Better Body Composition and Lipid Profile Can Be Associated with Vitamin D Status in Spanish Elderly? The PHYSMED Study

Association Between Decreased Serum Vitamin D Level and Dyslipidemia: A Cross-Sectional Study in Southern Taiwan

Purpose

Previous studies revealed an inconclusive association between dyslipidemia and decreased vitamin D levels. This study aims to investigate the association between dyslipidemia parameters and decreased serum vitamin D levels among the southern Taiwanese population during a health examination.

Patients and Methods

A retrospective cross-sectional study was conducted from January 2020 to December 2020, enrolling 2430 subjects in a southern Taiwanese medical center. We performed logistic regression to examine the association between lipid profiles and vitamin D insufficiency or deficiency.

Results

The prevalence of vitamin D sufficiency was higher in males (65.9%). Compared to individuals with total cholesterol (TC) < 200 mg/dL, those with TC ≥ 200 mg/dL exhibited vitamin D insufficiency or deficiency (OR, 1.46; 95% confidence intervals (CI), 1.10-1.94) after adjustment for age, gender, waist circumference (WC), fasting blood glucose, and uric acid levels. Compared to triglyceride (TG) levels of <150 mg/dL, TG levels ≥ 150 mg/dL had a higher association with vitamin D insufficiency or deficiency (OR, 1.48; 95% CI, 1.17-1.86) after adjustment for the same covariates. Post-gender stratification, we found female individuals with TC ≥ 200 mg/dL had a significantly higher association with vitamin D insufficiency or deficiency (OR, 2.11; 95% CI, 1.36-3.27), whereas TG ≥ 150 mg/dL in males exhibited a significantly higher association with vitamin D insufficiency or deficiency (OR, 1.70; 95% CI, 1.29-2.24) after adjustment for the same covariates.

Conclusion

The study revealed a negative association between decreased serum vitamin D levels and TC and TG levels. However, no significant association was observed with low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Further studies are needed to understand the mechanism.

Cholesterol Interference in the Assessment of Vitamin D Status: A Canadian Health Measures Survey Biobank Project

BACKGROUND

Matrix effects are a known problem with immunoassays measuring serum 25-hydroxyvitamin D [25(OH)D].

OBJECTIVES

To determine if the inverse association between serum 25(OH)D and serum cholesterol concentrations is a function of assay method: Diasorin Liaison 25(OH) Vitamin D Total Assay (Liaison Total Assay), an immunoassay, compared with liquid chromatography tandem mass spectrometry (LC-MS/MS).

METHODS

Canadian Health Measures Survey data and biobank serum (White males aged 20-79 y, n = 392) were evaluated for bias in serum 25(OH)D using Bland-Altman plots. Differences in serum 25(OH)D (Liaison Total Assay - LC-MS/MS) were compared among non-HDL-cholesterol <4.2 (n = 295) compared with ≥4.2 (n = 97) mmol/L and total cholesterol groups <5.2 (n = 256) compared with ≥5.2 (n = 136) mmol/L, and associations tested between 25(OH)D and non-HDL-cholesterol or total cholesterol concentrations, using regression.

RESULTS

Serum 25(OH)D measured using Liaison Total Assay ranged from 10.7 to 137.0 nmol/L and 14.4 to 137.9 nmol/L by LC-MS/MS. Liaison Total Assay - LC-MS/MS showed a negative bias of 5.5 (95% limits of agreement -23.8, 12.7) nmol/L. Differences in 25(OH)D were -4.0 ± 9.0 (±SD) nmol/L if non-HDL-cholesterol was <4.2 mmol/L and -10.2 ± 8.7 nmol/L if ≥4.2 mmol/L (P < 0.0001). Differences in 25(OH)D, if total cholesterol was <5.2 mmol/L, were -3.4 ± 8.6 nmol/L and -9.6 ± 9.3 nmol/L if ≥5.2 mmol/L (P < 0.0001). Serum non-HDL-cholesterol (beta -3.17, P = 0.0014) and total cholesterol (beta -2.77, P = 0.0046) were inversely associated with Liaison Total Assay 25(OH)D (adjusted for age, fasting, and body mass index), but not with LC-MS/MS measured 25(OH)D. Interference by these lipoproteins was not eliminated by standardization of the Liaison Total Assay. Similar associations were observed with triglycerides as for the lipoproteins.

CONCLUSIONS

Total cholesterol inversely associates with 25(OH)D, which is likely due to elevated non-HDL-cholesterol lipoprotein or triglyceride interference with the Liaison Total Assay. This is important as elevated cholesterol is common, and an underestimation of vitamin D status could be an unnecessary cause for concern.

Vitamin D is negatively associated with triglyceride in overweight/obese patients with type 2 diabetes

PURPOSE

Vitamin D has been identified to have a relation to the development of insulin resistance-related diseases, such as type 2 diabetes (T2D). T2D is often associated with obesity and dyslipidemia. Our study aimed to analyze the relationship between vitamin D and lipid profile in patients with T2D.

METHODS

A total of 446 T2D patients who were hospitalized from January 2015 to December 2016 were recruited. Baseline characteristics were recorded, including body mass index (BMI), serum level of 25 hydroxy vitamin D (25(OH)D), and other biochemical indicators. T2D patients were divided into normal-weight group and overweight/obese group according to their BMI. Subgroup analysis was conducted after patients were subdivided using the quartet-method according to serum level of 25(OH)D. Differences in glucose and lipid metabolism indicators were analyzed. The correlation between serum 25(OH)D and lipid profiles was assessed by the multiple linear regression.

RESULTS

The levels of serum 25(OH)D and high-density lipoprotein cholesterol in T2D patients of overweight/obesity group were significantly lower than those in normal-weight group, while the levels of triglyceride (TG) and HOMA-IR were significantly higher (P < 0.05). Subgroup analysis uncovered that total cholesterol (TC) and TG levels were lower with higher 25(OH)D in normal weight T2D patients. In overweight/obese T2D patients, TG level was lower in patients with higher 25(OH)D (P < 0.05). There were no significant differences in low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), fasting insulin (FINS), and hemoglobin Alc (HbAlc) among Q1-Q4 in both normal weight and overweight/obese groups. Pearson test showed that serum 25(OH)D was positively correlated with high density lipoprotein cholesterol (HDL-C), and negatively correlated with TC and TG. Serum 25(OH)D was unrelated to low density lipoprotein cholesterol (LDL-C) in both groups. Multiple linear regression analysis only demonstrated an independent negative correlation between 25(OH)D and TG levels in the overweight/obese group (P < 0.01).

CONCLUSIONS

In overweight/obese patients with T2D, serum 25(OH)D was independently, negatively correlated with TG. Vitamin D supplementation should be guaranteed in patients with diabetes, especially with obese T2D.

Relationship between abdominal obesity (based on waist circumference) and serum vitamin D levels: a systematic review and meta-analysis of epidemiologic studies

CONTEXT

Although previous observational studies have investigated the association between waist circumference (WC) values and serum vitamin D levels, findings have been inconsistent.

OBJECTIVE

A systematic review and meta-analysis was performed to evaluate the effect of abdominal obesity (based on WC) on vitamin D deficiency or insufficiency in adults.

DATA SOURCES

A systematic search of the published literature up to September 2020 was conducted in electronic databases, including MEDLINE (PubMed), EMBASE, Institute for Scientific Information (ISI) (Web of Science), Scopus, and Google Scholar, for observational studies that investigated the association between abdominal obesity (based on WC) or different categories of WC as the exposure and serum 25-hydroxy vitamin D levels as the outcome.

DATA EXTRACTION

Eighteen cross-sectional studies were included in the review. The relationship between WC values and combined serum vitamin D deficiency and insufficiency (<30 ng/mL) or vitamin D deficiency (<20 ng/mL) was evaluated.

DATA ANALYSIS

Combining 8 effect sizes from 5 investigations, including 7997 individuals, illustrated that the highest category of WC, compared with the lowest category of WC, was related to 82% increased odds of combined serum vitamin D deficiency and insufficiency (<30 ng/mL) (OR: 1.82; 95% CI: 1.34, 2.49). Moreover, in studies that investigated both genders together, the highest category of WC, compared with the lowest category of WC, was associated with 61% increased odds of serum vitamin D deficiency (<20 ng/mL) (OR: 1.61; 95% CI: 1.12, 2.31). The same results were obtained for almost all subgroups for several covariates.

CONCLUSION

This meta-analysis of cross-sectional studies confirmed that increased WC was related to the elevated risk of combined vitamin D deficiency and insufficiency in adults. More prospective studies are needed to confirm causality.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020190485.

Vitamin D Status and Correlation with Glucose and Lipid Metabolism in Gansu Province, China

OBJECTIVE

To investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and blood glucose and lipid levels in people over 18 years of age in Gansu, China.

SUBJECTS AND METHODS

A total of 1928 volunteers (958 males and 970 females) were selected. The prevalence of abnormal glucose metabolism and lipid metabolism in the vitamin D deficiency group (<20 ng/mL) and the non-vitamin D deficiency group (≥20 ng/mL) were compared. The correlations between serum 25(OH)D and blood glucose and lipid were analyzed.

RESULTS

A total of 1681 patients had 25(OH)D deficiency, with an overall prevalence of 87.2% (82.9% in males and 91.4% in females). The levels of 25(OH)D in the diabetic group and the IGT/IFG group were significantly lower than that in the normal group. The level of 25(OH)D was significantly lower in the dyslipidemia group than that in the normal group, and was significantly lower in the fasting plasma glucose (FPG) ≥5.6 mmol/L group than that in the FPG <5.6 mmol/L group (p=0.002). The 25(OH)D level in the serum triglyceride (TG) ≥1.7 mmol/L group was significantly lower than that of the TG <1.7 mmol/L group (p=0.0274). The age, heart rate, TG, TC, FPG and H₂PG levels in the vitamin D deficiency group were significantly higher than those in the non-vitamin D deficiency group (p<0.05). The prevalence of FPG ≥5.6 mmol/L in the vitamin D deficiency group was higher than that in the non-vitamin D deficiency group (23.5% vs 16.6%, p=0.016). Multiple linear regression analysis suggested that serum 25(OH)D levels were independently correlated with gender, age, FPG, TG and heart rate (β=-0.218, -0.129, -0.075, β=-0.103, -0.058, all p<0.05).

CONCLUSION

The incidences of dyslipidemia and dysglycemia were higher in the vitamin D deficiency group. The vitamin D level was independently and negatively correlated with FPG and TC, but not with waist circumference, BMI and blood pressure.