Vitamin D status and insulin resistance among young obese Saudi females

Vitamin D Deficiency Is Inversely Associated with Homeostatic Model Assessment of Insulin Resistance

The study was conducted to comprehensively assess the association of the concentration of vitamin D in the blood and insulin resistance in non-diabetic subjects. The objective was to pool the results from all observational studies from the beginning of 1980 to August 2021. PubMed, Medline and Embase were systematically searched for the observational studies. Filters were used for more focused results. A total of 2248 articles were found after raw search which were narrowed down to 32 articles by the systematic selection of related articles. Homeostatic Model Assessment of Insulin Resistance (HOMAIR) was used as the measure of insulin resistance and correlation coefficient was used as a measure of the relationship between vitamin D levels and the insulin resistance. Risk of bias tables and summary plots were built using Revman software version 5.3 while Comprehensive meta-analysis version 3 was used for the construction of forest plot. The results showed an inverse association between the status of vitamin D and insulin resistance (r = -0.217; 95% CI = -0.161 to -0.272; p = 0.000). A supplement of vitamin D can help reduce the risk of insulin resistance; however further studies, like randomized controlled trials are needed to confirm the results.

Dietary Intake and Physical Activity in Relation to Insulin Resistance in Young Overweight Saudi Females: An Exploratory Pilot Study

Insulin resistance is a major contributor to the development of several chronic metabolic diseases, including type 2 diabetes mellitus, and is an increasing health concern in Saudi Arabia. Diet and physical activity have been postulated to affect insulin resistance; however, their effects on development of insulin resistance in young overweight Saudi females have not been explored. Therefore, the aim of the study is to investigate whether diet and physical inactivity increases the risk of insulin resistance in young overweight Saudi females. In a cross-sectional study, 42 overweight female Saudi students, aged between 20 and 30 years, were recruited from King Abdul-Aziz University. A questionnaire was used to collect demographics, anthropometric measurements, physical activity, and food frequency data. Blood biomarkers (lipid profile, fasting glucose, and fasting insulin) were measured. Insulin resistance was assessed using homeostasis model assessment 2 (HOMA2)-insulin resistance (IR) scores. A significant difference in median body mass index (BMI) was observed between the HOMA2-IR normal and HOMA2-IR raised index groups (P=0.04). In terms of dietary habits, the insulin resistant group had a higher intake of canned beverages compared with the normal group (P=0.03). No significant differences were found between the groups in terms of waist circumference, hip circumference, waist-to-hip ratio, or body fat percentage. The lipid profile also did not significantly differ between the two groups. This study demonstrates significant differences in HOMA2-IR-defined insulin resistance according to subjects’ BMI and canned beverage intake. A larger study is needed to confirm these associations.

Relationship between Vitamin D Deficiency, Diabetes, and Obesity

AIM

This study aimed to assess the prevalence of VDD in Saudi Arabia, revealing the lifestyle and nutritional habits; and assesses the association between VDD, Diabetes Mellitus, and obesity.

METHODS

A descriptive, cross-sectional, and correlational design was used in this study. A convenience sampling method of 350 participants participated in the study.

RESULTS

The results revealed that the probability of having vitamin D Deficiency was higher among females (OR = 2.06, p > .05); younger age-whereby with each one year decrease in age there was about 0.03 probability of having Vitamin D Deficiency (B = -0.03; p > .05); individuals with higher incomes (OR = 1.44, p > .05); smokers (OR = 0.08, p > .05); and a lack of exposure to the sun (OR = 8.50; p > .05). In addition, exercise is also a predictor of Vitamin D deficiency (OR = 3.8; p > .05). Moreover, less Vitamin D intake (OR 9.7; p > .05), less intake of Calcium (OR = 12.2, p > .05); In addition increase one unit in the BMI, cholesterol, LDL, HDL, and FBS increased the log odd of having liability of Vitamin D deficiency by 3.2; 1.9, 1.8, 1.0, and 2.4 (p > .05).

CONCLUSION

Vitamin D Deficiency was prevalent in both males and females across different age groups in the citizens of Saudi. Because of the connection between Vitamin D Deficiency and main chronic disease, it is necessary to emphasize the need to recognize Vitamin D Deficiency screening for risk factors. It may be reasonable for the nutritionists, nurses, and physicians, to encourage the community on approaches to enhance dietary Vitamin D or suggest supplementation.

Biomarker potential of C-peptide for screening of insulin resistance in diabetic and non-diabetic individuals

Insulin resistance is a hallmark feature of type-2 diabetes mellitus (T2DM). We determined the homeostatic model assessment insulin resistance (HOMA-IR) and evaluated its association with C-peptide, insulin, fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) in T2DM patients and non-diabetic subjects. This study comprised a total of 47 T2DM patients and 38 non-diabetic controls. Venous blood samples from all the subjects were collected and sera were analyzed for FBG, HbA1c, insulin and C-peptide using an autoanalyzer. HOMA-IR was calculated using the following equation: HOMA-IR = fasting insulin (µU/ml) × fasting glucose (mmol/L)/22.5. There was a significant increase in the levels of FBG and HbA1c in diabetic patients. Although the levels of C-peptide and insulin did not differ significantly between the two groups, a significant increase in HOMA-IR was observed in T2DM patients. Both insulin and C-peptide were significantly correlated with HOMA-IR. In conclusion, C-peptide may serve as a simple and convenient predictor of HOMA-IR.

Associations of vitamin D status and metabolic dyslipidemia and hypertriglyceridemic waist phenotype in apparently healthy adults

BACKGROUND

Recent studies have shown that Vitamin D deficiency is very common globally. Vitamin D deficiency is associated with lipid metabolism. A relationship between vitamin D levels and waist circumference (WC) has been observed. The purpose of this study is to evaluate the relationship between vitamin D status and metabolic dyslipidemia and the hypertriglyceridemic waist phenotype.

METHODS

This cross-sectional study was conducted on 265 healthy Tehran adults. Hypertriglyceridemic waist phenotype (HTGWP) was described as serum triacylglycerol concentrations >150 mg/dL and concurrent WC > 88 cm (women) and >102 cm (men). Dyslipidemia was defined as: 1) TG level of >150 mg/dL 2) HDL > 40 mg/dL for men or >50 mg/dL for women, as has been previously described.

RESULTS

Current study's results demonstrated that HTGWP was significantly associated with weight, age, WC, hip, fat percent, TG, lipid profile, ALT and BMI. We found 77% reduction in the chances of developing metabolic dyslipidemia in suficient satus of vitamin D in compare to deficiency, although the significancy was mariginal, OR: 0.33, 95% CI of 0.09 to 1.21, P = 0.09. However, our results revealed that vitamin D deficiency, compared with normal status, can increase the risk of phenotype 1 (high TG/high WC); OR: 3.86 and 95% CI from 0.86 to 0.99, p for trend = 0.05.

CONCLUSIONS

Significant associations were found between vitamin D status and HTGWP. In addition, there was a relationship between vitamin D and lipid profiles. There is a direct correlation between TG and waist circumference in insulin resistance in healthy Tehran adults.

The Prevalence of Hypovitaminosis D and Its Associated Risk Factors Among Women of Reproductive Age in Saudi Arabia: A Systematic Review and Meta-Analysis

Vitamin D deficiency is currently a worldwide epidemic. Middle Eastern countries, including Saudi Arabia, have high vitamin D deficiency prevalence, most prominently among women, despite their plentiful year-round sunshine. Previous research investigating vitamin D status among Saudi women of reproductive age (15-49 years) is scarce, and no study has used a nationally representative sample, so this review quantified overall hypovitaminosis D prevalence among women in Saudi Arabia and explored the associated risk factors. The Web of Science, Scopus, and Medline databases were searched for prior studies in Saudi Arabia exploring vitamin D status among women of reproductive age, published between January 1, 2000 and May 25, 2017. Data were extracted from the identified studies, and a random effects model meta-analysis established the overall hypovitaminosis D prevalence. The initial search yielded 223 possibly relevant articles; 13 were confirmed as eligible, with samples totaling 2877 women aged between 15 and 49 years. Meta-analysis revealed a mean serum 25-hydroxyvitamin D, 25(OH)D, level of 13.1 ng/mL (95% confidence interval [CI]: 11.6-14.6) and an overall prevalence of hypovitaminosis D, defined as 25(OH)D < 30 ng/mL, of 77.4% (95% CI: 63.2-87.3), mostly due to insufficient sunlight exposure and low dietary vitamin D intake. There is therefore a need for a national strategy to raise vitamin D levels among women in Saudi Arabia by advising them on natural vitamin D sources, and recommending the timing and duration of sun exposure, while also defining a national approach to vitamin D fortification and supplementation.

Vitamin D supplementation and body fat mass: a systematic review and meta-analysis

Studies have indicated that 25-hydroxyvitamin D (25(OH)D) level in obese is lower than normal weight subjects; however, results of studies that investigated relationship between 25(OH)D and fat mass are inconsistent. In addition, several randomized clinical trials (RCTs) have studied the influence of cholecalciferol supplement on percentage fat mass (PFM) but their results are conflicting. The objectives were to investigate the association between vitamin D3 and PFM pooling together observational studies and RCTs. PubMed/MEDLINE, Cochrane, and Scopus were comprehensively searched from inception to September 2016. The Fisher's Z (SE) of correlation coefficient and mean (SD) of changes in PFM from baseline were used to perform meta-analysis in observational studies and RCTs, respectively. To determine potential source of heterogeneity, subgroup and meta-regression analyses were conducted. Pooling correlation coefficients showed an inverse association between PFM (Fisher's Z: - 0.24, 95% CI: - 0.30 to -0 .18) and FM (Fisher's Z: - 0.32, 95% CI: - 0.43 to - 0.22) and 25(OH)D. Subgroup analysis revealed continent but not gender influence on the effect size. Meta-regression analysis indicated that age, latitude, and longitude are not sources of heterogeneity. Combining trials showed vitamin D3 supplementation had a mild but insignificant effect on PFM (- 0.31%, 95% CI: - 1.07 to 0.44). Subgroup analyses indicated that type of cholecalciferol and treatment regimens explain source of heterogeneity. Age, baseline body mass index, dose of cholecalciferol, length of study, female (%), and baseline 25(OH)D are not source of heterogeneity. In conclusion, our results state that 25(OH)D level is inversely correlated with PFM but cholecalciferol supplementation had no effect on PFM.

Current Evidence on Vitamin D Deficiency and Metabolic Syndrome in Obese Children: What Does the Evidence from Saudi Arabia Tell Us?

Obesity and vitamin D deficiency represent major health problems among Saudi children, and have been linked to chronic diseases. Obese children are at risk of developing vitamin D deficiency, which appears to have negative influences on energy homeostasis, impeded bone mineralisation, insulin resistance and inflammation. Evidence supporting the association between vitamin D deficiency of obese children and metabolic syndrome has not specifically been studied in early childhood. The mechanisms through which vitamin D deficiency is associated with metabolic syndrome in obese children needs further elucidation. This commentary aims to (i) summarise current knowledge of the association between vitamin D deficiency and metabolic syndrome in obese children; and (ii) discuss current evidence for the association among Saudi Arabian children.

Vitamin D in Saudi Arabia: Prevalence,distribution and disease associations

More than 33 years have passed since the first paper highlighting vitamin D deficiency as a public health concern in Saudi Arabia was published in 1983. Despite "early" detection,it wasn't until the year 2010 where the interest in vitamin D research grew exponentially worldwide and was finally visible in Saudi clinical and academic areas. Since then,many landmark studies have been generated with regards to the physiologic functions of vitamin D,both skeletal and extra-skeletal. This review is limited to the prevalence,distribution A systematic review on the prevalence studies done in KSA from 2011 to 2016 was done and revealed that the prevalence of vitamin D deficiency (<50nmol/l) in Saudi Arabia among different populations (adults,children and adolescents,newborns and pregnant/lactating women) is 81.0% (Confidence Interval 95% 68.0-90.0),in line with most neighboring Gulf countries. Vitamin D deficiency in KSA has been mostly associated with bone and insulin-resistant diseases but limited data are available to prove causality. In conclusion,there is a need to develop local consensus guidelines that will identify candidates for screening,monitoring and treating those who are at most risk for vitamin D deficiency complications.

The Prevalence of Micronutrient Deficiencies and Inadequacies in the Middle East and Approaches to Interventions

Micronutrient deficiencies and inadequacies constitute a global health issue, particularly among countries in the Middle East. The objective of this review is to identify micronutrient deficits in the Middle East and to consider current and new approaches to address this problem. Based on the availability of more recent data, this review is primarily focused on countries that are in advanced nutrition transition. Prominent deficits in folate, iron, and vitamin D are noted among children/adolescents, women of childbearing age, pregnant women, and the elderly. Reports indicate that food fortification in the region is sporadic and ineffective, and the use of dietary supplements is low. Nutrition monitoring in the region is limited, and gaps in relevant information present challenges for implementing new policies and approaches to address the problem. Government-sponsored initiatives are necessary to assess current dietary intakes/patterns, support nutrition education, and to reduce food insecurity, especially among vulnerable population groups. Public-private partnerships should be considered in targeting micronutrient fortification programs and supplementation recommendations as approaches to help alleviate the burden of micronutrient deficiencies and inadequacies in the Middle East.