of beta cells to secrete insulin.
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Affiliation(s)
- Lilja Kjalarsdottir
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, United States.
| | - Sarah A Tersey
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, United States; Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Mridula Vishwanath
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX, 75390, United States
| | - Jen-Chieh Chuang
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, United States
| | - Bruce A Posner
- Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX, 75390, United States
| | - Raghavendra G Mirmira
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, United States; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, United States; Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN, 46202, United States
| | - Joyce J Repa
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, United States; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, 75390, United States.
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14
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Yang Y, Liu B, Gao L, Li Q, Wang H, Wang L. Impact of 1,25(OH) 2 D 3 on TG content in liver of rats with type 2 diabetes. Acta Cir Bras 2018; 33:542-550. [PMID: 30020316 DOI: 10.1590/s0102-865020180060000009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/10/2018] [Indexed: 01/24/2023] Open
Abstract
PURPOSE To evaluate the effects of 1,25 dihydroxy vitamin D3 (1,25(OH)2D3) on the content of triglyceride (TG), as well as on the gene and protein expressions of adiponectin receptor 2 (AdipoR2), p38 mitogen-activated protein kinase (P38MAPK), and lipoprotein lipase (LPL) in the liver of rats with type 2 diabetes mellitus (T2DM) so as to provide theoretical basis for exploring the mechanism by which 1,25(OH)2D3 regulates TG. METHODS Wistar rats were divided into four groups (n=25), with different treatments and detected the gene and protein expressions of AdipoR2, p38MAPK, and LPL in the liver tissue by reverse transcription polymerase chain reaction (RT-PCR) and Western blotting. Meanwhile, the content of TG in the liver tissue was detected by the Enzyme-linked immunosorbent assay. RESULTS The expression of AdipoR2, p38MAPK, LPL gene and protein in the liver of VitD intervention group was significantly higher than that in T2DM group (P <0.05), while the TG content was significantly lower than that in T2DM group (P <0.05). CONCLUSION 1,25(OH)2D3 can decrease the content of TG in the liver, and its mechanism may be achieved by upregulating the expressions of AdipoR2, p38MAPK, and LPL in the liver.
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Affiliation(s)
- Yan Yang
- PhD, Department of Endocrinology, Affiliated Hospital of Zunyi Medical College, China. Manuscript preparation and writing
| | - Beibei Liu
- Fellow Master degree, Department of Endocrinology, Affiliated Hospital of Zunyi Medical College, China. Analysis and interpretation of data, statistical analysis
| | - Ling Gao
- MD, Department of Endocrinology, Affiliated Hospital of Zunyi Medical College, China. Critical revision, final approval
| | - Qi Li
- Fellow Master degree, Department of Endocrinology, Affiliated Hospital of Zunyi Medical College, China. Technical procedures, acquisition of data
| | - He Wang
- Fellow Master degree, Department of Endocrinology, Affiliated Hospital of Zunyi Medical College, China. Technical procedures, acquisition of data
| | - Liandi Wang
- Fellow Master degree, Department of Endocrinology, Affiliated Hospital of Zunyi Medical College, China. Acquisition and interpretation of data
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Angellotti E, Pittas AG. The Role of Vitamin D in the Prevention of Type 2 Diabetes: To D or Not to D? Endocrinology 2017; 158:2013-2021. [PMID: 28486616 PMCID: PMC5505219 DOI: 10.1210/en.2017-00265] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 05/03/2017] [Indexed: 01/08/2023]
Abstract
Evidence on biological plausibility from mechanistic studies and highly consistent data from observational studies raise the possibility that optimizing vitamin D status may reduce the risk of type 2 diabetes. However, the observational nature of cohort studies precludes a definitive assessment of cause and effect because residual confounding or reverse causation cannot be excluded. Confounding is especially problematic with studies of vitamin D because blood 25-hydoxyvitamin D concentration is not only an excellent biomarker of vitamin D status, reflecting intake or biosynthesis, but also an excellent marker of good overall health. Results from underpowered trials and post hoc analyses of trials designed for nondiabetic outcomes do not support a role of vitamin D supplementation for prevention of type 2 diabetes among people with normal glucose tolerance. Whether vitamin D supplementation may have a role in the prevention of diabetes in high-risk populations remains to be seen. Adequately powered, randomized trials in well-defined populations (e.g., prediabetes) are ongoing and expected to establish whether vitamin D supplementation lowers risk of diabetes.
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Affiliation(s)
- Edith Angellotti
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts 02111
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, University of Campania Luigi Vanvitelli, Naples 80128, Italy
| | - Anastassios G. Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts 02111
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Lotito A, Teramoto M, Cheung M, Becker K, Sukumar D. Serum Parathyroid Hormone Responses to Vitamin D Supplementation in Overweight/Obese Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutrients 2017; 9:nu9030241. [PMID: 28272298 PMCID: PMC5372904 DOI: 10.3390/nu9030241] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/27/2017] [Accepted: 02/28/2017] [Indexed: 02/07/2023] Open
Abstract
Obesity is often associated with vitamin D deficiency and secondary hyperparathyroidism. Vitamin D supplementation typically leads to the reductions in serum parathyroid hormone (PTH) levels, as shown in normal weight individuals. Meanwhile, the dose of vitamin D supplementation for the suppression of PTH may differ in overweight and obese adults. We conducted a systematic review and meta-analysis of randomized controlled trials to determine the dose of vitamin D supplementation required to suppress PTH levels in overweight/obese individuals. We identified 18 studies that examined overweight or obese healthy adults who were supplemented with varying doses of vitamin D3. The primary outcomes examined were changes in PTH and serum 25-hydroxyvitamin D (25OHD) levels from baseline to post-treatment. The results of the meta-analysis showed that there was a significant treatment effect of vitamin D supplementation on PTH, total standardized mean difference (SMD) (random effects) = -0.38 (95% CI = -0.56 to -0.20), t = -4.08, p < 0.001. A significant treatment effect of vitamin D supplementation was also found on 25OHD, total SMD (random effects) = 2.27 (95% CI = 1.48 to 3.06) t = 5.62, p < 0.001. Data from available clinical trials that supplemented adults with D3 ranging from 400 IU to 5714 IU, showed that 1000 IU of vitamin D supplementation best suppressed serum PTH levels, total SMD = -0.58, while vitamin D supplementation with 4000 IU showed the greatest increase in serum 25OH levels. Vitamin D and calcium supplementation of 700 IU and 500 mg, respectively, also showed a significant treatment effect on the suppression of PTH with a total SMD = -5.30 (95% CI = -9.72 to -0.88). In conclusion, the meta analysis of available clinical trials indicates that 1000 IU vitamin D supplementation can suppress serum PTH levels, while 4000 IU of vitamin D was associated with the largest increase in serum 25OHD levels in the overweight and obese population.
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Affiliation(s)
- Ashley Lotito
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, USA.
| | - Masaru Teramoto
- Division of Physical Medicine & Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA.
| | - May Cheung
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, USA.
| | - Kendra Becker
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, USA.
| | - Deeptha Sukumar
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, USA.
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Ni W, Glenn DJ, Gardner DG. Tie-2Cre mediated deletion of the vitamin D receptor gene leads to improved skeletal muscle insulin sensitivity and glucose tolerance. J Steroid Biochem Mol Biol 2016; 164:281-286. [PMID: 26369613 PMCID: PMC4788578 DOI: 10.1016/j.jsbmb.2015.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 09/09/2015] [Accepted: 09/10/2015] [Indexed: 02/06/2023]
Abstract
A variety of studies have suggested that vitamin D may play a palliative role in improving insulin secretion and glucose tolerance. Endothelial cells of the microcirculation are thought to play an important role in regulating both insulin secretion and insulin sensitivity in target tissues. We have selectively deleted the vitamin D receptor (VDR) gene in endothelial cells of the murine vasculature. These mice demonstrate improved glucose tolerance, improved insulin sensitivity in skeletal muscle, but not in liver, and a reduction in expression and secretion of insulin in the pancreatic islets. Collectively, these data, taken within the context of recent publications in this field, suggest that the endothelial cell VDR plays a tonic inhibitory role in regulating glucose disposal and could prove to be a factor in controlling glucose homeostasis in the intact organism.
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Affiliation(s)
- Wei Ni
- Diabetes Center, University of California, San Francisco, CA 94143-0540, United States
| | - Denis J Glenn
- Department of Medicine, University of California, San Francisco, CA 94143-0540, United States
| | - David G Gardner
- Department of Medicine, University of California, San Francisco, CA 94143-0540, United States.
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18
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Kwon HN, Lim H. Relationship between Serum Vitamin D Status and Metabolic Risk Factors among Korean Adults with Prediabetes. PLoS One 2016; 11:e0165324. [PMID: 27783655 PMCID: PMC5082612 DOI: 10.1371/journal.pone.0165324] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/10/2016] [Indexed: 02/06/2023] Open
Abstract
Serum vitamin D status has been associated with prediabetes and metabolic syndrome. Evidence for the increased risk of metabolic disorders in individuals with prediabetes and a low vitamin D status is limited and uncertain. Furthermore, it has not been confirmed whether this possible relationship occurs in the Korean population. The aim of this study was to assess serum vitamin D status and to examine the relationship between serum vitamin D levels and metabolic risk factors in Korean adults with prediabetes. This cross-sectional study was conducted among 60 subjects aged 20-65 years. Participants had fasting glucose levels of 100 to 125 mg/dl. A questionnaire was used to assess vitamin D synthesis from sun exposure and a dietary intake examined using 3-days dietary records. Clinical and biochemical data were also collected. The 2009 harmonized definition of metabolic syndrome was used. Serum vitamin D levels were classified according to criteria from the 2011 Institute of Medicine report. The majority of subjects (75%) had a serum 25(OH)D level < 20 ng/ml, and among them, 31.1% were vitamin D deficiency (< 12 ng/ml). The proportion (42.9%) of subjects having low HDL-cholesterol was the highest among vitamin D deficiency (< 12 ng/ml) group (12 to < 20 ng/ml: 16.1%, ≥ 20 ng/ml: 6.7%). We observed an inverse relationship between 25(OH)D levels and TG, AI (β = -6.355, SE = 2.463; β = -0.020, SE = 0.008) after adjusted confounders. Korean adults with prediabetes were more likely to have low serum 25(OH)D levels. A sufficient 25(OH)D level may have possible beneficial effects on lipid profiles.
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Affiliation(s)
- Han Na Kwon
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yong-In, Gyenggi-do 17104, Republic of Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yong-In, Gyenggi-do 17104, Republic of Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Republic of Korea
- * E-mail:
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Wakayo T, Whiting SJ, Belachew T. Vitamin D Deficiency is Associated with Overweight and/or Obesity among Schoolchildren in Central Ethiopia: A Cross-Sectional Study. Nutrients 2016; 8:190. [PMID: 27043619 PMCID: PMC4848659 DOI: 10.3390/nu8040190] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/19/2016] [Accepted: 03/22/2016] [Indexed: 12/11/2022] Open
Abstract
Childhood and adolescent obesity is an international public health problem leading to an increased risk of adulthood obesity, mortality and morbidity. Its prevalence is increasing in low-income populations, and we hypothesized it may be associated with vitamin D deficiency. Low vitamin D status is a worldwide public health issue including in Ethiopia; however, no one has examined overweight/obesity in Ethiopian schoolchildren with regard to vitamin D status. The Analyses of a data set from a school-based cross-sectional study conducted in Adama Town (n = 89) and in rural Adama Woreda (n = 85) was carried out to determine vitamin D deficiency and its association with overweight and/or obesity. Data on a total of 174 schoolchildren aged 11-18 years was used for these analyses. The overall prevalence of overweight and/or obesity was 10.3%, with 8.5% overweight and 2.3% obese; the prevalence of underweight was 19%. In the multivariable logistic regression model, vitamin D deficiency, being in the higher age group, female sex and urban residence of students, their mothers' occupation of being employed and their households' high and middle socioeconomic status were significantly associated with overweight and/or obesity. We concluded that vitamin D deficiency is an independent predictor significantly associated with overweight and/or obesity among schoolchildren from rural and urban settings in Ethiopia. The results imply the need for behavior change communications on the importance of exposure to sunlight to produce adequate vitamin D to curb this emerging health problem of overweight/obesity following economic growth and globalization in Ethiopia. As this study only highlighted the association, prospective studies and randomized controlled trials are required to establish causality.
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Affiliation(s)
- Tolassa Wakayo
- College of Health Sciences, Jimma University, Jimma, Ethiopia.
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Tefera Belachew
- College of Health Sciences, Jimma University, Jimma, Ethiopia.
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Diaz GM, González L, Ramos-Trautmann G, Pérez CM, Palacios C. Vitamin D Status Is Associated with Metabolic Syndrome in a Clinic-Based Sample of Hispanic Adults. Metab Syndr Relat Disord 2016; 14:259-64. [PMID: 26741699 DOI: 10.1089/met.2015.0117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Vitamin D status has been associated with metabolic syndrome (MetSyn) and its components in different populations, but few studies have assessed this among Hispanics. The objective of this analysis was to assess such association in a clinic-based sample of Hispanic adults. METHODS Medical records were reviewed retrospectively for the years 2005-2013. MetSyn was assessed using the revised NCEP-ATP III criteria. Vitamin D status was evaluated from reported serum 25(OH)D levels. A multivariable logistic regression model was used to assess the association between MetSyn risk and vitamin D status, controlling for important confounders. RESULTS From 1379 medical records evaluated, 712 met the inclusion criteria. Most were females (62.6%), with a mean age of 53.8 ± 14.1 years, mean body mass index (BMI) of 30.1 ± 6.4 kg/m(2), and mean serum 25(OH)D levels of 24.4 ± 8.3 ng/mL. MetSyn was identified in 40.5% of the participants. Serum 25(OH)D levels in those with MetSyn (22.7 ± 8.0 ng/mL) were significantly lower compared to those without MetSyn (25.5 ± 8.4 ng/mL; P < 0.001). Serum 25(OH)D levels were inversely correlated to triglycerides, waist circumference, and fasting blood glucose (P < 0.05). In the multivariable logistic regression model, decreased serum 25(OH)D levels were associated with higher odds of MetSyn, even after adjusting for age, gender, BMI, and seasonality. CONCLUSION In this clinic-based sample, the odds of MetSyn increased as serum 25(OH)D levels decreased. These results have important public health implications for developing recommendations directed to increase vitamin D status in this sample.
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Affiliation(s)
- Giselle M Diaz
- 1 Nutrition Program, Department of Human Development, Graduate School of Public Health, University of Puerto Rico , San Juan, Puerto Rico
| | - Lilliana González
- 1 Nutrition Program, Department of Human Development, Graduate School of Public Health, University of Puerto Rico , San Juan, Puerto Rico
| | - Grisel Ramos-Trautmann
- 1 Nutrition Program, Department of Human Development, Graduate School of Public Health, University of Puerto Rico , San Juan, Puerto Rico
| | - Cynthia Marie Pérez
- 2 Epidemiology Program, Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico , San Juan, Puerto Rico
| | - Cristina Palacios
- 1 Nutrition Program, Department of Human Development, Graduate School of Public Health, University of Puerto Rico , San Juan, Puerto Rico
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