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Begga A, Mehaoudi RI, Ghozlani A, Azzoug S, Soltani Y. The risk of metabolic syndrome is associated with vitamin D and inflammatory status in premenopausal and postmenopausal Algerian women. Ir J Med Sci 2024; 193:615-626. [PMID: 37702977 DOI: 10.1007/s11845-023-03516-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND This first cross-sectional study examined whether vitamin D status and proinflammatory cytokines may be associated with metabolic syndrome (MetS) in Algerian women regarding their menopausal status. METHODS Fasting plasma glucose (FPG), lipids, insulin, 25(OH)D, PTH, adiponectin, resistin, TNFα, and IL-6 levels were assessed in 277 participants aged 18-74 years. MetS was diagnosed according to NCEP-ATPIII criteria. The association of vitamin D deficiency, IL-6, and TNFα with components of MetS was analyzed by the logistic regression. RESULTS Among a cohort of 277 participants, the prevalence of MetS in 115 premenopausal vs. 162 postmenopausal women was 54.02 vs. 68.1%. Cut-offs for vitamin D deficiency were 15.7 vs. 13 ng/mL, 51.07 vs. 41 pg/mL for IL-6 and 8.28 vs. 9.33 pg/mL for TNFα, respectively. 25(OH)D levels were positively correlated with adiponectin levels, while negatively with HOMA-IR in postmenopausal-MS + women. Adjustment for age and BMI reveals a significant association between vitamin deficiency and high FPG (OR: 2.92 vs. 2.90), TG (OR:2.79 vs. 3.51), BP (OR:2.20 vs. 1.92), and low HDL-c (OR:2.26 vs. 3.42), respectively. A significant association was also detected in postmenopausal women between IL-6 and high FPG (OR5.11, p = 0.03), BP (OR:3.13, p = 0.04), and low HDL-c (OR5.01, p = 0.02), while TNFα was associated with high BP in postmenopausal women (OR: 3.70, p = 0.01), and inversely with TG in premenopausal women (OR: 0.16, p = 0.04). CONCLUSION This study highlighted that severe vitamin D deficiency increases MetS score and was closely associated with four components of MetS, more potently in postmenopausal women, probably related with estrogens. Abdominal obesity, as influential component of MetS, may be involved in enhancing vitamin D deficiency, and dysregulating some metabolic hormones such as adiponectin, resistin and insulin, that contributes in onset an inflammatory state, through the increase in IL-6 and TNFα levels. These findings need to be improved by expanding investigation to a large cohort of participants.
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Affiliation(s)
- Asma Begga
- Endocrinology team, Laboratory of Biology and Physiology, Faculty of Biological Sciences, USTHB, DZ-16111, Algiers, Algeria
| | - Rym-Ikram Mehaoudi
- Endocrinology team, Laboratory of Biology and Physiology, Faculty of Biological Sciences, USTHB, DZ-16111, Algiers, Algeria
| | - Amel Ghozlani
- Endocrinology team, Laboratory of Biology and Physiology, Faculty of Biological Sciences, USTHB, DZ-16111, Algiers, Algeria
| | - Said Azzoug
- Unit of Clinical Endocrinology, IBN ZIRI Hospital, DZ-16082, Algiers, Algeria
- Department of Diabetology, Mustapha Bacha University Hospital Center, DZ-16000, Algiers, Algeria
| | - Yacine Soltani
- Endocrinology team, Laboratory of Biology and Physiology, Faculty of Biological Sciences, USTHB, DZ-16111, Algiers, Algeria.
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Adeniyi OV, Masilela C, George JA. Prevalence of vitamin D deficiency and its association with cardiometabolic risk factors among healthcare workers in the Eastern Cape province, South Africa; cross-sectional study. Sci Rep 2024; 14:4756. [PMID: 38413628 PMCID: PMC10899187 DOI: 10.1038/s41598-024-54977-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
This study assesses the prevalence of Vitamin D deficiency and its potential association with cardiometabolic risk factors among South African adults residing in the Eastern Cape province. In this cross-sectional study, 1244 healthcare workers (HCWs) completed a self-administered questionnaire and venous blood samples were drawn at two academic hospitals in the Eastern Cape. History of hypertension and diabetes mellitus were self-reported. Participants were categorised as obese if their body mass index (BMI) ≥ 30 kg/m2. Participants were classified as having metabolic syndrome if they had hypertension, diabetes mellitus and obesity. Vitamin D [25(OH)D] deficiency was defined as venous blood concentrations < 50 nmol/L. Associations between vitamin D deficiency and participants' characteristics were assessed using multivariate logistic regression model analysis. The prevalence of vitamin D deficiency was 28.5% (n = 355), of whom 292 were female. Among the participants who were deficient in vitamin D, the prevalence of obesity, diabetes mellitus, hypertension, chronic kidney disease, and metabolic syndrome was 64.9% (n = 230), 9% (n = 32), 16.6% (n = 59), 2.3% (n = 8) and 18% (n = 64), respectively. In the adjusted multivariate logistic regression model, black Africans (AOR = 2.87; 95% CI 1.52-5.43) and individuals ≥ 42 years (AOR = 1.37; 95% CI 1.07-1.77) were more likely to exhibit vitamin D deficiency. However, there was no significant association by age, sex, and cardiometabolic markers. More than one in four healthcare workers was deficient in vitamin D among the study sample, especially the black Africans and older individuals. Further studies are needed at the population level to elucidate on the vitamin D status in the region.
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Affiliation(s)
| | - Charity Masilela
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa, South Africa
| | - Jaya A George
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Parktown, Johannesburg, South Africa
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Association between Serum Vitamin D and Metabolic Syndrome in a Sample of Adults in Lebanon. Nutrients 2023; 15:nu15051129. [PMID: 36904128 PMCID: PMC10004784 DOI: 10.3390/nu15051129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/19/2023] [Accepted: 02/22/2023] [Indexed: 02/25/2023] Open
Abstract
The evidence on the association between vitamin D and metabolic syndrome (MetS) is inconclusive. This was a cross-sectional study to explore the relationship between vitamin D serum levels and MetS in a sample of Lebanese adults (n = 230), free of diseases that affect vitamin D metabolism, recruited from an urban large university and neighboring community. MetS was diagnosed according to the International Diabetes Federation criteria. A logistic regression analysis was performed taking MetS as the dependent variable, and vitamin D was forced into the model as an independent variable. The covariates included sociodemographic, dietary, and lifestyle variables. The mean (SD) serum vitamin D was 17.53 (12.40) ng/mL, and the prevalence of MetS was 44.3%. Serum vitamin D was not associated with MetS (OR = 0.99 (95% CI: 0.96, 1.02), p < 0.757), whereas the male sex, compared with the female sex and older age, was associated with higher odds of having MetS (OR = 5.92 (95% CI: 2.44, 14.33), p < 0.001 and OR = 1.08 (95% CI: 1.04, 1.11), p < 0.001, respectively). This result adds to the controversy in this field. Future interventional studies are warranted to better understand the relationship between vitamin D and MetS and metabolic abnormalities.
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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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Abuhijleh H, Alkhatib D, Ganji V. Hypovitaminosis D and Metabolic Syndrome in Postmenopausal Women. Healthcare (Basel) 2022; 10:healthcare10102026. [PMID: 36292473 PMCID: PMC9602081 DOI: 10.3390/healthcare10102026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/20/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022] Open
Abstract
Metabolic syndrome (MetSyn) is a precursor for several cardiometabolic diseases. The prevalence of MetSyn is higher in postmenopausal women compared to premenopausal women. The role of vitamin D in postmenopausal women is not clearly understood. Hypovitaminosis D is more prevalent in postmenopausal women compared to premenopausal women. For this review, Pubmed, Cochrane, SCOPUS, Embase, and Google Scholar databases were searched up to August 2022. Findings from one randomized controlled trial (RCT) and ten cross-sectional studies were included in this review. Several cross-sectional studies (8 out of 10 reviewed) unequivocally demonstrated an inverse association between serum 25-hydroxyvitamin D concentrations and MetSyn. However, RCTs are severely lacking in the effect of vitamin D intake on the biomarkers of MetSyn and the prevalence of MetSyn. Therefore, caution should be used in recommending mega doses of vitamin D supplements for postmenopausal women because of the potential adverse effects associated with this vitamer.
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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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Rezaei S, Tabrizi R, Nowrouzi-Sohrabi P, Jalali M, Shabani-Borujeni M, Modaresi S, Gholamalizadeh M, Doaei S. The Effects of Vitamin D Supplementation on Anthropometric and Biochemical Indices in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis. Front Pharmacol 2021; 12:732496. [PMID: 34803681 PMCID: PMC8595299 DOI: 10.3389/fphar.2021.732496] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/06/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Vitamin D was reported to be associated with non-alcoholic fatty liver disease (NAFLD). This systematic review and meta-analysis aimed to investigate the effects of the vitamin D supplementation on anthropometric and biochemical indices in patient with NAFLD. Methods: PubMed, Web of science, Scopus, and Embase databases were explored to identify all randomized controlled trial (RCT) investigating the effects of vitamin D supplementation on anthropometric and biochemical indices in patients with NAFLD. A random-effects model was used to pool weighted mean difference (WMD) and corresponding 95% confidence intervals (CIs). The statistical heterogeneity among the studies was assessed using I2 statistic (high ≥ 50%, low < 50%) and Cochran's Q-test. Results: Sixteen RCTs were included in this meta-analysis. The results identified that high-density lipoprotein-cholesterol (HDL-C) level significantly increased following vitamin D supplementation (P = 0.008). Vitamin D reduced body weight (P = 0.007), body mass index (P = 0.002), waist circumstance (WC) (P = 0.02), serum alanine transaminase (ALT) (P = 0.01), fasting blood sugar (FBS) (P = 0.01), homeostatic model assessment for insulin resistance (HOMA-IR) (P = 0.004), and calcium (P = 0.01). No significant changes were found on body fat, triglyceride (TG), total cholesterol, low-density lipoprotein-cholesterol (LDL-C), aspartate transaminase, alkaline phosphatase, gamma-glutamyl transferase, and adiponectin following vitamin D supplementation. Conclusion: Vitamin D had significant effects on anthropometric and biochemical indices including HDL-C, body weight, BMI, WC, serum ALT, serum FBS, HOMA-IR, and calcium. Vitamin D supplementation can be considered as an effective strategy in management of patients with NAFLD. Systematic Review Registration: [website], identifier [registration number].
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Affiliation(s)
- Shahla Rezaei
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Tabrizi
- Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Peyman Nowrouzi-Sohrabi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Jalali
- Nutrition Research Center, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Shabani-Borujeni
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shayan Modaresi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Gholamalizadeh
- Student Research Committee, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Doaei
- Research Center of Health and Enviroment, School of Health, Guilan University of Medical Sciences, Rasht, Iran
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Yoshikata R, Myint KZY, Ohta H, Ishigaki Y. Effects of an equol-containing supplement on advanced glycation end products, visceral fat and climacteric symptoms in postmenopausal women: A randomized controlled trial. PLoS One 2021; 16:e0257332. [PMID: 34506596 PMCID: PMC8432832 DOI: 10.1371/journal.pone.0257332] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/17/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Equol, an isoflavone derivative whose chemical structure is similar to estrogen, is considered a potentially effective agent for relieving climacteric symptoms, for the prevention of lifestyle-related diseases, and for aging care in postmenopausal women. We investigated the effect of an equol-containing supplement on metabolism and aging and climacteric symptoms with respect to internally produced equol in postmenopausal women. METHODS A single-center, randomized controlled trial (registration number: UMIN000030975) on 57 postmenopausal Japanese women (mean age: 56±5.37 years) was conducted. Twenty-seven women received the equol supplement, while the remaining received control. Metabolic and aging-related biomarkers were compared before and after the 3-month intervention. Climacteric symptoms were assessed every month using a validated self-administered questionnaire in Japanese postmenopausal women. RESULTS Three months post-intervention, the treatment group showed significant improvement in climacteric symptoms compared to the control group (81% vs. 53%, respectively, p = 0.045). We did not observe any beneficial effect on metabolic and aging-related biomarkers in the intervention group. However, in certain populations, significant improvement in skin autofluorescence, which is a measurement of AGE skin products, and visceral fat area was observed, especially among equol producers. CONCLUSION Women receiving equol supplementation showed improved climacteric symptoms. This study offered a new hypothesis that there may be a synergy between supplemented equol and endogenously produced equol to improve skin aging and visceral fat in certain populations.
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Affiliation(s)
- Remi Yoshikata
- Hamasite Clinic, Minato-ku, Tokyo, Japan
- Tokyo Midtown Medical Center, Minato-ku, Tokyo, Japan
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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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Huang F, Liu Q, Zhang Q, Wan Z, Hu L, Xu R, Cheng A, Lv Y, Wang L. Sex-Specific Association between Serum Vitamin D Status and Lipid Profiles: A Cross-Sectional Study of a Middle-Aged and Elderly Chinese Population. J Nutr Sci Vitaminol (Tokyo) 2021; 66:105-113. [PMID: 32350171 DOI: 10.3177/jnsv.66.105] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Studies have shown that vitamin D status might be associated with dyslipidaemia, but results are conflicting and there might exist sex differences. The aim of our study was to explore the sex-specific association between vitamin D status and serum lipids and atherogenic index of plasma (AIP, a predictor for atherosclerosis) among Chinese middle-aged and elderly adults. A total of 4,021 middle-aged and elderly participants from a health management centre were included in this cross-sectional study. The individuals were classified into tertiles according to serum 25(OH)D. Linear and logistic regression models were used to estimate the association between vitamin D levels and serum lipids among the tertiles. The mean serum 25(OH)D level was 21.60 (16.60-27.20) ng/mL in all participants. After adjusting for potential confounders, a 10 ng/mL increase in 25(OH)D was associated with decreases of 1.156 mmol/L in triglycerides (TGs) and 0.068 in the AIP and an increase of 0.051 mmol/L in high-density lipoprotein cholesterol (HDL-C) in all subjects. In addition, 25(OH)D deficiency was associated with an increased prevalence of hypertriglyceridaemia (odds ratio (OR), 1.880; 95% confidence interval (CI), 1.351-2.615), hypoalphalipoproteinaemia/HDL (OR, 1.505; 95% CI, 1.146-1.977) and abnormal AIP (OR, 1.933; 95% CI, 1.474-2.534) in males, and 25(OH)D-deficient women had a 2.02-fold higher risk for hypoalphalipoproteinaemia/HDL than women with sufficient 25(OH)D levels (95% CI, 1.044-3.904; all p values <0.05). Vitamin D deficiency was positively associated with the prevalence of dyslipidaemia and abnormal AIP in the middle-aged and elderly Chinese population. And this association was stronger in men than in women.
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Affiliation(s)
- Fei Huang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Qingquan Liu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Qian Zhang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Zhengce Wan
- Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Liu Hu
- Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Ranran Xu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Anying Cheng
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Yongman Lv
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.,Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Le Wang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
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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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12
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Jeenduang N, Plyduang T, Horpet D. Association of 25-hydroxyvitamin D levels and metabolic syndrome in Thai postmenopausal women. Diabetes Metab Syndr 2020; 14:1585-1590. [PMID: 32861147 DOI: 10.1016/j.dsx.2020.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Low serum 25-hydroxyvitamin D [25(OH)D] levels have been reported to be associated with metabolic syndrome (MetS). In this study, we aimed to investigate the association between serum 25(OH)D levels and MetS in Thai postmenopausal women. METHODS A total of 340 postmenopausal women were enrolled in the study. The concentration of 25(OH)D, lipid profiles, fasting blood glucose (FBG) levels, blood pressure, and demographic and anthropometric parameters were measured. Subjects were divided into the hypovitaminosis D and vitamin D sufficiency groups. The association of serum 25(OH)D levels with MetS in postmenopausal women was analyzed using multivariate regression analysis. RESULTS Waist circumference, total cholesterol levels, and triglyceride levels were significantly higher in hypovitaminosis D than in vitamin D sufficiency (p < 0.05). The prevalence of MetS, central obesity, and hypertriglyceridemia in hypovitaminosis D was significantly higher than in vitamin D sufficiency (p < 0.05). In the multivariable logistic regression model, hypovitaminosis D was associated with MetS (OR 1.85; 95% CI 1.12-3.04, p = 0.015), central obesity (OR 2.41; 95% CI 1.20-4.85, p = 0.014), and hypertriglyceridemia (OR 1.91; 95% CI 1.12-3.26, p = 0.018) compared with vitamin D sufficiency after adjusting for covariates. Serum vitamin D concentrations were significantly lower in the MetS group than in the non-MetS group (p = 0.016) and decreased with an increasing number of MetS components (p for trend = 0.034). CONCLUSIONS Hypovitaminosis D was associated with an increased risk of MetS, central obesity, and hypertriglyceridemia in Thai postmenopausal women.
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Affiliation(s)
- Nutjaree Jeenduang
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand.
| | - Thunyaluk Plyduang
- Center for Scientific and Technological Equipments, Walailak University, Nakhon Si Thammarat, Thailand
| | - Dararat Horpet
- Center for Scientific and Technological Equipments, Walailak University, Nakhon Si Thammarat, Thailand
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13
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Maroufi NF, Pezeshgi P, Mortezania Z, Pourmohammad P, Eftekhari R, Moradzadeh M, Vahedian V, Nouri M. Association between vitamin D deficiency and prevalence of metabolic syndrome in female population: a systematic review. Horm Mol Biol Clin Investig 2020; 41:/j/hmbci.ahead-of-print/hmbci-2020-0033/hmbci-2020-0033.xml. [PMID: 32986612 DOI: 10.1515/hmbci-2020-0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 08/24/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The increasing prevalence of metabolic syndrome (MS) especially in female population, has become a major problem in health care systems. In this regards, it is necessary to identify the risk factors. Vitamin D deficiency is now proposed as one of the possible risk factors for metabolic syndrome, we investigated the relationship between vitamin D status and MS in female. METHODS We searched observational studies with keywords Vitamin D, metabolic syndrome, metabolic syndrome X, insulin-resistance syndrome, metabolic cardiovascular syndrome and Reaven Syndrome X and female in pubmed, scopus, science direct, cochrane, web of science, google scholar and SID databases, regardless of publication time. Two hundred ninety five studies were found, and finally only 12 articles were selected according to exclusion and inclusion criteria. RESULTS In nine studies that reported the prevalence of MS, the prevalence of MS among women with vitamin D deficiency was higher than female with normal vitamin D (34.5 vs. 30.2%). The prevalence of abdominal obesity, high blood pressure, high TG and HDL deficiency is higher in women with vitamin D deficiency. Also, the mean waist circumference, blood pressure, fast blood sugar (FBS), TG and BMI were higher. The most incident factor was high blood pressure (61.4 vs. 56.5%) and the lowest prevalence is associated with high FBS (32.2 vs. 33.5% in the other group). CONCLUSION The prevalence of MS is significantly associated with vitamin D deficiency, and among related factors, HDL, TG and blood pressure are statistically associated with vitamin D status.
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Affiliation(s)
- Nazila Fathi Maroufi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.,Stem Cell and Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.,Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Pourya Pezeshgi
- Department of Medical Laboratory Science, Student Research Committee, Maragheh Faculty of Medical Sciences, Maragheh, Islamic Republic of Iran
| | - Zohreh Mortezania
- Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Pirouz Pourmohammad
- Department of Clinical Biochemistry, School of Medicine, Ardabil University of Medical Science, Ardabil, Islamic Republic of Iran
| | - Reyhaneh Eftekhari
- Department of Genetic, Faculty Biotechnology, Semnan University, Semnan, Islamic Republic of Iran
| | - Mahmood Moradzadeh
- Department of Medical Laboratory Science, Student Research Committee, Maragheh Faculty of Medical Sciences, Maragheh, Islamic Republic of Iran
| | - Vahid Vahedian
- Department of Experimental Biomedicine, Dr.Vahid Vahedian Medical Diagnostic Laboratory Gorgan, Tehran, Islamic Republic of Iran.,Department of Medical Laboratory Sciences, Faculty of Medicine, Islamic Azad University (IAU), Sari, Islamic Republic of Iran
| | - Mohammad Nouri
- Stem Cell and Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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14
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Association of Hypovitaminosis D with Metabolic Syndrome in Postmenopausal Women. J Obstet Gynaecol India 2020; 70:184-188. [PMID: 32476763 DOI: 10.1007/s13224-020-01314-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 04/04/2020] [Indexed: 10/24/2022] Open
Abstract
The prevalence of vitamin D deficiency and metabolic syndrome is spreading like a pandemic globally; postmenopausal women are particularly vulnerable population. Hypovitaminosis D is reported to predispose to various components of metabolic syndrome like dyslipidemia, hypertension, diabetes and obesity. The purpose of this review is to highlight the recently published evidence, evaluating the association of vitamin D deficiency with metabolic syndrome in postmenopausal women. Besides, it emphasizes the long-term risks involved with low vitamin D levels and importance of vitamin D supplementation. Data were obtained from PubMed, Google Scholar and individual searches.
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Serum Vitamin D Concentration ≥75 nmol/L Is Related to Decreased Cardiometabolic and Inflammatory Biomarkers, Metabolic Syndrome, and Diabetes; and Increased Cardiorespiratory Fitness in US Adults. Nutrients 2020; 12:nu12030730. [PMID: 32164233 PMCID: PMC7146199 DOI: 10.3390/nu12030730] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022] Open
Abstract
A serum vitamin D [25-hydroxyvitamin D, 25(OH)D] concentration of ≥75 nmol/L is recommended for optimal health. We investigated the relationship between serum 25(OH)D and metabolic syndrome (MetS), diabetes, cardiometabolic biomarkers, and cardiorespiratory fitness (CRF) in US adults using clinical cut points recommended by health organizations. Data from USA's National Health and Nutrition Examination Surveys were used. Prevalences and likelihood of having MetS and diabetes according to clinical cut points for serum 25(OH)D (<30 nmol/L, 30-<50 nmol/L, 50-<75 nmo/L, and ≥75 nmol/L) were determined with multivariate logistic regression. Relations between serum 25(OH)D and various cardiometabolic biomarkers, CRF, MetS, and diabetes were tested using multivariable adjusted regression. Prevalence of MetS and diabetes were significantly lower in individuals with serum 25(OH)D ≥75 nmol/L (MetS, 21.6%; diabetes, 4.1%) compared to those with 25(OH)D <30 nmol/L (MetS, 45.5%; diabetes, 11.6%) (p < 0.0001). Individuals with serum 25(OH)D ≥75 nmol/L had significantly lower waist circumference (p < 0.0001), C-reactive protein (p = 0.003), glycated hemoglobin (p < 0.0002), fasting triglycerides (p < 0.0001), total homocysteine (p < 0.0001), and insulin resistance (p = 0.0001) and had significantly higher HDL-cholesterol (p < 0.0001) and maximal oxygen uptake (marker for CRF) (p< 0.0009) compared to those with 25(OH)D <30 nmol/L. In conclusion, serum 25(OH)D ≥75 nmol/L is associated with positive indicators related to cardiometabolic diseases in US adults.
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16
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Zeng Y, Luo M, Pan L, Chen Y, Guo S, Luo D, Zhu L, Liu Y, Pan L, Xu S, Zhang R, Zhang C, Wu P, Ge L, Noureddin M, Pandol SJ, Han YP. Vitamin D signaling maintains intestinal innate immunity and gut microbiota: potential intervention for metabolic syndrome and NAFLD. Am J Physiol Gastrointest Liver Physiol 2020; 318:G542-G553. [PMID: 31984787 PMCID: PMC7099486 DOI: 10.1152/ajpgi.00286.2019] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/13/2019] [Accepted: 01/19/2020] [Indexed: 01/31/2023]
Abstract
A lack of sunlight exposure, residence in the northern latitudes, and dietary vitamin D insufficiency are coprevalent with metabolic syndrome (MetS), Type 2 diabetes (T2D), and nonalcoholic fatty liver diseases (NAFLD), implying a potential causality and underlying mechanism. Whether vitamin D supplementation or treatment can improve these disorders is controversial, in part, because of the absence of large-scale trials. Experimental investigations, on the other hand, have uncovered novel biological functions of vitamin D in development, tumor suppression, and immune regulation, far beyond its original role as a vitamin that maintained calcium homeostasis. While the large intestine harbors massive numbers of microbes, the small intestine has a minimal quantity of bacteria, indicating the existence of a gating system located in the distal region of the small intestine that may restrain bacterial translocation to the small intestine. Vitamin D receptor (VDR) was found to be highly expressed at the distal region of small intestine, where the vitamin D signaling promotes innate immunity, including the expression of α-defensins by Paneth cells, and maintains the intestinal tight junctions. Thus, a new hypothesis is emerging, indicating that vitamin D deficiency may impair the intestinal innate immunity, including downregulation of Paneth cell defensins, leading to bacterial translocation, endotoxemia, systemic inflammation, insulin resistance, and hepatic steatosis. Here, we review the studies for vitamin D for innate immunity and metabolic homeostasis, and we outline the clinical trials of vitamin D for mitigating MetS, T2D, and NAFLD.
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Affiliation(s)
- Yilan Zeng
- Chengdu Public Health Clinical Center, Chengdu, China
| | - Mei Luo
- Chengdu Public Health Clinical Center, Chengdu, China
| | - Liwei Pan
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
| | - Yuan Chen
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
| | - Siqi Guo
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
| | - Dongxia Luo
- Chengdu Public Health Clinical Center, Chengdu, China
| | - Li Zhu
- Chengdu Public Health Clinical Center, Chengdu, China
| | - Yong Liu
- Chengdu Public Health Clinical Center, Chengdu, China
| | - Lisha Pan
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
| | - Siya Xu
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
| | - Ruofei Zhang
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
| | - Chunyan Zhang
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
| | - Pengfei Wu
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
| | - Liangpeng Ge
- Chongqing Academy of Animal Sciences, Chongqing, China
| | | | | | - Yuan-Ping Han
- The Center for Growth, Metabolism and Aging, College of Life Sciences, Sichuan University, Chengdu, China
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17
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Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women. Nutrients 2020; 12:nu12010202. [PMID: 31941004 PMCID: PMC7019719 DOI: 10.3390/nu12010202] [Citation(s) in RCA: 174] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/19/2019] [Accepted: 01/07/2020] [Indexed: 12/12/2022] Open
Abstract
Menopause is clinically diagnosed as a condition when a woman has not menstruated for one year. During the menopausal transition period, there is an emergence of various lipid metabolic disorders due to hormonal changes, such as decreased levels of estrogens and increased levels of circulating androgens; these may lead to the development of metabolic syndromes including cardiovascular diseases and type 2 diabetes. Dysregulation of lipid metabolism affects the body fat mass, fat-free mass, fatty acid metabolism, and various aspects of energy metabolism, such as basal metabolic ratio, adiposity, and obesity. Moreover, menopause is also associated with alterations in the levels of various lipids circulating in the blood, such as lipoproteins, apolipoproteins, low-density lipoproteins (LDLs), high-density lipoproteins (HDL) and triacylglycerol (TG). Alterations in lipid metabolism and excessive adipose tissue play a key role in the synthesis of excess fatty acids, adipocytokines, proinflammatory cytokines, and reactive oxygen species, which cause lipid peroxidation and result in the development of insulin resistance, abdominal adiposity, and dyslipidemia. This review discusses dietary recommendations and beneficial compounds, such as vitamin D, omega-3 fatty acids, antioxidants, phytochemicals—and their food sources—to aid the management of abnormal lipid metabolism in postmenopausal women.
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Weldegiorgis TZ, Hidru TH, Yang X, Xia Y, Ma L, Li H. Association between serum 25-hydroxyvitamin D concentrations and metabolic syndrome in the middle-aged and elderly Chinese population in Dalian, northeast China: A cross-sectional study. J Diabetes Investig 2020; 11:184-191. [PMID: 31145541 PMCID: PMC6944851 DOI: 10.1111/jdi.13086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 05/07/2019] [Accepted: 05/25/2019] [Indexed: 02/06/2023] Open
Abstract
AIMS/INTRODUCTION To investigate the association between serum 25-hydroxyvitamin D (25-[OH]D) concentrations and metabolic syndrome (MetS) in the middle-aged and elderly Chinese population. METHODS The present study included 2,764 participants (aged >50 years). The joint interim statement was used for the standard definition of MetS. Serum 25-(OH)D concentrations were measured by electrochemiluminescence immunoassay. The study participants were categorized into quartiles based on serum 25-(OH)D concentrations, and the quartiles were calculated for the differences using anova and the χ2 -test for continuous and categorical data, respectively. A logistic regression analysis model was applied to estimate the odds ratios and 95% confidence intervals (95% CI) for each quartile of serum 25-(OH)D concentrations compared with the highest quartile. RESULTS Serum 25-(OH)D levels were markedly lower in men in the MetS group than in those without MetS. We observed a negative correlation between the higher quartiles of serum 25-(OH)D levels and the presence of MetS among men. The correlation between serum 25-(OH)D levels and the prevalence of MetS persisted even after adjusting for potential confounders, including age, cigarette smoking status, alcohol consumption, physical activity, low-density lipoprotein, creatinine and total serum cholesterol. Adjusted odds ratios of MetS in the second through fourth compared with the lowest quartile for serum 25-(OH)D levels were 0.93 (95% CI 0.54-1.59), 0.89 (95% CI 0.50-1.56) and 0.48 (95% CI 0.28-0.84), respectively. CONCLUSIONS Decreased serum 25-(OH)D level is significantly correlated with MetS in middle-aged men.
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Affiliation(s)
| | | | - Xiao‐lei Yang
- Department of CardiologyInstitute of Cardiovascular DiseasesFirst Affiliated Hospital of Dalian Medical UniversityDalianChina
| | - Yun‐long Xia
- Department of CardiologyInstitute of Cardiovascular DiseasesFirst Affiliated Hospital of Dalian Medical UniversityDalianChina
| | - Li Ma
- School of Public HealthDalian Medical UniversityDalianChina
| | - Hui‐Hua Li
- School of Public HealthDalian Medical UniversityDalianChina
- Department of CardiologyInstitute of Cardiovascular DiseasesFirst Affiliated Hospital of Dalian Medical UniversityDalianChina
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Chun H, Kim GD, Doo M. Differences in the Association Among the Vitamin D Concentration, Dietary Macronutrient Consumption, and Metabolic Syndrome Depending on Pre- and Postmenopausal Status in Korean Women: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:3601-3609. [PMID: 33116711 PMCID: PMC7553659 DOI: 10.2147/dmso.s275847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/03/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To assess whether the consumption of dietary macronutrient could change metabolic syndrome (MetS) related to vitamin D deficiency according to menopausal status. METHODS AND STUDY DESIGN In a cross-sectional study of 8326 Korean women from the Korean National Health and Nutrition Examination Survey V (2010-2012), we investigated the combined interaction effect of serum 25-hydroxyvitamin D [25(OH)D] concentration and menopausal status on MetS-related variables. RESULTS The prevalence rates of 25(OH)D deficiency (vitamin D <50 nmol/L) among premenopausal and postmenopausal women were 84.5% and 67.9%, respectively. Significant differences in MetS-related variables such as body mass index (P<0.001), waist circumference (P=0.005), fast glucose (P=0.048), triglycerides (P=0.001), and high-density lipoprotein cholesterol (P=0.027) based on 25(OH)D concentration were observed among postmenopausal women but not among premenopausal women. Among the postmenopausal women with high consumption of dietary carbohydrate, the adjusted odds ratios (ORs) [95% confidence intervals (95% CIs)] of MetS among participants with 25(OH)D deficiency increased 1.380-fold (95% CI = 1.086-1.753) using the 25(OH)D-sufficient group as a reference. In contrast, the participants with 25(OH)D deficiency showed an increased risk of MetS [OR (95% CI) = 1.313 (1.041-1.655)] with low-fat consumption. However, the aforementioned findings did not differ among premenopausal women. CONCLUSION Thus, MetS due to 25(OH)D deficiency among postmenopausal women may be modified by the consumption of dietary macronutrient.
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Affiliation(s)
- Hyejin Chun
- Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi, 13496, Republic of Korea
| | - Gi Dae Kim
- Department of Food and Nutrition, Kyungnam University, Changwon, Gyeongnam51767, Republic of Korea
| | - Miae Doo
- Department of Food and Nutrition, Kunsan National University, Gunsan, Jeonbuk54150, Republic of Korea
- Correspondence: Miae Doo Department of Food and Nutrition, Kunsan National University, Daehak-Ro 558, Gunsan, Jeonbuk54150, Republic of KoreaTel +82-63-469-4635Fax +82-63-469-2085 Email
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García-Carrasco M, Mendoza-Pinto C, Cabrera-Jiménez M, Munguía-Realpozo P, Méndez-Martínez S, Etchegaray-Morales I, Berra-Romani R, Zamora-Ginez I, López-Colombo A, Monroy-Azuara MG, Ruiz-Arguelles A. 25-Hydroxyvitamin D concentrations and risk of metabolic syndrome in systemic lupus erythematosus women. Int J Rheum Dis 2019; 22:2067-2072. [PMID: 31596554 DOI: 10.1111/1756-185x.13715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/21/2019] [Accepted: 09/07/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE A protective function of vitamin D in metabolic syndrome (MetS) has been described. The objective of the present study was to examine the relationship between serum 25-hydroxyvitamin D (25(OH)D) concentrations and MetS in non-diabetic systemic lupus erythematosus (SLE) women. METHODS Cross-sectional analyses of the relationship between concentrations of 25(OH)D, MetS, and its components were made in 160 non-diabetic SLE women. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria. Serum 25(OH)D was measured by chemiluminescent immunoassay. Serum 25(OH)D concentrations were categorized into quartiles (<16.6, 16.6-21.1, 21.2-26.3, ≥26.4 ng/mL). RESULTS A total of 79 (49.3%) SLE women had MetS. Without adjusting for body mass index (BMI) or smoking, the odds of having MetS decreased according to increasing quartiles of 25(OH)D concentrations (P for trend = .03). The odds ratio (OR) of having MetS was 0.4 (95% confidence interval: 0.2-0.9, P = .04) for the highest vs the lowest quartile of 25(OH)D concentrations when adjusted by age. The crude OR of having elevated hypertriglyceridemia decreased according to increasing quartiles of 25(OH)D concentrations (P for trend = .036). However, further adjustments for BMI and smoking removed the inverse association between 25(OH)D concentrations and MetS and its individual components. CONCLUSION In non-diabetic SLE women with mild activity, 25(OH)D concentrations are not associated with MetS and its components.
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Affiliation(s)
- Mario García-Carrasco
- Systemic Autoimmune Diseases Research Unit, Hospital de Especialidades, UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico
- Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, IMSS, Metepec, Puebla, Mexico
- Department of Immunology and Rheumatology, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Claudia Mendoza-Pinto
- Systemic Autoimmune Diseases Research Unit, Hospital de Especialidades, UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico
- Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, IMSS, Metepec, Puebla, Mexico
- Department of Immunology and Rheumatology, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Miriam Cabrera-Jiménez
- Systemic Autoimmune Diseases Research Unit, Hospital de Especialidades, UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Pamela Munguía-Realpozo
- Systemic Autoimmune Diseases Research Unit, Hospital de Especialidades, UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | | | - Ivet Etchegaray-Morales
- Department of Immunology and Rheumatology, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Roberto Berra-Romani
- Department of Biomedicine, School of Medicine, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Irma Zamora-Ginez
- Secretary of Research and Postgraduate Studies, Faculty of Medicine, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Aurelio López-Colombo
- State Research and Education Department, UMAE, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Marianne G Monroy-Azuara
- Department of Immunology and Rheumatology, Medicine School, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
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Abstract
STUDY DESIGN Retrospective Cohort. OBJECTIVE Establish 1-year patient-reported outcomes after spine surgery for symptomatic pseudarthrosis compared with other indications. In the subgroup of pseudarthrosis patients, describe preexisting metabolic and endocrine-related disorders, and identify any new diagnoses or treatments initiated by an endocrine specialist. SUMMARY OF BACKGROUND Despite surgical advances in recent decades, pseudarthrosis remains among the most common complications and indications for revision after fusion spine surgery. A better understanding of the outcomes after revision surgery for pseudarthrosis and risk factors for pseudarthrosis are needed. METHODS Using data from our institutional spine registry, we retrospectively reviewed patients undergoing elective spine surgery between October 2010 and November 2016. Patients were stratified by surgical indication (pseudarthrosis vs. not pseudarthrosis), and 1-year outcomes for satisfaction, disability, quality of life, and pain were compared. In a descriptive subgroup analysis of pseudarthrosis patients, we identified preexisting endocrine-related disorders, frequency of endocrinology referral, and any new diagnoses and treatments initiated through the referral. RESULTS Of 2721 patients included, 169 patients underwent surgery for pseudarthrosis. No significant difference was found in 1-year satisfaction between pseudarthrosis and nonpseudarthrosis groups (77.5% vs. 83.6%, respectively). A preexisting endocrine-related disorder was identified in 82% of pseudarthrosis patients. Endocrinology referral resulted in a new diagnosis or treatment modification in 58 of 59 patients referred. The most common diagnoses identified included osteoporosis, vitamin D deficiency, diabetes, hyperlipidemia, sex-hormone deficiency, and hypothyroidism. The most common treatments initiated through endocrinology were anabolic agents (teriparatide and abaloparatide), calcium, and vitamin D supplementation. CONCLUSIONS Patients undergoing revision spine surgery for pseudarthrosis had similar 1-year satisfaction rates to other surgical indications. In conjunction with a bone metabolic specialist, our descriptive analysis of endocrine-related disorders among patients with a pseudarthrosis can guide protocols for workup, indications for endocrine referral, and guide prospective studies in this field.
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Ferreira PP, Cangussu L, Bueloni-Dias FN, Orsatti CL, Schmitt EB, Nahas-Neto J, Nahas EAP. Vitamin D supplementation improves the metabolic syndrome risk profile in postmenopausal women. Climacteric 2019; 23:24-31. [PMID: 31134822 DOI: 10.1080/13697137.2019.1611761] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: This study aimed to evaluate the effect of isolated vitamin D (VD) supplementation on the metabolic syndrome (MetS) risk profile in postmenopausal women.Methods: In this double-blind, placebo-controlled trial, 160 postmenopausal women aged 50-65 years were randomized into two groups: VD group, supplementation with 1000 IU vitamin D3/day (n = 80); or placebo group (n = 80). The intervention time was 9 months, and the women were assessed at baseline and endpoint. Clinical and anthropometric data were collected. Biochemical parameters, including total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, and insulin, were measured. The plasma concentration of 25-hydroxyvitamin D (25(OH)D) was measured by high-performance liquid chromatography.Results: After 9 months, there was a significant increase in the 25(OH)D levels for VD group (+45.4%, p < 0.001), and a decrease (-18.5%, p = 0.049) in the placebo group. In the VD group, a significant reduction was observed in triglycerides (-12.2%, p = 0.001), insulin (-13.7%, p = 0.008), and the homeostasis model assessment of insulin resistance (-17.9%, p = 0.007). In the placebo group, there was an increase in glucose (+6.2%, p = 0.009). Analysis of the risk adjusted for age, time since menopause, and body mass index showed that women supplemented with VD had a lower risk of MetS (odds ratio [OR] 0.42; 95% confidence interval [CI] 0.21-0.83), hypertriglyceridemia (OR 0.43; 95% CI 0.22-0.85), and hyperglycemia (OR 0.23; 95% CI 0.10-0.52) compared to the placebo group (p < 0.05).Conclusions: In postmenopausal women with VD deficiency, isolated supplementation with 1000 IU vitamin D3 for 9 months was associated with a reduction in the MetS risk profile. Women undergoing VD supplementation had a lower risk of MetS, hypertriglyceridemia, and hyperglycemia.
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Affiliation(s)
- P P Ferreira
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - L Cangussu
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - F N Bueloni-Dias
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - C L Orsatti
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - E B Schmitt
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - J Nahas-Neto
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - E A P Nahas
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
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Lee SJ, Lee EY, Lee JH, Kim JE, Kim KJ, Rhee Y, Kim HC, Youm Y, Kim CO. Associations of serum 25-hydroxyvitamin D with metabolic syndrome and its components in elderly men and women: the Korean Urban Rural Elderly cohort study. BMC Geriatr 2019; 19:102. [PMID: 30975093 PMCID: PMC6458686 DOI: 10.1186/s12877-019-1118-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 03/25/2019] [Indexed: 01/07/2023] Open
Abstract
Background Many studies have investigated the association between vitamin D and metabolic syndrome (MetS). However, few studies have investigated the association stratified by sex in the elderly. Therefore, we aimed to evaluate the association between vitamin D, MetS, and its components in Korean elderly men and women. Methods A total of 987 men and 1949 women aged ≥65 years were recruited through Korean Urban Rural Elderly cohort study. Serum 25-hydroxyvitamin D (25(OH)D) levels were categorized into 4 quartiles and all data were analyzed separately by sex. MetS was defined by the revised criteria of the National Cholesterol Education Program Adult Treatment Panel III. Results The participants in the lowest quartile of serum 25(OH)D showed a significant increase in the prevalence of high waist circumference, elevated triglyceride level, and low high-density lipoprotein cholesterol level, as well as MetS itself, in both men and women in a univariate analysis. After adjusting for potential confounders including age, smoking status, drinking status, exercise status, region of residence, seasonality, and parathyroid hormone level, the lowest 25(OH)D quartile group was associated with a higher risk of MetS (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.48–3.43 in men and OR 1.65, 95% CI 1.27–2.16 in women) compared to the highest 25(OH)D quartile group as the reference group. However, no significant association was found between serum 25(OH)D levels and the prevalence of MetS components including hyperglycemia or hypertension in both men and women. Conclusions Low 25(OH)D levels were associated with increased odds of MetS; in particular, they were associated with MetS components of high waist circumference, hypertriglyceridemia, and low high-density lipoprotein-cholesterol, after adjusting for age, smoking, alcohol, exercise, region of residency, and seasonality, in men and women over 65 years old. Electronic supplementary material The online version of this article (10.1186/s12877-019-1118-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Su Jin Lee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jung Hyun Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Jong Eun Kim
- Graduate School of Public Health Yonsei University, Seoul, South Korea
| | - Kwang Joon Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03772, Republic of Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03772, Republic of Korea.
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24
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A systematic review and meta-analysis of the response of serum 25-hydroxyvitamin D concentration to vitamin D supplementation from RCTs from around the globe. Eur J Clin Nutr 2019; 73:816-834. [PMID: 30872787 DOI: 10.1038/s41430-019-0417-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/10/2019] [Accepted: 02/18/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Optimal doses of vitamin D (VitD) supplement in different populations are unclear. We aim to evaluate the relationship between VitD supplementation and post-intervention serum 25-hydroxyvitamin D [25(OH)D] concentration, to provide a recommended dosage of VitD for achieving an optimal 25(OH)D concentration for different populations. SUBJECTS/METHODS Literature search was conducted in Embase, etc. Randomized controlled trials about VitD supplemental intakes and their effect on 25(OH)D concentration were enrolled. The effect on 25(OH)D concentration between different supplementation doses in each population group was compared by meta-analysis. Multivariate meta-regression model is utilized to establish reference intake dosage of VitD. RESULTS A total of 136 articles were included about children (3-17 years), adults (18-64 years), postmenopausal women, the elderly ( >64 years), pregnant, or lactating women. Overall, intervention groups obtained higher 25(OH)D concentration than controls and there was obvious dose-response effect between intake dose and 25(OH)D concentration. Baseline 25(OH)D concentration and age were significant indicators for 25(OH)D concentration. To reach sufficient 25(OH)D concentration (75 nmol/L), the recommended VitD supplemental intakes was 1340 and 2250 IU/day for children and pregnant women, 2519 and 797 IU/day for European adults aged 18-64 and 65-85 years, 729, 2026, and 1229 IU/day for adults in North America, Asia and Middle East and Africa, respectively. CONCLUSIONS Regional- and age-specific recommended dosages of VitD supplements for population to achieve optimal 25(OH)D concentrations have been suggested.
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25
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Wieder-Huszla S, Jurczak A, Szkup M, Barczak K, Dołęgowska B, Schneider-Matyka D, Owsianowska J, Grochans E. Relationships between Vitamin D₃ and Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E175. [PMID: 30634516 PMCID: PMC6352038 DOI: 10.3390/ijerph16020175] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/25/2018] [Accepted: 01/06/2019] [Indexed: 02/06/2023]
Abstract
The growing number of overweight and obese individuals is an alarming global problem; these conditions are risk factors for the development of health problems such as metabolic syndrome (MetS), type-2 diabetes, atherosclerosis, and cardiovascular disease. Numerous studies have suggested that vitamin D₃ deficiency plays a role in the pathogenesis of MetS. The aim of this study was to analyze the relationship between MetS and vitamin D₃ levels in women. Laboratory analysis demonstrated that only 26.89% of the participants had vitamin D₃ levels close to normal, and waist-to-hip ratio (WHR) measurements revealed android obesity in 75.63% of the women. The menstruating women more often suffered from vitamin D₃ deficiency, and less often had elevated vitamin D₃ levels. The conclusions are as follows: (1) There were no statistically significant relationships between vitamin D₃ levels and MetS parameters, namely the level of triglycerides, the levels of low- and high-density lipoproteins (LDL and HDL), the level of total cholesterol, and systolic and diastolic blood pressure (SBP and DBP). Vitamin D deficiency was only observed in the women with abdominal obesity. (2) Low vitamin D₃ levels were typical of perimenopausal women. Age was a variable correlating with vitamin D. (3) The presence of menstrual cycles was an important contributor to vitamin D levels. Vitamin D deficiency was significantly more common in the menstruating women.
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Affiliation(s)
- Sylwia Wieder-Huszla
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland.
| | - Anna Jurczak
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland.
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland.
| | - Katarzyna Barczak
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland.
| | - Barbara Dołęgowska
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland.
| | - Daria Schneider-Matyka
- Department of Nursing, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland.
| | - Joanna Owsianowska
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland.
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland.
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26
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Shidfar F, Mousavi SN, lorvand Amiri H, Agah S, Hoseini S, Hajimiresmail SJ. Reduction of Some Atherogenic Indices in Patients with Non-Alcoholic Fatty Liver by Vitamin D and Calcium Co-Supplementation: A Double Blind Randomized Controlled Clinical Trial. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2019; 18:496-505. [PMID: 31089384 PMCID: PMC6487410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The role of non-alcoholic fatty liver disease (NAFLD) as a potential independent cardiovascular disease (CVD) risk factor has recently gained considerable attention because CVD is the common cause of death in NAFLD patients. We aimed to estimate the effects of vitamin D supplementation alone or in combination with calcium on atherogenic indices, liver function tests, and grade of disease in patients with NAFLD. One-hundred twenty NAFLD patients were randomized in a double-blind, placebo-controlled clinical trial as follows: D (1000 IU vitamin D), CaD (500 mg as calcium carbonate plus 1000 IU vitamin D) or P (placebo), once daily with meals over 12 weeks. Adjusted for all the baseline measures, reduction in serum ALT, AST, LDL-C/HDL-C, TC/HDL-C, and non-HDL-C were significantly higher in the CaD compared with the P group (p < 0.001, p = 0.03, p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). Also, mean difference of serum ALT, LDL-C/HDL-C, TC/HDL-C, and TG/HDL-C were significantly higher in the CaD than D group (p < 0.001, p = 0.006, p < 0.001 and p = 0.03, respectively). Serum non-HDL-C was marginally decreased in the CaD compared with the D group (p = 0.06). With considering the BMI changes as covariate, reduction in the grade of fatty liver was significantly higher in the CaD and D groups than the P (p < 0.001). The present study suggests that supplemental calcium combined with vitamin D, but not vitamin D alone, may reduce serum atherogenic indices, liver function tests, and grade of disease in patients with NAFLD.
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Affiliation(s)
- Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Seyedeh Neda Mousavi
- Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Hamid lorvand Amiri
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Shahram Agah
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Sharieh Hoseini
- Department of Applied chemistry, Faculty of Pharmaceutical Chemistry, Pharmaceutical Sciences Branch, Isalmic Azad University, Tehran, Iran.
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Yang HY, Huang JH, Chiu HW, Lin YK, Hsu CY, Chen YJ. Vitamin D and bisphosphonates therapies for osteoporosis are associated with different risks of atrial fibrillation in women: A nationwide population-based analysis. Medicine (Baltimore) 2018; 97:e12947. [PMID: 30412111 PMCID: PMC6221698 DOI: 10.1097/md.0000000000012947] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Osteoporosis and atrial fibrillation (AF) are common in post-menopausal women. Vitamin D and bisphosphonates are widely used to treat osteoporosis, and these may have different effects on the risk of AF.The goal of this study was to evaluate whether different agents for treating osteoporosis modulate the risk of AF in a population-based database.We identified 20,788 female patients suffering from osteoporosis who were or were not treated with vitamin D or bisphosphonates using the Taiwan National Health Insurance nationwide database from 2000 to 2008 and followed them up for 5 consecutive years to determine if they had a new diagnosis of AF after the diagnosis of osteoporosis.There were 14 (2.67%) new AF diagnoses in osteoporosis patients treated with bisphosphonates, one (0.28%) new AF diagnosis in patients treated with vitamin D, and 279 (1.40%) new AF diagnoses in patients who were not treated with vitamin D or bisphosphonates (neither group). Osteoporosis patients who received bisphosphonates showed a higher incidence of AF occurrence than those that were not treated with bisphosphonates (P = .015). In contrast, 1 patient who received vitamin D had a new diagnosis of AF during the study period; thus, the incidence was significantly lower than that in the patients treated with bisphosphonates (P = .007). In addition, the patients who were treated with vitamin D had a lower incidence of AF than did those who were not treated with either vitamin D or bisphosphonates (P = .074). Kaplan-Meier analysis also showed a significant difference in AF occurrence in different groups during the 5-year follow-up (P = .010).Different treatment for osteoporosis may carry diverse risks of AF occurrence. Vitamin D may have potential beneficial effects of reducing AF occurrence in osteoporosis patients.
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Affiliation(s)
- Hung-Yu Yang
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology
- Department of Internal Medicine, School of Medicine, College of Medicine
| | - Jen-Hung Huang
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital
- Department of Internal Medicine, School of Medicine, College of Medicine
| | - Hung-Wen Chiu
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology
| | - Yung-Kuo Lin
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital
- Department of Internal Medicine, School of Medicine, College of Medicine
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences
- Master Program in Global Health and Development
| | - Yi-Jen Chen
- Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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28
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Kwak SY, Yongjoo Park C, Jo G, Yoen Kim O, Shin MJ. Association among genetic variants in the vitamin D pathway and circulating 25-hydroxyvitamin D levels in Korean adults: results from the Korea National Health and Nutrition Examination Survey 2011-2012. Endocr J 2018; 65:881-891. [PMID: 29937467 DOI: 10.1507/endocrj.ej18-0084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Vitamin D deficiency affects >60% of the Korean population. Recent reports in Caucasian, African American, and Chinese populations indicate an association between vitamin D status and related single nucleotide polymorphisms (SNPs), but specific associations differ among study populations. We investigated the relationship between five SNPs involved in the vitamin D metabolic pathway (DHCR7 rs12785878, GC rs2282679, CYP2R1 rs12794714, CYP2R1 rs10741657, and CYP24A1 rs6013897) and serum 25-hydroxyvitamin D [25(OH)D] status in Koreans using the Korea National Health and Nutrition Examination Survey, a nationwide database. Whether the association was modified by demographic and lifestyle factors, including sex, body mass index (BMI), smoking status, drinking status, physical activity, and sun exposure, were also investigated. The results showed the serum level of 25(OH)D was associated with rs12785878, rs2282679, and rs12794714 genotypes, but not with rs10741657 or rs6013897. The genetic risk score (GRS) calculated by summing the number of alleles of these 5 SNPs was associated with low circulating levels of 25(OH)D. However, the negative association between 25(OH)D and GRS was modified by obesity and sun exposure. Specifically, negative associations between 25(OH)D and GRS were present in adults with lower BMI (<25 kg/m2) and longer sun exposure time (≥2 h/day). In conclusion, common variants of vitamin D-related SNPs are associated with vitamin D status in Koreans, and this genetic effect was masked when BMI ≥25 kg/m2 or sun exposure <2 h/day. Additionally, seasonal variation must be considered in future studies among Koreans.
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Affiliation(s)
- So-Young Kwak
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Republic of Korea
| | - Clara Yongjoo Park
- Department of Food and Nutrition, Human Ecology Research Institute, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Garam Jo
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Republic of Korea
| | - Oh Yoen Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Republic of Korea
| | - Min-Jeong Shin
- Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul 02841, Republic of Korea
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29
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Lee JH, Kim S, Kim MK, Yun BH, Cho S, Choi YS, Lee BS, Seo SK. Relationships between 25(OH)D concentration, sarcopenia and HOMA-IR in postmenopausal Korean women. Climacteric 2017; 21:40-46. [DOI: 10.1080/13697137.2017.1395410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- J. H. Lee
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - S. Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - M. K. Kim
- CHA University, Fertility Center of Gangnam CHA Hospital, Seoul, Republic of Korea
| | - B. H. Yun
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - S. Cho
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Y. S. Choi
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - B. S. Lee
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - S. K. Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
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30
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Pinkas J, Bojar I, Gujski M, Bartosińska J, Owoc A, Raczkiewicz D. Serum Lipid, Vitamin D Levels, and Obesity in Perimenopausal and Postmenopausal Women in Non-Manual Employment. Med Sci Monit 2017; 23:5018-5026. [PMID: 29055024 PMCID: PMC5665606 DOI: 10.12659/msm.906895] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Increasing age, increased body mass index (BMI), and abnormal lipid profiles contribute to an increased risk of vitamin D deficiency. Women who have a perimenopausal and postmenopausal reduction in estrogen levels are a high-risk group for vitamin D deficiency. The aims of this study were to compare the serum vitamin D levels, lipid profile, and BMI between perimenopausal and postmenopausal women in non-manual employment, and to determine whether there were any interdependent factors. MATERIAL AND METHODS Three hundred women in non-manual employment, aged between 44-66 years, were divided into three groups: early perimenopausal; late perimenopausal; and postmenopausal. Laboratory tests included measurement of serum lipid profiles and vitamin D levels, the BMI, waist-hip ratio (WHR) and body fat were measured. Statistical analysis included F-test analysis of variance and the least significance difference (LSD) test was used for multiple comparisons. RESULTS For the 300 women who were in non-manual employment, and in the early and late perimenopausal and postmenopausal periods, serum vitamin D levels were reduced (mean 16.8±8.7 ng/mL); 29% of women had abdominal obesity; 41% had excessive body fat accumulation; and 56% had an increased body mass index (BMI) (>25 kg/m²) with raised total cholesterol, low-density lipoprotein (LDL) cholesterol, LDL/high-density lipoprotein (HDL), and total cholesterol/HDL ratios (p<0.05). CONCLUSIONS The findings of this study showed that in perimenopausal and postmenopausal women in non-manual employment, serum vitamin D levels were associated with serum lipid profile and degrees of obesity.
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Affiliation(s)
- Jarosław Pinkas
- School of Public Health, Center for Postgraduate Medical Education, Warsaw, Poland
| | - Iwona Bojar
- Department of Women's Health, Institute of Rural Health, Lublin, Poland
| | - Mariusz Gujski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Bartosińska
- Department of Dermatology, Venereology, and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Alfred Owoc
- The College of Business and Entrepreneurship in Ostrowiec Świętokrzyski, Ostrowiec Świętokrzyski, Poland
| | - Dorota Raczkiewicz
- Institute of Statistics and Demography, Warsaw School of Economics, Warsaw, Poland
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Schmitt EB, Nahas-Neto J, Bueloni-Dias F, Poloni PF, Orsatti CL, Petri Nahas EA. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas 2017; 107:97-102. [PMID: 29169589 DOI: 10.1016/j.maturitas.2017.10.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/11/2017] [Accepted: 10/13/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate the association between vitamin D (VD) deficiency and risk factors for metabolic syndrome (MetS) in postmenopausal women. STUDY DESIGN Observational, cross-sectional cohort study. MAIN OUTCOME MEASURES In this study, 463 women, aged 45-75 years, with amenorrhea >12months, without VD supplementation or established cardiovascular disease were included. Clinical and anthropometric data were collected. Biochemical parameters, including total cholesterol (TC), HDL, LDL, triglycerides, glucose, insulin and 25-hydroxyvitamin-D [25(OH)D] were measured. Women meeting three or more of the following criteria were diagnosed with MetS: waist circumference >88cm, triglycerides ≥150mg/dL, HDL <50mg/dL, blood pressure ≥130/85mmHg and glucose ≥100mg/dL. Serum 25(OH)D levels were classified as sufficient (≥30ng/mL), insufficient (20-29ng/mL) or deficient (<20ng/mL). ANOVA, chi-square test and logistic regression (odds ratio, OR) were used for statistical analysis. RESULTS Serum 25(OH)D levels were sufficient in 148 women (32.0%), insufficient in 151 (32.6%) and deficient in 164 (35.4%). Women with low 25(OH)D levels had higher TC, triglycerides, insulin and HOMA-IR levels (p<0.05). MetS was detected in 57.8% (182/315) of women with hypovitaminosis D (insufficient and deficient) and in 39.8% (59/148) of those with sufficient VD (p=0.003). In a multivariate logistic regression analysis, a low 25(OH)D level (<30ng/mL) was significantly associated with MetS (OR1.90, 95%CI=1.26-2.85), high triglyceride levels (OR1.55, 95%CI=1.13-2.35), and low HDL levels (OR1.60, 95%CI=1.19-2.40) (p<0.05) compared with women with sufficient 25(OH)D levels, after adjusting for age, time since menopause, body mass index, smoking and physical exercise. The mean concentration of 25(OH)D decreased with increasing numbers of MetS components (p=0.016). CONCLUSIONS VD deficiency in postmenopausal women was associated with a higher prevalence of MetS. Women with VD deficiency had a higher risk of MetS, hypertriglyceridemia and low HDL than those with adequate levels.
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Affiliation(s)
- Eneida Boteon Schmitt
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - Jorge Nahas-Neto
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - Flavia Bueloni-Dias
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - Priscila Ferreira Poloni
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - Claudio Lera Orsatti
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - Eliana Aguiar Petri Nahas
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil.
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Pannu PK, Piers LS, Soares MJ, Zhao Y, Ansari Z. Vitamin D status is inversely associated with markers of risk for type 2 diabetes: A population based study in Victoria, Australia. PLoS One 2017; 12:e0178825. [PMID: 28575036 PMCID: PMC5456387 DOI: 10.1371/journal.pone.0178825] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 05/21/2017] [Indexed: 12/24/2022] Open
Abstract
A growing body of evidence suggests a protective role of vitamin D on the risk of type 2 diabetes mellitus (T2DM). We investigated this relationship in a population sample from one Australian state. The data of 3,393 Australian adults aged 18-75 years who participated in the 2009-2010 Victorian Health Monitor survey was analyzed. Socio-demographic information, biomedical variables, and dietary intakes were collected and fasting blood samples were analyzed for 25, hydroxycholecalciferol (25OHD), HbA1c, fasting plasma glucose (FPG), and lipid profiles. Logistic regression analyses were used to evaluate the association between tertiles of serum 25OHD and categories of FPG (<5.6 mmol/L vs. 5.6-6.9 mmol/L), and HbA1c (<5.7% vs. 5.7-6.4%). After adjusting for social, dietary, biomedical and metabolic syndrome (MetS) components (waist circumference, HDL cholesterol, triglycerides, and blood pressure), every 10 nmol/L increment in serum 25OHD significantly reduced the adjusted odds ratio (AOR) of a higher FPG [AOR 0.91, (0.86, 0.97); p = 0.002] and a higher HbA1c [AOR 0.94, (0.90, 0.98); p = 0.009]. Analysis by tertiles of 25OHD indicated that after adjustment for socio-demographic and dietary variables, those with high 25OHD (65-204 nmol/L) had reduced odds of a higher FPG [AOR 0.60, (0.43, 0.83); p = 0.008] as well as higher HbA1c [AOR 0.67, (0.53, 0.85); p = 0.005] compared to the lowest 25OHD (10-44 nmol/L) tertile. On final adjustment for other components of MetS, those in the highest tertile of 25OHD had significantly reduced odds of higher FPG [AOR 0.61, (0.44, 0.84); p = 0.011] and of higher HbA1c [AOR 0.74, (0.58, 0.93); p = 0.041] vs. low 25OHD tertile. Overall, the data support a direct, protective effect of higher 25OHD on FPG and HbA1c; two criteria for assessment of risk of T2DM.
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Affiliation(s)
- Poonam K. Pannu
- Food, Nutrition & Health, School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Leonard S. Piers
- Health Intelligence Unit, System Intelligence and Analytics Branch, Health Strategy, Productivity and Analytics Division, Department of Health, Melbourne, Victoria, Australia
| | - Mario J. Soares
- Food, Nutrition & Health, School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Yun Zhao
- Occupation and the Environment, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Zahid Ansari
- Health Intelligence Unit, System Intelligence and Analytics Branch, Health Strategy, Productivity and Analytics Division, Department of Health, Melbourne, Victoria, Australia
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Alkhatatbeh MJ, Abdul-Razzak KK, Khasawneh LQ, Saadeh NA. High Prevalence of Vitamin D Deficiency and Correlation of Serum Vitamin D with Cardiovascular Risk in Patients with Metabolic Syndrome. Metab Syndr Relat Disord 2017; 15:213-219. [DOI: 10.1089/met.2017.0003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Mohammad J. Alkhatatbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid K. Abdul-Razzak
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Lubna Q. Khasawneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Nesreen A. Saadeh
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Al-Dabhani K, Tsilidis KK, Murphy N, Ward HA, Elliott P, Riboli E, Gunter M, Tzoulaki I. Prevalence of vitamin D deficiency and association with metabolic syndrome in a Qatari population. Nutr Diabetes 2017; 7:e263. [PMID: 28394362 PMCID: PMC5436094 DOI: 10.1038/nutd.2017.14] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/26/2017] [Accepted: 02/13/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Despite long hours of sunlight in Qatar and other regions of the Middle East, vitamin D deficiency has been rising. In parallel, the prevalence of metabolic syndrome has also been increasing in Qatar. Vitamin D levels have been associated with metabolic syndrome but the data are inconsistent and no studies have addressed these inter-relationships in a Middle Eastern population where the prevalence of these conditions is high. The objective is to investigate the prevalence of vitamin D deficiency and its association with metabolic syndrome and its components in the Qatar Biobank population. METHODS A cross-sectional study of 1205 participants (702 women and 503 men) from the Qatar Biobank, comprising Qataris and non-Qataris between the ages of 18 and 80 years, was used to perform multivariate linear regression analyses to examine the association between metabolic syndrome and prevalence of vitamin D deficiency (defined as <20 ng ml-1 serum vitamin D levels) adjusting for age, sex, ethnicity, season of blood collection, physical activity and education. Odds ratios and 95% confidence intervals were calculated for all analyses. RESULTS Approximately 64% of participants were vitamin D deficient (<20 ng ml-1) with more men being deficient (68.6%) than women (61.3%). Serum vitamin D was 8% lower in individuals with metabolic syndrome (RR: 0.92, 95%CI: 0.87-0.98, P-value: 0.01) compared to individuals without metabolic syndrome. Waist circumference and HDL as well as high triglyceride levels were also significantly positively associated with vitamin D deficiency. No association was found between the other components of metabolic syndrome or diabetes and the presence of vitamin D deficiency. CONCLUSIONS Vitamin D deficiency is prevalent in this Qatari population. Presence of metabolic syndrome was associated with presence of vitamin D deficiency. Future prospective studies need to be conducted to investigate the potential for causality.
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Affiliation(s)
- K Al-Dabhani
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, London, UK
| | - K K Tsilidis
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - N Murphy
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, London, UK
- Nutritional Epidemiology Group, International Agency for Research on Cancer
| | - H A Ward
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, London, UK
| | - P Elliott
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - E Riboli
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, London, UK
| | - M Gunter
- Nutritional Epidemiology Group, International Agency for Research on Cancer
| | - I Tzoulaki
- Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
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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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36
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Yoon H, Jeong DK, Park CE, Oh HJ, Kim SG. The association between gender difference with metabolic syndrome, metabolic syndrome score and serum vitamin D levels in Korean adults. Int J Food Sci Nutr 2016; 68:121-129. [PMID: 27580963 DOI: 10.1080/09637486.2016.1221899] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study assessed the association between gender difference with metabolic syndrome (MetS), metabolic syndrome score (MSS) and serum vitamin D levels in Korean adults. Analyses were restricted to 5147 adults (2162 men; 2985 women) aged 20 and older, using the 2012 Korean National Health and Nutrition Examination Survey (KNHANES) data. In the non-adjusted model, serum 25-hydroxyvitamin D [25(OH)D] levels were inversely associated with MetS (p = .001) and MSS (p = .009) in men, but positively associated with MetS (p = .002) and MSS (p < .001) in women. However, when adjusted for related variables (including age), serum 25(OH)D levels were inversely associated with MetS (p < .001) and MSS (p < .001) in men, but were not associated with MetS (p = .200) and MSS (p = .541) in women. In conclusion, increases in MetS and its components were inversely associated with the serum vitamin D concentration in men.
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Affiliation(s)
- Hyun Yoon
- a Department of Biomedical Laboratory Science , Hanlyo University , Gwangyang-si , Jeollanam-do , South Korea
| | - Dae Keun Jeong
- b Department of Physical Therapy , Sehan University, Samho-eup , Youngam-gun , jeollanam-do , South Korea
| | - Chang Eun Park
- c Department of Biomedical Laboratory Science , Namseoul University , Cheonan-si , Chungcheongnam-do , South Korea
| | - Hye Jong Oh
- d Department of Biomedical Laboratory Science , Hanlyo University , Gwangyang-si , Jeollanam-do , South Korea
| | - Sung Gil Kim
- e Department of Radiological Science , Hanlyo University , Gwangyangsi , jeollanamdo , South Korea
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37
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Akter S, Eguchi M, Kurotani K, Kochi T, Kashino I, Ito R, Kuwahara K, Tsuruoka H, Kabe I, Mizoue T. Serum 25-hydroxyvitamin D and metabolic syndrome in a Japanese working population: The Furukawa Nutrition and Health Study. Nutrition 2016; 36:26-32. [PMID: 28336104 DOI: 10.1016/j.nut.2016.02.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/19/2016] [Accepted: 02/29/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Increasing evidence has suggested a protective role of vitamin D on metabolic syndrome (MetS). However, studies addressing this issue are limited in Asia and it remains unclear whether calcium could modify the association. We examined the association of serum 25-hydroxyvitamin D (25(OH)D) status with MetS, and the potential effect modification by calcium intake in a Japanese working population. METHODS Study subjects were 1790 workers, ages 18 to 69 y, who participated in a health survey at the time of periodic checkup. MetS was defined according to the joint interim statement. Serum 25(OH)D was measured by a protein binding assay. Multilevel logistic regression was used to estimate the odds ratio (OR) with adjustment for potential confounding variables. RESULTS An inverse trend was observed between 25(OH)D and MetS. Compared with those with a 25(OH)D of <20 ng/mL, multivariable adjusted OR (95% confidence interval) for MetS was 0.79 (0.55-1.15) and 0.52 (0.25-1.04) for those with a 25(OH)D of 20 to 29 ng/mL and ≥30 ng/mL, respectively (P for trend = 0.051). Similar association was observed in the analysis using quartile categories of 25(OH)D; the OR in the highest quartile of 25(OH)D compared with the lowest quartile was 0.61 (0.36-1.01) (P for trend = 0.046). This association was noted only in older subjects (≥44 y). The inverse association between serum 25(OH)D and MetS was more pronounced in subjects with high calcium intake. The inverse association between 25(OH)D and MetS appears to be linear according to restricted cubic spline regression. There was inverse, but statistically nonsignificant, associations between 25(OH)D and each component of MetS. CONCLUSION Our results suggest that higher circulating vitamin D is associated with decreased likelihood of having MetS among Japanese adults.
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Affiliation(s)
- Shamima Akter
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Masafumi Eguchi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Kayo Kurotani
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Ikuko Kashino
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Rie Ito
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Hiroko Tsuruoka
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Isamu Kabe
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Mitra S, Nayak PK, Agrawal S, Sahoo JP, Kamalanathan S, Nanda R. Vitamin D Status and Cardio-Metabolic Risk in Indian Postmenopausal Women. J Clin Diagn Res 2016; 10:QC17-20. [PMID: 27134948 DOI: 10.7860/jcdr/2016/17839.7438] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 01/14/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The prevalence of chronic and non-communicable health disorders like cardiovascular diseases and metabolic syndrome is increasing worldwide including in India. The various risk factors for these health issues need to be addressed. The role of vitamin D deficiency in the causation of all these abnormal health conditions among postmenopausal women is a matter of debate now-a-days. AIM To determine the correlation of serum vitamin D levels with various cardio-metabolic risk factors and metabolic syndrome (MetS) in postmenopausal women (PMW). MATERIALS AND METHODS Total of 64 PMW were included in this cross-sectional study. Clinical (waist circumference, body mass index, blood pressure) and biochemical (fasting plasma glucose, lipid profile and serum 25-hydroxyl vitamin D levels) parameters were measured. MetS was defined using modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) guidelines. Serum 25-hydroxyl vitamin D levels <50 nmol/l, between 52.5-72.5 nmol/l and >75 nmol/l were classified as deficient, insufficient and sufficient, respectively. RESULTS MetS was prevalent in 33 (52%) subjects. There were no differences in serum vitamin D levels or proportion of vitamin D deficient individuals in those with and without MetS. 33 women (52%) had vitamin D deficiency. Cardio-metabolic risk profile was similar in both vitamin D deficient and replete women. CONCLUSION Despite a high prevalence of vitamin D deficiency and MetS in Indian PMW, serum vitamin D concentrations do not correlate with the cardio-metabolic risk factors or MetS.
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Affiliation(s)
- Subarna Mitra
- Senior Resident, Department of Obstetrics & Gynecology, All India Institute of Medical Sciences , Raipur, India
| | - Prasanta Kumar Nayak
- Assistant Professor, Department of Obstetrics & Gynecology, All India Institute of Medical Sciences , Raipur, India
| | - Sarita Agrawal
- Professor, Department of Obstetrics & Gynecology, All India Institute of Medical Sciences , Raipur, India
| | - Jaya Prakash Sahoo
- Assistant Professor, Department of Endocrinology & Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India
| | - Sadishkumar Kamalanathan
- Associate Professor, Department of Endocrinology & Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India
| | - Rachita Nanda
- Associate Professor, Department of Biochemistry, All India Institute of Medical Sciences , Raipur, India
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Stefanska A, Bergmann K, Sypniewska G. Metabolic Syndrome and Menopause: Pathophysiology, Clinical and Diagnostic Significance. Adv Clin Chem 2015; 72:1-75. [PMID: 26471080 DOI: 10.1016/bs.acc.2015.07.001] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Menopause is a risk factor for cardiometabolic diseases, including metabolic syndrome (MetS), type 2 diabetes, and cardiovascular diseases. MetS is a constellation of interdependent factors such as insulin resistance, abdominal obesity, dyslipidemia, and hypertension. The prevalence of MetS in postmenopause is due to loss of the protective role of estrogens and increased circulating androgens resulting in changes to body fat distribution and development of abdominal obesity. Excessive visceral adipose tissue plays an important role due to synthesis and secretion of bioactive substances such as adipocytokines, proinflammatory cytokines, reactive oxygen species, prothrombotic, and vasoconstrictor factors. MetS may also impact risk assessment of breast cancer, osteoporosis and chronic kidney disease, and quality of life during the menopausal transition. Increased MetS has stimulated the exploration of new laboratory tests for early detection and therapies.
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Affiliation(s)
- Anna Stefanska
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - Katarzyna Bergmann
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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40
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Yoon H, Kim GS, Kim SG, Moon AE. The relationship between metabolic syndrome and increase of metabolic syndrome score and serum vitamin D levels in Korean adults: 2012 Korean National Health and Nutrition Examination Survey. J Clin Biochem Nutr 2015; 57:82-7. [PMID: 26236105 PMCID: PMC4512900 DOI: 10.3164/jcbn.15-31] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 03/04/2015] [Indexed: 12/20/2022] Open
Abstract
The present study was conducted to assess the relationship between metabolic syndrome and metabolic syndrome score (MSS) and serum vitamin D levels in adults aged 20 or older (n = 5,483) using 2012 Korean National Health and Nutrition Examination Survey data, which represents national data in Korea. Key study results were as follows: First, serum 25-hydroxyvitamin D [25(OH)D] levels decreased significantly with an increase in MSS (p = 0.004), shown by serum 25(OH)D levels after adjusting the variables (age, gender, BMI, TC, HDL-C, FBS, SBP, and DBP, etc.). These were 17.30 ± 0.16 ng/ml for MSS 0, 17.13 ± 0.15 ng/ml for MSS 1, 17.02 ± 0.16 ng/ml for MSS 2, 16.60 ± 0.20 ng/ml for MSS 3, 16.55 ± 0.28 ng/ml for MSS 4, and 15.52 ± 0.50 ng/ml for MSS 5. Second, after adjusting the related variables, serum 25(OH)D levels were significantly lower (p = 0.004) in the metabolic syndrome group (16.49 ± 0.19 ng/ml) than the non-metabolic syndrome group (17.16 ± 0.09 ng/ml). In conclusion, metabolic syndrome and the increased levels of its components are inversely associated with the serum vitamin D concentration in Korean adults.
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Affiliation(s)
- Hyun Yoon
- Department of Biomedical Laboratory Science, Hanlyo University, 94-13, Hallyeodae-gil, Gwangyang-eup, Gwangyang-si, Jeollanam-do 545-704, Korea
| | - Gwang Seok Kim
- Emergency Medical Technology, Chungbuk Health and Science University, 10, Deogam-gil, Naesu-eup, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do 363-993, Korea
| | - Sung Gil Kim
- Department of Radiological Science, Hanlyo University, 94-13, Hallyeodae-gil, Gwangyang-eup, Gwangyang-si, Jeollanam-do 545-704, Korea
| | - Ae Eun Moon
- Department of Dental Hygiene, Honam University, 417, Eodeung-daero, Gwangsan-gu, Gwangju 506-714, Korea
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Yun BH, Choi YR, Choi YS, Cho S, Lee BS, Seo SK. Age at First Delivery and Osteoporosis Risk in Korean Postmenopausal Women: The 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). PLoS One 2015; 10:e0123665. [PMID: 25946162 PMCID: PMC4422688 DOI: 10.1371/journal.pone.0123665] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 03/06/2015] [Indexed: 11/22/2022] Open
Abstract
It has been reported in several studies that there may be a significant correlation between reproductive history and the risk of osteoporosis due to the effect of estrogen. Under this hypothesis, however, it is unclear whether the age at first delivery has any major influences on the risk of osteoporosis. Therefore, this study aimed to investigate the relationship between the age at first delivery and the risk of osteoporosis in Korean menopausal women. This study was performed using data from the 2008–2011 Korea National Health and Nutrition Examination Survey and included 2,530 Korean postmenopausal women. The diagnosis of osteoporosis was made using the World Health Organization T-score criteria (T-score ≤ -2.5, at the femoral neck or lumbar spine). Participants were categorized into 3 groups according to age at first delivery: ≤23, 24–29, and ≥30 years. Older age, lower body mass index, lower calcium intake, later menarche, and earlier menopause increased the risk of osteoporosis, whereas hormone therapy and oral contraceptive use were associated with a decreased risk of osteoporosis. Postmenopausal women whose first delivery occurred at age 24–29 years were shown to have a significantly increased risk of osteoporosis (odds ratio, 2.124; 95% confidence interval, 1.096–4.113; P = 0.026) compared to those who first gave birth after the age of 30 years. These findings suggest that postmenopausal women whose first delivery occurred in their mid to late 20s, a period during which bone mass slowly accumulates to the peak, are at an increased risk of osteoporosis.
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Affiliation(s)
- Bo Hyon Yun
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yun Rak Choi
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Sik Choi
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - SiHyun Cho
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byung Seok Lee
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seok Kyo Seo
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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Bea JW, Jurutka PW, Hibler EA, Lance P, Martínez ME, Roe DJ, Sardo Molmenti CL, Thompson PA, Jacobs ET. Concentrations of the vitamin D metabolite 1,25(OH)2D and odds of metabolic syndrome and its components. Metabolism 2015; 64:447-59. [PMID: 25496802 PMCID: PMC4312532 DOI: 10.1016/j.metabol.2014.11.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/25/2014] [Accepted: 11/26/2014] [Indexed: 12/19/2022]
Abstract
AIM Few epidemiological studies have investigated the association between circulating concentrations of the active vitamin D metabolite 1,25(OH)2D and metabolic syndrome. We sought to determine whether blood levels of 1,25(OH)2D are associated with metabolic syndrome and its individual components, including waist circumference, triglycerides, blood pressure, and glucose, and high-density lipoprotein. We also investigated these associations for the more abundant precursor vitamin D metabolite, 25(OH)D. METHODS Participants from two completed clinical trials of colorectal neoplasia with available metabolic syndrome data and blood samples for measurement of 1,25(OH)2D (n=1048) and 25(OH)D (n=2096) were included. Cross-sectional analyses of the association between concentrations of 1,25(OH)2D, 25(OH)D, metabolic syndrome, and its components were conducted. RESULTS A statistically significant inverse association was observed for circulating concentrations of 1,25(OH)2D and metabolic syndrome, with adjusted ORs (95% CIs) of 0.73 (0.52-1.04) and 0.52 (0.36-0.75) for the second and third tertiles of 1,25(OH)2D, respectively (p-trend <0.001). Significant inverse relationships were also observed between 1,25(OH)2D and high triglycerides (p-trend <0.001), and low high-density lipoprotein (p-trend <0.001). For 25(OH)D concentrations, significant inverse associations were found for metabolic syndrome (p-trend <0.01), high waist circumference (p-trend <0.04) and triglyceride levels (p-trend <0.01). Participants with 25(OH)D ≥30 ng/ml and in the highest tertile of 1,25(OH)2D demonstrated significantly lower odds of metabolic syndrome, with an OR (95% CI) of 0.38 (0.19-0.75) compared to those in the lowest category for both metabolites. CONCLUSION These results provide new evidence that the relatively rarely-studied active hormonal form of vitamin D, 1,25(OH)2D, is associated with metabolic syndrome and its components, and confirm prior findings for 25(OH)D. The finding that 1,25(OH)2D is related to high-density lipoprotein, while 25(OH)D is not, suggests that there may be an independent mechanism of action for 1,25(OH)2D in relation to metabolic dysregulation.
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Affiliation(s)
- Jennifer W Bea
- University of Arizona Cancer Center, 1515N. Campbell Avenue, Tucson, AZ 85724-5024, USA
| | - Peter W Jurutka
- School of Mathematical and Natural Sciences, Arizona State University, 4701W. Thunderbird Rd, Phoenix, AZ 85306, USA
| | - Elizabeth A Hibler
- Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 2220 Pierce Ave, Nashville, TN 37232, USA; Mel and Enid Zuckerman College of Public Health, 1295N. Martin Ave., Tucson, AZ, 85724, USA
| | - Peter Lance
- University of Arizona Cancer Center, 1515N. Campbell Avenue, Tucson, AZ 85724-5024, USA
| | - Maria E Martínez
- UCSD Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA 92093, USA
| | - Denise J Roe
- University of Arizona Cancer Center, 1515N. Campbell Avenue, Tucson, AZ 85724-5024, USA; Mel and Enid Zuckerman College of Public Health, 1295N. Martin Ave., Tucson, AZ, 85724, USA
| | | | - Patricia A Thompson
- University of Arizona Cancer Center, 1515N. Campbell Avenue, Tucson, AZ 85724-5024, USA
| | - Elizabeth T Jacobs
- University of Arizona Cancer Center, 1515N. Campbell Avenue, Tucson, AZ 85724-5024, USA; Mel and Enid Zuckerman College of Public Health, 1295N. Martin Ave., Tucson, AZ, 85724, USA.
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